MSA Worksheet

Marital Settlement Agreement (MSA)
MSA Worksheet
CASE INFORMATION:
Name

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Type of Case
Date of Marriage

MonthDayYear
Date
Date of Separation

MonthDayYear
Date
Section 1:
COMMUNITY PROPERTY ASSETS
Under Family Code Sections 2104-2107
A Community Property Asset is anything you owned at date of separation, or now own, that was purchased with money earned during the marriage by either party; IT REMAINS COMMUNITY PROPERTY UNTIL IT IS DIVIDED IN YOUR MSA.

Indicate who is being awarded each asset, or how the interest in each asset is being divided, in the column at right
If, according to the above definition, you DO NOT have ANY community property assets,
1.1 REAL ESTATE:

Real Estate Information

Rows	Address	Amount Owed	Division
1
2
3
4
5

If division of asset above was other, provide details:
1.2 FURNITURE, HOUSEHOLD GOODS & PERSONAL BELONGINGS:

(Only items of special value need to be listed separately. If that is necessary, please attach a separate sheet with details
Check If Applicable
Exceptions/Notes
1.3 JEWELRY, ANTIQUES, ART, COLLECTIONS:
Jewelry
Antiques
Art
Collectables/Collections
Describe who gets what and details of any buyout agreement if applicable
1.4 CASH ACCOUNTS:

Checking, Savings, Money Market, CD's, Etc)

Rows	Type	Bank Name	Last 4 Account #	Division
1
2
3
4
5

If "Other" selected in Division above, please provide details here:
1.5 VEHICLES (including boats, trailers, mobile homes, recreational vehicles:

Rows	Year	Make/Model	Division
1
2
3
4
5
6

If Division is Other above please add comments here:

1.6 LIFE INSURANCE w/CASH SURRENDER

Rows	Life Insurance Company	Policy #	Cash Value	Who Gets Asset?
Policy 1
Policy 2
Policy 3
Policy 4

Additional Comments

1.7 SECURITIES: (publicly traded stocks or bonds, secured notes, mutual funds, limited partnerships)

Rows	Type	Institution/Broker	Account #	Division
1
2
3
4
5

Retirement Plan Information

1.7 Retirement/Pension:

Rows	Name of Plan	Type	Division
1
2
3
4
5

If division above is split, provide details here:
1.14 BUSINESS, Partnership, professional practice, shares in closely held corporation
Describe (has it been valued by professional, how will it be divided?
If you have a valuation, please attach a copy.

1.15 INTELLECTUAL PROPERTY, trademark, copyright, or patent
Describe (value, name of holder, trademark, copyright, how will it be divided?
1.16 (Money Owed to You) - Name of borrower and amount
1.17 OTHER ASSETS
Section 2:
COMMUNITY PROPERTY DEBTS
List Community Property Debt that was incurred during the marriage by either party that is not attached to an asset in section 1 above
If, according to the above definition, you DO NOT have ANY community property debts,
2.1 List Personal Loans, Credit Cards, Tax Bills (name of creditor, last 4 of account/loan #, & distribution
Section 3:
SEPARATE PROPERTY: ASSETS AND DEBTS
List Separate Assets owned by either spouse before marriage, acquired with earnings after separation, given by gift to one of the spouses, or received any time by inheritance. List Separate Debts that were incurred by either spouse before marriage or after separation. List below the assets or debts of either spouse that meet this definition.
There Are No Separate Property Assets or Debts
3.1 PETITIONER’S SEPARATE PROPERTY AND SEPARATE DEBTS:
Description of Asset or Debt, including address of property or other description, and account numbers.
Date Acquired
If acquired between dates of marriage and separation, indicate why it is separate property
3.2 RESPONDENT’S SEPARATE PROPERTY AND SEPARATE DEBTS:
Description of Asset or Debt, including address of property or other description, and account numbers.
Date Acquired
If acquired between dates of marriage and separation, indicate why it is separate property
Section 4: Equalization of Division of Community Property
4.1 CASH EQUALIZATION PAYMENT
Choose One
Amount of cash equalization payment
To be made on or before (date)

MonthDayYear
Date
To be made on or before (date)

MonthDayYear
Date
or as follows
Section 5: Sale of a Real Property to a Third Party or Continued Co-Ownership of a Real Property
Address of Property to be sold or co-owned
To be sold to a third party: Date or occasion on which it will be (or was) listed for sale

MonthDayYear
Date
Occupation of Property until sold?
Other agreement regarding this property
Until the property is sold, we will hold title as: Joint Tenants Tenants In Common
How will title be held:

Other
Who will make the required payments until sold or while co-owned?

Other
Who will responsible for ordinary maintenance until sold or while co-owned?

Other
Who will responsible for capital improvements until sold or while co-owned?

Other
DISTRIBUTION OF PROCEEDS FROM SALE:
A) BEFORE the division of proceeds between the spouses, the following debt(s), other than mortgage and selling costs will be paid:
B) BEFORE the division of proceeds between the spouses,
Petitioner
B) BEFORE the division of proceeds between the spouses, this person will be reimbursed
Amount to be reimbursed:
C) AFTER payment of the mortgage(s), selling costs, and “A” and/or “B” above (if applicable), the remaining net proceeds will be divided as follows:
Responsibility for capital gains/tax liabilities from sale of this asset
Responsibility for losses incurred from sale of this asset:
Section 6: TAXES
Current Year
If Still Married on Dec 31 of this year.
Tax Obligations or Refunds

Other
Previous Year
Filing Status
Tax Obligations or Refunds

Other
Section 8: CHILDREN
CUSTODY AND PARENTING OF MINOR CHILDREN

8.1 Give the following information for all minor children born to this marriage or adopted:

Rows	Name	Social Security Number	Birth date	Gender

If a child is near 18 years old, when will he or she graduate from high school?
Primary Residence of minor children shall be with

Other
Custody
%; with other party if joint physical cusody
If sole cusody, describe visitation schedule
Other requirements concerning visitation, vacations, travel out of state, move away notices, etc.
Section 9:
CHILD SUPPORT
Child Support Payable
Date of first payment

MonthDayYear
Date
Type a question
Section 10: Health Insurance & Health Costs for Minor Children, Child Care, Child Dependency Exemptions
HEALTH INSURANCE, HEALTH COSTS:
Health Insurance for the minor child(ren) to be provided by

Other
Health costs for the child(ren) not covered by insurance will be paid as follows
Section 11: CHILD CARE
Child care costs as follows

Other
CHILD DEPENDENCY TAX EXEMPTION FOR DEPENDENT CHILDREN:

Other
Section 12: SPOUSAL SUPPORT
Payable To (Select All That Apply):
Date of first payment

MonthDayYear
Date
Payable on

Other
Will it be modifiable in the future?
14.1.a Ending Date of Monthly Support:
Spousal support will end upon the remarriage of the recipient, the death of either party, or further order
Termination of support
Date of Last Payment

MonthDayYear
Date
Should be Empty:

Marital Settlement Agreement (MSA)

MSA Worksheet

CASE INFORMATION:

Section 1:

COMMUNITY PROPERTY ASSETS

Under Family Code Sections 2104-2107

Retirement Plan Information

Section 2:

COMMUNITY PROPERTY DEBTS

Section 3:

SEPARATE PROPERTY: ASSETS AND DEBTS

Section 4: Equalization of Division of Community Property

Section 5: Sale of a Real Property to a Third Party or Continued Co-Ownership of a Real Property

DISTRIBUTION OF PROCEEDS FROM SALE:

Section 6: TAXES

Current Year

Previous Year

Section 8: CHILDREN

CUSTODY AND PARENTING OF MINOR CHILDREN

Section 9:

CHILD SUPPORT

Section 10: Health Insurance & Health Costs for Minor Children, Child Care, Child Dependency Exemptions

HEALTH INSURANCE, HEALTH COSTS:

Section 11: CHILD CARE

Section 12: SPOUSAL SUPPORT