Separation Agreement Questionnaire is one that provides the terms and conditions which govern the separation of a couple. This is a legal document that discusses all the terms and conditions agreed by both the parties. This questionnaire helps to identify the opinion of the couple regarding the separation agreement and also obtain valuable inputs to modify the same for the mutual benefit of the couples. Check the given below sample of Separation Agreement Questionnaire in order to understand the format of this questionnaire in a better manner.
Sample Separation Agreement Questionnaire
Name of the Husband __________________________________
Name of the Wife __________________________________
Complete Address __________________________________
Number of Children __________________________________
Social Security Number __________________________________
Date of Marriage __________________________________
Place of Marriage __________________________________
Reason for Separation __________________________________
Q1) What was your experience with this marriage?
Q2) What is the primary reason behind the decision of separation?
Q3) Are you satisfied with the terms and conditions which are mentioned in the separation agreement?
a. Yes very much satisfied
c. Not much
d. No not at all satisfied
Q4) Are you happy on the compensation you would be receiving for managing the custody of your children?
Q5) Are you willing to let your children meet your ex-spouse on some special occasions, or on the dates decided by this separation agreement?
Q6) Please provide a rating for the terms and conditions mentioned in the agreement?
Q7) Will you be ready to make any future modifications in the child support system?
Q8) Who manages and maintains the health insurance for the children and what is the monthly installment for that insurance?
Q9) Should there be an escalator clause regarding the support amount increase added to this agreement?
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