5.4 Separation Agreement Worksheet



Fill out the questionnaire to the best of your abilities before sitting down to negotiate with your former spouse. When answering, consider the other party’s position and what would realistically work for your situation. Use this worksheet while negotiating an agreement.


  • Basic Information
    1. Date of marraige or cohabitation? 

    2. Date of separation?

    3. Children? (names and dates of birth)

    4. Issues to be discussed? (check all that apply)


  • Children
    1. Shared guardianship or sole guardianship? 

    2. Who has day to day care, control and supervision of children? 

    3. Where will the children live? 

    4. Who will make decisions about the child's...

    5. What will the scheduled time with parents look like? (try to be specific with dates and times)

    6. Where will the children spend holidays and school breaks? 

    7. How are children to be picked up and dropped off? 

    8. Who will pay what amount for child support? (use the Child Support Guidelines)

    9. How will extraordinary expenses be paid for? 

    10. When will payments occur? (e.g. first of each month)

    11. When will the payments start? (give a date)

    12. How will the payments be made? (e.g. cheque, direct deposit)

    13. How will medical expenses be covered? (e.g. under benefits)

    14. Any outstanding child support payments still owing? 

    15. Agree to share financial information? (e.g. annually exchange tax returns, assessments) 

    16. Other issues regarding children that should be discussed? 


  • Spousal Support
    1. Who pays what amount? 

    2. When will the first payment be made? 

    3. When will payments occur? (e.g. first of each month)

    4. How will the payments be made? (e.g. cheque, direct deposit) 

    5. When will the last payment be made? 

    6. Will you meet to review and revise support payments? 

      a. How often? 
    7. Other issues regarding spousal support that should be discussed? 


  • Property and Debt Division
    1. Details about family home? 

    2. How will the family home be dealt with? (e.g. put up for sale, stays with one of the parties)

    3. Who will pay for home upkeep expenses?

    4. List all other family property. How are they each to be divided? 

    5. Other issues regarding property division that should be discussed? 

    6. Details about family debt? 

      a. Who will be responsible for which debt?
      b. Other issues regarding debt division that should be discussed? 


5.4 Separation Agreement Worksheet