As a result of the cessation of the separation proceedings, initiated by _______________, and as a result of the withdrawal of application for alimony and reimbursement of attorney fees, the spouse of the above-stated individual agrees to state him/her as the sole owner of the property described as _____________________.

The spouse agrees to have no claims to this property, in accordance with the above-stated agreement.

Date:

________________________________

Signature of Wife

________________________________

Signature of Husband

_______________________________

Signature of Witness