As a result of the termination of the separation proceedings between husband and wife, such cessation being initiated by __________________________________, and as a result of the withdrawal of application for alimony and reimbursement of attorney fees, the spouse of the above-named individual agrees to declare __________ (him/her) as the sole owner of the property described as __________________________________. The spouse of the above-named individual agrees to have no claims to this property.

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(Signature of Wife) (Date)

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(Signature of Husband) (Date)

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(Signature of Witness) (Date)