Addendum Re Compliance PDF Details

In legal proceedings, particularly those involving settlements and agreements in the context of domestic relations, the Addendum Re Compliance with Domestic Relations Law 255(2) plays a crucial role. This form acts as an official acknowledgment by both parties that, following a settlement or agreement, each individual will be responsible for their own health insurance coverage, marking a significant shift from any prior arrangements wherein one party might have been covered under the other's plan. It vividly outlines the prospects for individuals to secure health insurance independently, possibly through COBRA if applicable, ensuring clarity and responsibility post-agreement. This addendum also includes mandatory signatures from both parties, underscoring consent and understanding regarding the stipulated conditions. Notarization by a Notary Public reinforces the document's legality and the serious acknowledgement by each party of their obligations and entitlements concerning health insurance post-settlement. Detailing the procedure and necessity of such an addendum, its implication stretches beyond mere formalities, embedding into the fabric of legal compliance and personal accountability in the aftermath of domestic legal agreements.

QuestionAnswer
Form NameAddendum Re Compliance
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namesstipulation, addendum to stipulation of settlement agreement re compliance with domestic relations law 255 2, divorce, COMPLIANCE

Form Preview Example

ADDENDUM TO STIPULATION OF SETTLEMENT/AGREEMENT RE: COMPLIANCE WITH DOMESTIC RELATIONS LAW 255(2)

___________________________ VS ___________________________ INDEX #:_________

Each party is aware that he or she will no longer be covered by the other party’s health insurance plan and that each party shall be responsible for his or her own health insurance coverage, and may be entitled to purchase health insurance on his or her own through a COBRA option, if available.

Dated:

, 20_____

___________________________________

 

 

Plaintiff’s Signature

 

 

___________________________________

 

 

Print Name

SS:STATE OF __________________, COUNTY OF _______________

On this ______ day of ____________ 20____ , before me; the undersigned,

personally appeared ___________________, personally known to me or proved to me on the basis

of satisfactory evidence to be the individual whose name is subscribed to the within instrument and acknowledged to me that he/she executed the same in his/her capacity, and that by his/her signature on the instrument, the individual, or the person upon behalf of which the individual acted, executed the instrument.

________________________

NOTARY PUBLIC

 

 

Dated:

, 20_____

____________________________________

 

 

Defendant’s Signature

 

 

____________________________________

 

 

Print Name

SS:STATE OF __________________, COUNTY OF _______________

On this ______ day of ____________ 20____ , before me; the undersigned,

personally appeared ___________________, personally known to me or proved to me on the basis

of satisfactory evidence to be the individual whose name is subscribed to the within instrument and acknowledged to me that he/she executed the same in his/her capacity, and that by his/her signature on the instrument, the individual, or the person upon behalf of which the individual acted, executed the instrument.

________________________

NOTARY PUBLIC

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