What You Need Before Starting
Before you fill out the addendum, gather these items:
- The finalized divorce settlement or stipulation of settlement document
- Both parties' full legal names as they appear on the settlement
- The date the settlement was signed
- Contact information for a Notary Public
- Current health insurance details for both parties
If you are also completing related documents, review the health insurance application form to understand your coverage options after the divorce.
Steps to Fill Out the Form Online
Our PDF editor lets you complete this document quickly from any device. Follow the steps below.
Step 1: Click the orange "Get Form Now" button at the top of this page to open the PDF editor.
Step 2: Use the editing toolbar to add text, highlight sections, and make corrections as needed. This multifunctional toolbar gives you full control over every field in the document.
In order to fill out the document, enter the content the system will ask you for in each of the following areas:
Complete the NOTARY PUBLIC section, including your printed name, signature, state, county, and date. Both parties must sign in the presence of a Notary Public for the document to be legally valid.
Step 3: Click "Done" to save your completed form. Download a copy to your device or send it by email directly from the editor.
Step 4: Print two copies - one for each party - and have both copies notarized. File the document with your divorce proceedings as required by your attorney or the court.
Common Questions About This Form
Do both parties have to sign this addendum?
Yes. Both spouses must sign the Addendum Re Compliance in front of a Notary Public. A signature from only one party is not sufficient to satisfy DRL 255(2) requirements.
What happens if health insurance is not mentioned in the settlement?
DRL 255(2) still requires both parties to acknowledge their responsibility even when the main agreement does not specifically mention health insurance. Courts can require this addendum as part of the finalization process.
Can I use this form outside New York?
This form is designed specifically for New York Domestic Relations Law 255(2) compliance. Other states have similar requirements, but the exact form and wording may differ. Check with an attorney if you are outside New York.
For other compliance-related legal documents, see our notice of noncompliance form and related legal templates.
