DRL 255 Addendum
New York Supreme Court · Family Law
Copy of the court's form from nycourts.gov, taken October 21, 2026. See it on the court's site ↗
Addendum to a divorce stipulation of settlement confirming under Domestic Relations Law §255(2) that each spouse knows coverage under the other's health insurance will end and that each is responsible for their own coverage.
This form must be printed and filled by hand, or opened in Adobe Acrobat.