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State of
Date:
PARENTS & CHILDREN
Parent A: ________________, residing at ________________________, ____ _____
Parent B: ________________
________, ____ _____
This plan covers the following minor child(ren):
LEGAL CUSTODY (DECISION-MAKING)
Legal custody is ________________PHYSICAL CUSTODY & RESIDENTIAL SCHEDULE
The child(ren) will live with the parents on the following schedule:HOLIDAYS, SUMMER & SPECIAL DAYS
Holidays follow this rotation: ________________ for [holidays]. This schedule overrides the regular schedule above.TRAVEL & RELOCATION
Travel: [travel rules]“A parent who intends to relocate with the child will provide [notice period], consistent with [state] law.”
COMMUNICATION & RECORDS
DISPUTE RESOLUTION & MODIFICATION
This plan may be modified by written agreement of both parents or by court order upon a substantial change in circumstances.
CHILD SUPPORT & TAXES
Child support cannot be waived and is set by [state]'s guidelines.
BEST-INTERESTS STATEMENT & SIGNATURES
The parents agree this plan is in the best interests of the child(ren) and submit it to the court for approval and entry as an order._______________________
[Parent A] Date
[Parent A] Date
_______________________
[Parent B] Date
[Parent B] Date
Approved and ordered: ___________________ Judge ___________________
Frequently Asked Questions
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