
SUGGESTED PARENTING PLAN FOR PARENTS WITH MINOR CHILDREN
This
suggested parenting plan will be used to assist the Court or
your lawyers in the preparation of your Marital Settlement
Agreement and/or Final Judgment in your case. The Marital
Settlement Agreement and/or Final Judgment entered by the Court
after trial will include some form of written Parenting Plan
addressing all of the issues which are relevant to your minor
children and the facts of your case.
The Marital
Settlement Agreement and/or Final Judgment must contain
provisions for the allocation of parental responsibilities
including decision-making and parenting time. This suggested
Parenting Plan will be used to establish the final Parenting
Plan in your case. This Parenting Plan Form does not
include every possible issue that may be relevant to the facts
of your case. A section entitled "Other Terms" is available for
you to identify unique issues that you may have in your case.
If you need more space than is provided, attach additional
pages to the form. Please be sure to sign any additional pages
which are added to identify these unique issues.
In order to prepare an agreement or Final Judgment for the
parties where children are involved, it is the position of our
office that both parties should be jointly involved in creating
a written Parenting Plan whenever possible. If you are unable
to prepare a joint written Parenting Plan to which both the
Mother an Father agrees, you should use this checklist to
prepare your own written Parenting Plan which you believe
represents the best interest of your child(ren). Without an
agreement between the parties, the Court must enter its
own plan which may be a recommended plan presented by one of the
parties or may be entirely different. Whether the Court
approves your plan or enters its own, the Parenting Plan will
become a Court Order. Therefore, it is the position of our
office that your participation in and preparation of this
Checklist will at least allow you the opportunity to address and
present your position on all the issues affecting the needs of
your child(ren).
This is a:
q
Full Joint Parenting Plan
(we agree to everything and the plan is signed by both parties.)
q
Partial Joint Parenting Plan
(we agree to some things and the plan is signed by both
parties.)
q
Parenting Plan prepared by one party
(no agreement).
If this is a partial joint Parenting Plan or a Parenting Plan
prepared by one party, please identify in the section identified
below the issues that you and your spouse have not agreed on.
A final hearing may be necessary to address those issues.
The
Petitioner is the child(ren)’s:
qFather
qMother
qOther
Party
(state
relationship to child(ren)
_____________________________________
The
Co-Petitioner/Respondent is the child(ren)’s:
qFather
qMother
qOther
Party (state
relationship to child(ren)_____________________________________
The child(ren) are:
|
Full Name of Child |
Present Address |
Sex |
Date of Birth |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Section A: Allocation of Parental Responsibilities
(Decision-making)
1.
The parties understand that day-to-day decisions such as minor
training or correction, minor medical and dental care, curfew,
chores, allowance, clothing, hygiene, etc. will be made by the
party who has the child(ren) at the time such decisions are
necessary.
2.
Each party will inform the other party of any changes with their
address and/or phone numbers in advance.
3.
Both parties will provide the names, addresses, and telephone
numbers of all medical, dental, and mental health care
providers. Either party may authorize emergency care, but if
possible both parties agree to contact the other party first.
4.
Unless
otherwise ordered by the Court for good cause shown, state law
provides that both parties have access to the records of the
child(ren) including school, medical, dental, and mental health
records, pursuant to Florida law.
5.
For purposes
of school attendance only, the child(ren)’s residence will be
with the:
qMother
qFather
qOther
Party
|
Type of Major Decision-Making
|
Joint |
Father |
Mother |
Other Party |
|
Educational, if needed specify: |
q |
q |
q |
q |
|
Medical/Dental/Mental Health, if needed specify: |
q |
q |
q |
q |
|
Religious, if needed specify: |
q |
q |
q |
q |
|
Extracurricular and Recreational Activities, if needed
specify:
|
q |
q |
q |
q |
|
Other (please identify):
|
q |
q |
q |
q |
|
Other (please identify):
|
q |
q |
q |
q |
|
Other (please identify):
|
q |
q |
q |
q |
|
Other (please identify):
|
q |
q |
q |
q |
Section B: Allocation of Parental Responsibilities
(Parenting Time)
Parties are encouraged to create a Parenting Plan that meets
the needs of the child(ren) and individual needs of their
family. If you have any unique issues, please identify them
under “other” or provide an attachment to this Parenting
Plan Checklist. If a party fails to comply with a provision
of this plan, child support is not affected.
1.
Weekday and Weekend Schedule during the School Year
(You may attach a calendar or other document to identify your
schedule.)
The child(ren) will be in the care of the Father. List the days
of the week and times.
____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
The child(ren) will be in the care of the Mother List the days
of the week and times.
____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
The child(ren) will be in the care of another party, specify
who____________________. List the days of the week and times.
______________________________________________________________________________________________________________________________________________________________________________
Transportation and drop-off/pick-up arrangements will be as
follows:
_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
2.
Summer Schedule
or
q
During the summer months, the
child(ren)
will be in the care of the Father. List the days of the weeks
and times.
____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
q
During the summer months, the
child(ren)
will be in the care of the Mother. List the days of the weeks
and times.
____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
The child(ren) will be in the care of another party, specify
who____________________. List the days of the week and times.
______________________________________________________________________________________________________________________________________________________________________________
Transportation and drop-off/pick-up arrangements will be as
follows:
_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
3.
Holidays and Special Occasions
The following schedule will take priority over the
schedules in Sections 1 and 2. Please check all that
apply and indicate the time and place of exchange, which party
the child(ren) will spend time with, and the schedule, i.e.
even/odd/all years, alternating events, etc. Identify any
unique situations under “Other”. If a box is not checked, the
regular parenting time schedule will apply to that holiday
event.
Event
|
Name of party spending time with child(ren) |
Odd years |
Even years |
All Years |
Time & Place of exchange |
|
q
Spring Break |
|
|
|
|
|
|
q
Easter |
|
|
|
|
|
|
q
Mother’s Day/Weekend |
|
|
|
|
|
|
q
Memorial Day/Weekend |
|
|
|
|
|
|
q
Father’s Day/Weekend |
|
|
|
|
|
|
q
July 4th |
|
|
|
|
|
|
q
Labor Day/Weekend |
|
|
|
|
|
|
q
Halloween |
|
|
|
|
|
|
q
Thanksgiving Day/Break |
|
|
|
|
|
|
q
Christmas Eve |
|
|
|
|
|
|
q
Christmas Day |
|
|
|
|
|
|
q
Week 1 of Winter Break |
|
|
|
|
|
|
q
Week 2 of Winter Break |
|
|
|
|
|
|
q
Children’s Birthdays |
|
|
|
|
|
|
q
Other (Identify)
|
|
|
|
|
|
|
q
Other (Identify)
|
|
|
|
|
|
|
q
Other (Identify)
|
|
|
|
|
|
q
Other parenting time arrangements:
_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
4.
Number of Overnights:
Based upon the foregoing schedule(s), Mother will have ____
total overnights per year and Father will have ______ total
overnights per year. Note: These two numbers must equal 365.
5.
Telephone Access
q
Each parent
may have reasonable telephone contact with the child(ren) during
the child(ren)’s normal waking hours.
q
Other:
_________________________________________________________________________________
6.
Travel and Vacation Plans
q
The parties agree that should either of them require
out-of-state or any type of overnight travel with the child(ren),
each party will inform the other party of such travel and
vacation plans, including notice and contact information.
q
Other:
_________________________________________________________________________________
_______________________________________________________________________________________
______________________________________________________________________________________________________________________________________________________________________________
_______________________________________________________________________________________
Relocation
Relocation refers to moving the child(ren)’s residence so that
the geographic ties between the child(ren) and the other parent
are substantially changed requiring a modification of allocation
of parental responsibilities (decision-making and parenting
time).
The parties understand that after the Decree or Final Order is
issued, if a party wants to relocate, he/she must file a Motion
with the Court, pursuant to Florida law and obtain court
permission to relocate, unless the parties have submitted
to the Court a written agreement/stipulation (with verified
signatures of all parties) allowing one of the parties to
relocate with the minor child(ren) together with a new proposed
parenting plan which addresses how the parties intent to address
all the parenting issues given the fact that one of the parties
is now relocating with the minor child(ren).
q
Neither the Father or Mother have current plans to relocate with
the child(ren).
The
qFather
qMother
qOther
Party is planning to relocate with the child(ren) to
____________________(city) ________________ (state) on
______________________ (date) and we have agreed to the
following terms:
______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Section D:Financial Obligations for the Benefit of the Child(ren)
1.
Child Support
(all
child support agreements must be reviewed by the Court to
see if the agreement complies with the child support
guidelines):
a.
Child Support Calculation
q
Child Support shall be paid per a previously issued
Administrative or Court Order in _____________________ (DOR
number or case number) issued on ________________ (date) in
___________________ (County).
or
q
The amount of child support agreed to by the parties is based
upon the attached Child Support Worksheet which reflects an
amount of child support of $___________ per month.
or
q
The amount of child support agreed to by the parties is not
based upon the attached Child Support Worksheet which
reflects an amount of child support of $__________ per month.
Please identify the agreed upon amount and the reasons why you
agree to deviate from the amount identified in the Child Support
Worksheet. (The Court must approve any deviation from the
guideline amount and will do so only for compelling reasons if
this amount is lower than the guideline amount.)
________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
b.
Child Support Agreement
The
qFather
qMother
shall pay child support to the
qFather
qMother
qOther
Party in the sum of $ _____________
per month beginning on _________________________ (date).
Child support payments shall be paid: (check one)
q
To the Department of Revenue – Child Support Division (IDO –
Income Deduction Order);
q
To the Department of Revenue – Child Support Division (direct
pay)
q
Directly to the
qFather
qMother
qOther
Party
Child support payments shall be paid: (check one)
qweekly
qbi-weekly
qtwice
a month
qmonthly
qOther:
________________________ and will be paid on the _____________
day of the
qweek
qmonth.
It is the responsibility of the Obligee (the person
receiving the payment) to complete the appropriate forms to
activate an income deduction order (IDO)
2.
Medical, Dental, Vision, and Mental Health Insurance and
Extraordinary/Out-of Pocket Medical Expenses
q
Father shall provide
qmedical
qdental
qvision
qmental
health insurance for the child(ren). If not all children,
please identify the names of the children the Father will be
providing insurance for:
_________________________________________
and/or
q
Mother shall provide
qmedical
qdental
qvision
qmental
health insurance for the child(ren). If not all children,
please identify the names of the children the Mother will be
providing insurance for:
_______________________________________________________________________________________
and/or
q
________________________________ (name of party) shall provide
qmedical
qdental
qvision
qmental
health insurance for the child(ren). If not all children,
please identify the names of the children that this party will
be providing insurance for:
_______________________________________________________________________________________
q
Extraordinary Medical Expenses are defined as uninsured
expenses, including co-payments and deductible amounts in excess
of $250.00 per child per calendar year. The parties agree that
extraordinary medical, dental, vision, or mental health expenses
for the child(ren) shall be divided with the Father paying
___________ %, the Mother paying ____________%, and the Other
Party paying _____________%.
q
Other:
_________________________________________________________________________________
_______________________________________________________________________________________
A “Notice to Employer to Deduct for Health Insurance” can be
completed by the Obligee (person receiving) and served upon
the Obligor (person paying) and Obligor’s employer.
3.
Extraordinary Expenses (Private schools,
school/sport/extracurricular activities, etc.)
q
The parties agree to the following:
_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
4.
OPTIONAL - Post-Secondary Expenses (college, trade
school, etc.)
Post-secondary education expenses CANNOT be ordered by
the Court without an agreement. If you agree that they should
be paid by the parents, please indicate the terms of the
agreement below.
NOTE: Agreements made under this provision, if approved by the
Court and made a part of the Decree or Final Order, become
enforceable by the Court.
q
Post-secondary education expenses for the child(ren) shall be
divided with the Father paying _________% and Mother paying
__________% of every expense checked below. Post-secondary
expenses include the following:
q
Tuition (indicate any restrictions or maximum monetary amounts)
_______________________________
_______________________________________________________________________________________
q
Room and Board
q
Books
q
Fees
q
Travel
q
Other:
______________________________________________________________________________
Section E: Child Tax Exemption
Only one party may claim a deduction for each child on his/her
income tax return. Both parties agree to prepare appropriate
IRS forms, for example, Form 8332 “Release of Claim to Exemption
for Child of Divorced or Separated Parents” IRS link to forms:
http://www.irs.gov/formspubs/index.html
Note:
�
If there is no agreement, the dependency exemption will be
divided between the parties. These rights shall be allocated
between the parties in proportion to their contributions to the
costs of raising their children.
�
A parent shall not be entitled to claim a child as a dependent,
if he or she has not paid all court-ordered child support for
that tax year or if claiming the child as a dependent would not
result in any tax benefit.
“F”
= Father “M” = Mother “O” = Other party
|
Full Name of Child |
Deduction to be claimed every year by: |
Deduction to be claimed during odd years |
Deduction to be claimed during even years |
|
|
qF
|
qM |
qO |
qF
|
qM |
qO |
qF
|
qM |
qO |
|
|
qF
|
qM |
qO |
qF
|
qM |
qO |
qF
|
qM |
qO |
|
|
qF
|
qM |
qO |
qF
|
qM |
qO |
qF
|
qM |
qO |
|
|
qF
|
qM |
qO |
qF
|
qM |
qO |
qF
|
qM |
qO |
q
Other:
_________________________________________________________________________________
_______________________________________________________________________________________
Section
F: Other Terms
q
If the parties cannot reach an agreement in the future on any
issues involving the child(ren), they agree to enter into
qmediation
qarbitration
qparenting
coordinator
qdecision-maker
at their own cost.
q
The parties will exchange financial information on an annual
basis, for example, income, verification of insurance and its
costs.
q
Identify below any issues or agreements not already identified
in this agreement.
_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
Minor changes may be made at any time if both parties agree
to the changes. A written agreement to modify child
support, the primary caretaking party, or other substantial
changes to the parenting plan should be filed with the Court
along with a proposed order for the Court to approve the
modification.
Please
re-read this document carefully to make sure it accurately
reflects your entire agreement. Items agreed upon outside of
this document may not be enforceable.
Your
signature below indicates that you have read, understand, and
agree with all terms of this agreement. This document should be
signed in the presence of a notary public or court clerk.
___________________________________
____________________________________________
Petitioner’s Signature
Date
qCo-Petitioner’s
qRespondent’s
Signature Date
___________________________________
____________________________________________
Signature of Attorney, if applicable
Date Signature of Attorney, if
applicable Date
___________________________________
____________________________________________
Petitioner’s
Address
Co-Petitioner/Respondent’s Address
___________________________________
____________________________________________
City, State, Zip
Code
City, State, Zip Code
___________________________________
____________________________________________
(Area Code) Home Telephone Number
(Area Code) Home Telephone Number
___________________________________
____________________________________________
(Area Code) Work Telephone
Number (Area Code)
Work Telephone Number
Subscribed and affirmed, or sworn to before me
Subscribed and affirmed, or sworn to
before me
in the County of ________________________, in the
County of _________________________,
State of ____________________, this _______ State
of ____________________, this ________
day of ________________, 20 ____.
day of ________________, 20 ____.
My Commission Expires: _________________ My
Commission Expires: ___________________
_____________________________________
________________________________________
Notary
Public/Clerk
Notary Public/Clerk
(IF ONLY
ONE PARTY SIGNS THE PARENTING PLAN, COMPLETE A CERTIFICATE OF
SERVICE.)
CERTIFICATE
OF SERVICE
I certify
that on ________________________ (date) the original was filed
with the Court and a true and accurate copy of the
PARENTING PLAN was served on the other party by:
qHand
Delivery, qE-filed,
qFaxed
to this number: ___________________, or
qby
placing it in the United States mail, postage pre-paid, and
addressed to the following:
To: _______________________________________
_______________________________________
_______________________________________
______________________________________
Your signature