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Parenting Agreement Form. This is a Alaska form and can be use in Domestic Relations Statewide.
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Tags: Parenting Agreement, DR-475, Alaska Statewide, Domestic Relations
Alaska Cour t System
Mode l Parent ing Ag reement
Instructions
This form was developed by a superior court judge to help parents reach agreement on
important issues concerning their children. It covers many issues that parents may not
think about when making custody decisions. The form may be used in a divorce case, a
dissolution, a custody case between unmarried parents, or an action to modify an
existing custody order.
If you want this agreement to be part of your custody order, you must file it with the
court. If the judge approves your agreement, it will become part of the custody order in
your case.
The form offers you many options for arranging your children’s custody and care. Fill out
the sections you agree will apply to your children and you. In each section, you can pick
one of the choices that is offered, or you can write your own arrangement in the space
marked “Other.” If you need more space, you can attach additional pages. (If you
continue on a separate page, you need to make it clear which section of the agreement
that you are writing about (for example: "Continuation of agreement on vacations and
travel by children – Sec. 4.4").
You can fill out the form by hand. Be sure to print neatly in black ink. If you want to type
your responses, an electronic version of the form is available on the Alaska Court
System’s web site at http://www.alaska.net/~akctlib/forms.htm. The clerk of court may
also have the form available on a computer diskette.
Each parent must sign the form in front of a notary public. A court clerk can provide this
notary service for you (at no charge) when you file this agreement with the court. You
must bring a photo ID with you for the notarization.
If you have attached additional pages to the agreement, you should write the name of
the document, the case title, and the case number in the bottom left corner of each
page (for example: Parenting Agreement, Smith v. Jones, 4FA-01-1234CI).
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Table of Contents
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
Parents ...........................................................................................................................................1
Child(ren).......................................................................................................................................1
Legal Custody .............................................................................................................................2
Physical Custody ........................................................................................................................2
Parents Living in Same Community - Custody Schedule ....................................................3
5.1
Parents Living in Same Community: Regular Schedule - Infants to Age 3 (or Older)
5.2
Parents Living in Same Community: Regular Schedule - At Least Age 3 thru School Age
5.3
Parents Living in Same Community: Summer Schedule - At Least Age 3 thru School Age
5.4
Parents Living in Same Community: Winter School Break (Christmas)
5.5
Parents Living in Same Community: Other Holidays
5.6
Parents Living in Same Community: Birthdays
Parents Living in Same Community: Transportation and Exchanges of Child(ren)...10
6.1
Transportation
6.2
Exchanges
Move by Parent - Notice and Future Schedule ..................................................................11
Parents Living in Different Communities - Custody Schedule ........................................11
8.1
Parents Living in Different Communities: Infant to Age 3 (or Older)
8.2
Parents Living in Different Communities: Summer Visits: At Least Age 3 thru 6 Years
8.3
Parents Living in Different Communities: Summer Visits: At Least Age 6 - School Age
8.4
Parents Living in Different Communities: Failure to Give Notice / Loss of Summer Visit
8.5
Parents Living in Different Communities: Winter School Break (Christmas)
8.6
Parents Living in Different Communities: Spring Break
8.7
Parents Living in Different Communities: Other Holidays
8.8
Parents Living in Different Communities: Birthdays
Parents Living in Different Communities: Transportation ...............................................15
9.1
By Car
9.2
By Airplane
9.3
Airplane Escorts
Vacations and Travel by Child(ren)........................................................................................16
Information About Events and Activities ..............................................................................17
Parent Traveling .......................................................................................................................17
Changes or Modification of the Agreement .........................................................................17
Care of Our Child(ren)...............................................................................................................18
14.1 Parent Remarks and Behavior
14.2 Child(ren) as Messengers
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Table of Contents continued…
15.
16.
17.
18.
19.
20.
21.
22.
23.
14.3 Discipline
14.4 Education
Decision-Making ........................................................................................................................19
15.1 Communication Between Parents
15.2 Day-to-Day Decisions
15.3 Records
15.4 Braces
Disputes.......................................................................................................................................19
Contact with the Child(ren) When with the Other Parent .................................................20
17.1 Telephone
17.2 Mail
Re-Involving A Parent...............................................................................................................21
Child Care....................................................................................................................................21
19.1 Parents Living in Same Community - First Option Other Parent
19.2 Parents Living in Different Communities - First Option Other Parent
19.3 Child Care by Other People
Grandparents and Extended Family ......................................................................................22
Parents Same Community or Different Communities: Transition Times ......................22
Federal Taxes ............................................................................................................................23
Permanent Fund Dividend .......................................................................................................23
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IN THE SUPERIOR COURT FOR THE STATE OF ALASKA
JUDICIAL DISTRICT AT
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Case Number
PARENTING AGREEMENT
1.
Parents.
Name
Address
Dad
Mom
2.
Child(ren).
Name
DOB
Age
School
Child 1
Child 2
Child 3
Child 4
Child 5
(Attach another page for additional children.)
Note: This Parenting Agreement offers you many options to arrange your child(ren)'s custody and
care. Fill out the sections you agree shall apply to your child(ren) and you. Consider what will
happen if a parent moves. Each section gives you choices or you can write in your agreement in
the places marked "Other." If the judge approves your agreement it will become a court order.
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3.
4.
Legal Custody. The responsibility for making major decisions affecting the
child(ren)'s welfare including major medical decisions, educational, legal and
religious decisions.
3.1
We agree that legal custody of our child(ren) shall be: (choose one)
shared legal custody. We have the ability to communicate
and make joint decisions regarding our child(ren)'s major
medical, educational, legal and religious decisions that shall
be in their best interest.
shared legal custody. Most of the time, we have the ability to
communicate and make joint decisions regarding our
child(ren)'s major medical, educational, legal and religious
decisions that shall be in their best interest. However, after
consultation with each other, if we are unable to decide an
issue,
Dad
Mom shall make the final decision.
3.2
We agree that legal custody of our child(ren) shall be with
Dad
Mom. This parent shall keep the other parent advised of our
child(ren)'s health status, education, grades, activities, legal and
religious matters. This parent shall list the other parent on all forms
and registrations as a parent and "emergency contact" person.
Physical Custody. The responsibility for the physical care and immediate,
day-to-day supervision of the child(ren).
Note: Physical custody for child support purposes is governed by Civil Rule 90.3 and not by
the choice made below.
(choose either 4.1 or 4.2)
4.1
Shared Physical Custody: We have the ability to communicate
and coordinate with each other to provide for our child(ren)'s
physical care on a day-to-day basis. The schedule set forth below
(in Sec. 5 and/or 8) shall be the shared physical custody schedule
for our child(ren).
4.2
Primary Physical Custody: Our child(ren)'s needs can best be
met by primary physical custody being with
Dad
Mom and
the child(ren) spending time with
Dad
Mom for visitation as
set forth on the schedule we have chosen below (in Sec. 5 and/or
8).
4.3
School Calendar. (choose one)
No later than April 1 of each year,
Dad
Mom shall obtain the
school calendar for the next year and shall mark it with Dad's time
and Mom's time for the school year, holidays and summer under
this agreement and give a copy to the other parent. The parents
shall discuss any differences by May 1 and the parents shall reach
an agreement or use the dispute provisions (Sec. 16) by June 1.
This is the calendar that will be in effect for the following year.
No later than _________ (date) of each year,
Dad
Mom shall
obtain the school calendar for the next year and shall mark it with
Dad's time and Mom's time for the school year, holidays and
summer under this agreement and give a copy to the other parent.
The parents shall discuss any differences by _________ (date) and
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4.4
5.
the parents shall reach an agreement or use the dispute provisions
(Sec. 16) by _________ (date). This is the calendar that will be in
effect for the following year.
Conflicts in Scheduling.
Sometimes "holiday time" may conflict with time set aside for the
other parent. When this happens, the holiday time shall be
observed over all other schedules. For example, if it is Mom's
alternate weekend, but Dad's Labor Day weekend, Mom shall lose
her weekend.
Other:
Parents Living in Same Community - Custody Schedule.
Note: Physical custody requires a plan for day-to-day care for child(ren) that fosters stability
and predictability. Some child(ren) can handle frequent changes with each parent and other
child(ren) do better with a central residence. You must consider your child(ren) and what will
help them get enough sleep, be prepared for and participate in their school actively, have
routine meals and hygiene care, and receive nurturing and parental supervision. Some
child(ren) spend school days in one home and weekends in the other, some spend more time
in the summer in one home and school time in the other, some alternate between homes on
a regular schedule. The child(ren)’s age and individual needs and school situation should be
considered. Also, the parent’s work schedules and availability to provide transportation and
supervision may be factors.
5.1
Parents Living in Same Community: Regular Schedule - Infants to
Age 3 (or Older).
Our child(ren) shall be with
Dad
Mom at the times listed
below and with the other parent at all other times. (choose one)
Tu/Thurs Eve and Sat overnight
Tuesday 4pm-7pm
Thursday 4pm-7pm
Saturday 10am-Sunday 10am
Tu/Thurs Eve and Sat overnight
Tuesday 5pm-7:30pm
Thursday 5pm-7:30pm
Saturday 10am-Sunday 10am
Wed overnight/Sat overnight
Wed 5pm-Thursday 9am
Sat 12noon-Sun 6pm
Wed/Fri eve and Sat overnight
Wed 5pm-7:30pm
Fri 5pm-7:30pm
Sat 5pm-Sun 6pm
Wed eve/Sun daytime
Wed 5pm-7:30pm
Sun 1pm-4pm
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5.2
Supervised visits
Supervised visits
times per week.
The supervisor shall be
(person/agency)
The times shall be:
Future:
This custody schedule shall remain the same as our
child(ren) get older unless we agree to modify it or a court
modifies the custody.
The custody schedule below in Section 5.2 shall apply when
our child(ren) are older. The custody schedule shall change
at the following time:
If one of us moves, the custody schedule in the “Different
Communities” part of this agreement (Sec. 8) shall apply
unless we agree differently or a court order modifies the
custody.
Parents Living in Same Community: Regular Schedule - At Least
Age 3 thru School Age.
Our child(ren) shall be with
Dad
Mom at the times listed
below and with the other parent at all other times.
If we have chosen a weekend plan below, then any "no school"
days, such as teacher in-service days, go to the parent with that
weekend.
Alternate weekends:
Alternate weekends of Friday 6pm to Monday am/school.
Alternate weekends Friday 6pm to Sunday 6pm.
Alternate weekends Saturday 10am to Sunday 6pm.
Alternate weekends from:
Three full weekends a month:
("Full weekend" means a weekend with a Saturday and Sunday in that month.)
First three full weekends of every month from Friday 6pm to
Monday am/school.
First three full weekends of every month from Friday 6pm to
Sunday 6pm.
First three full weekends of every month from Saturday 10am to
Sunday 6pm.
First three full weekends of every month from:
Every weekend:
Every weekend from Friday 6pm to Monday am/school.
Every weekend from Friday 6pm to Sunday 6pm.
Every weekend from Saturday 10am to Sunday 6pm.
Every weekend from:
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Alternate weekends plus weeknight:
Alternate weekends from Friday 6pm - Monday am/school plus
every Wednesday 6pm - 8pm.
Alternate weekends from Friday 6pm - Sunday 6pm plus every
Wednesday 6pm - 8pm.
Alternate weekends from Saturday 10am to Sunday 6pm plus every
Wednesday 6pm - 8pm.
Alternate weekends from:
plus every
Day visits only:
Every Saturday from 10am to 6pm.
Every Sunday from 10am to 6pm.
Every
(day) from
(time) to
(time).
Other:
Split every week:
Dad
Mom from Saturday at 6pm to Wednesday after school and the
other parent from Wednesday after school until Saturday 6pm.
Dad
Mom from Sunday 10am to Wednesday after school and the
other parent from Wednesday after school until Sunday 10am.
Other:
Alternate weeks in each home:
Note: Alternate weeks or alternate 2 weeks in each home are generally too long
away from each parent for child(ren) below about age 6.
Alternate weeks in Dad's home and Mom's home with exchanges
every Friday at 6pm.
Alternate weeks in Dad's home and Mom's home with exchanges
every
(day) at
(time).
Other:
5.3
Alternate two weeks in each home:
Alternate two weeks in Dad's home and Mom's home with
exchanges every Friday at 6pm plus alternate Friday night from
6pm to Saturday noon with other parent.
Alternate two weeks in Dad's home and Mom's home with
exchanges every Friday at 6pm plus alternate Friday night from
6pm to 10pm with other parent.
Alternate two weeks in Dad's home and Mom's home with
exchanges every
(day) at
(time) plus
alternate
(day) from
(time) to
with
other parent.
Parents Living in Same Community: Summer Schedule - At Least Age 3
thru School Age.
Same schedule as school year:
The same schedule shall continue through the summer.
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The same schedule shall continue through the summer except that either
parent may travel with the child(ren) for up to 15 days for a vacation with
notice to the other parent at least 30 days in advance and a schedule,
location and telephone numbers provided at least 10 days before travel.
Other:
Opposite schedule as school:
The summer schedule shall be the exact opposite of the school year
schedule for Dad's time and Mom's time.
The summer schedule shall be the exact opposite of the school year
schedule for Dad's time and Mom's time except that either parent may
travel with the child(ren) for up to 15 days for a vacation with notice to the
other parent at least 30 days in advance and a schedule, location and
telephone numbers provided at least 10 days before travel.
Other:
Divided summer:
Dad
Mom shall have the child(ren) from one week after school is out until
July 15th and
Dad
Mom shall have the child(ren) from July 15th until
one week before school starts. The other parent shall have reasonable visits
arranged between the parents during the summer.
Dad
Mom shall have the child(ren) from the time school is out until
(date) and
Dad
Mom shall have the child(ren) from
(date) until
school starts. The other parent shall have reasonable visits arranged between
the parents during the summer.
Dad
Mom shall have the child(ren) from one week after school is out
until
(date) and
Dad
Mom shall have the
child(ren) from
(date) until one week before school starts. The other
parent shall have the child(ren) every week from Wednesday night at 6pm to
Thursday morning.
Other:
5.4
Parents Living in Same Community: Winter School Break (Christmas).
Note: Consider that this school break is not exactly the same dates every year and may be
as short as 12 days to as long as 20 days. Check your child(ren)’s school calendar each
year. Consider whether you want your child(ren) to have the traditions of having things the
same every year, such as Christmas Eve with one parent and Christmas Day with the other
parent, or if you want them to rotate so that Christmas Eve and Christmas Day are different
every other year for you and for them.
Definition:
Winter Break is 6pm the last day of school until 6pm the day
before school starts again.
Winter Break is defined as:
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Regular schedule or one parent:
whichever parent the child(ren) are with that year under our regular custody
schedule shall have all of Winter Break.
Dad
Mom shall have all of Winter Break every year.
All of break alternate years:
Dad
Mom shall have all of Winter Break in
even
odd years.
Dad
Mom shall have all of Winter Break in
even
odd years.
One-half of break:
Dad
Mom shall have first half of Winter Break every year and
Dad
Mom
shall have second half of Winter Break every year.
Dad
Mom shall have first half of Winter Break in even years and
Dad
Mom shall have the second half of Winter Break. The schedule shall be
the opposite in odd years.
Christmas Eve/Christmas Day:
the schedule chosen above shall apply.
in addition to the above schedule, the following applies:
One parent Christmas Eve, one parent Christmas Day - same every
year:
Dad
Mom shall have the child(ren) from 10am until 10pm
Christmas Eve and
Dad
Mom shall have the child(ren) from
10pm Christmas Eve until 6pm Christmas Day every year.
One parent Christmas Eve and one parent Christmas Day - alternate
years:
Dad
Mom shall have the child(ren) from 10am until 10pm
Christmas Eve and
Dad
Mom shall have the child(ren) from
10pm Christmas Eve until 6pm Christmas Day in even years. The
schedule shall be the opposite in odd years.
One parent both Christmas Eve and Christmas Day - alternate years:
Dad
Mom shall have the child(ren) Christmas Eve from 10am
to Christmas Day at 6pm in even years. The schedule shall be the
opposite in odd years.
Other:
Travel during Winter Break:
Either parent may travel with the child(ren) during their time under the above
schedule.
Dad
Mom may travel with the child(ren) for the entire Winter Break in even
years.
Dad
Mom may travel for the entire Winter Break in odd years.
If either parent is going to exercise the "travel during Winter Break" option,
they must provide notice to the other parent no later than
Nov 1
Nov 15
Dec 1
Dec 15
Other:
of when and where they
plan to travel with the child(ren). At least ten days prior to traveling, the
parent shall provide a schedule, location, and phone numbers for the trip.
Other:
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5.5
Parents Living in Same Community: Other Holidays.
NOTE: By deciding how your child(ren) will spend important days like holidays and birthdays
your child(ren) and you will know what to expect and can plan events and traditions. Pick only
the holiday options that you agree will have priority over your regular schedule for school,
summer, and winter break.
Mother's Day/Father's Day:
If the child(ren) are not already with the mother/father on this day,
then the mother/father shall be entitled to have the child(ren) for up
to 4 hours. The mother/father shall give notice to the other parent
of the schedule at least two days in advance.
Other:
Thanksgiving :
defined as 10am to 8pm on Thanksgiving Day.
defined as Wednesday after school until
(day & time)
defined as
whichever parent the child(ren) are with that year under our regular schedule.
Dad
Mom shall have Thanksgiving every year.
Dad
Mom shall have Thanksgiving in even years and
Dad
Mom
shall have Thanksgiving in odd years.
Other:
Halloween:
defined as 4pm to 8pm on Halloween day.
defined as
whichever parent the child(ren) are with that year under our regular schedule.
Dad
Mom shall have Halloween every year.
Dad
Mom shall have Halloween in even years and
Dad
Mom
shall have Halloween in odd years.
Other:
Easter Sunday:
defined as 10am to 6pm on Easter Sunday.
defined as:
whichever parent the child(ren) are with that year under our regular
schedule.
Dad
Mom shall have Easter Sunday every year.
Dad
Mom shall have Easter Sunday in even years and
Dad
Mom
shall have Easter Sunday in odd years.
Other:
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defined as 10am to 8pm on July 4 th .
defined as
whichever parent the child(ren) are with that year under our regular
schedule.
Dad
Mom shall have July 4th every year.
Dad
Mom shall have July 4th in even years and
Dad
Mom
shall have July 4th in odd years.
Other:
July 4th:
Passover:
defined as 6pm to 8pm.
Dad
Mom shall have the
first night
Dad
Mom shall have the
first night
Other:
second night every year.
second night every year.
Hanukkah:
defined as 6pm to 8pm.
Dad
Mom shall have nights: 1 2 3 4 5 6 7 8 (circle which nights)
Dad
Mom shall have nights: 1 2 3 4 5 6 7 8 (circle which nights)
Yom Kippur and Roshashanah:
Spring Break:
defined as 6pm last day of school to 6pm the day
before school starts (Sunday).
defined as
whichever parent the child(ren) are with that year under our regular
schedule.
Dad
Mom shall have Spring Break every year.
Dad
Mom shall have Spring Break in even years and
Dad
Mom
shall have Spring Break in odd years.
Other:
Spring Break Travel:
Either parent may travel with the child(ren) during Spring Break
during their time and shall give at least 30 days notice to the other
parent and a schedule, location and phone numbers at least 10
days before travel.
Other:
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Memorial Day weekend :
defined as Friday 6pm to Monday 6pm.
defined as
whichever parent the child(ren) are with that year under our regular
schedule.
Dad
Mom shall have Memorial Day weekend every year.
Dad
Mom shall have Memorial Day weekend in even years and the
other parent shall have Memorial Day weekend in odd years.
Other:
Labor Day weekend :
defined as Friday 6pm to Monday 6pm.
defined as
whichever parent the child(ren) are with that year under our regular
schedule.
Dad
Mom shall have Labor Day weekend every year.
Dad
Mom shall have Labor Day weekend in even years and the
other parent shall have Labor Day weekend in odd years.
Other:
5.6 Parents Living in Same Community: Birthdays.
Dad's Birthday is:
(date)
Mom's Birthday is:
(date)
Parent’s Birthday:
When it is Dad's or Mom's birthday, the birthday parent shall have
their celebration during their regularly scheduled time with the
child(ren).
When it is Dad's or Mom's birthday, the birthday parent shall be
entitled to have the child(ren) for up to three hours for a celebration
on the birthday and shall give notice to the other parent of their plan
to exercise this option at least three days in advance.
Other:
Child(ren)’s Birthday:
When it is our child(ren)'s birthday each parent shall hold their
celebration during their regularly scheduled time with the child.
When it is our child(ren)'s birthday, Dad shall hold a celebration
during even years and Mom shall hold a celebration during odd
years.
We shall hold a joint birthday celebration every year with Dad
organizing it during even years and Mom organizing it during odd
years.
Other:
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6.
Parents Living in Same Community: Transportation and Exchanges of Child(ren).
6.1
Transportation.
The parent receiving the child(ren) shall transport the child(ren).
Dad
Mom shall provide all the transportation between parents.
Other:
6.2
7.
Exchanges.
Exchanges shall be at mother’s and father's homes unless we
agree to another place.
Exchanges shall be at
unless
we agree to another place.
Exchanges shall occur on time. Each parent shall be on time for
the drop off and pick up of the child(ren) and shall have the
child(ren) ready. If a parent is more than 15 minutes late without
contacting the other parent to make other arrangements, the parent
with the child(ren) may proceed with other plans and activities for
the child(ren).
Exchanges shall occur on time. Each parent shall be on time for
the drop off and pick up of the child(ren) and shall have the
child(ren) ready. If a parent is more than
late without
contacting the other parent to make other arrangements, the parent
with the child(ren) may proceed with other plans and activities for
the child(ren).
Other:
Move by Parent - Notice and Future Schedule.
Note: If you do not have an agreement about how your child(ren) will spend time with both
parents if one of you moves then you may create a very difficult time for your child(ren). It is
helpful to have an agreement in place as to what the arrangement will be if one parent moves,
and then either parent can file a Motion to Modify with the court. A Motion to Modify Custody
or Visitation takes from about 2 months to 8 months to be decided by the court, depending on
the issues.
(choose all that apply)
Each parent shall give at least 120 days notice to the other parent of any
intent to move.
Each parent shall give at least
days notice to the other parent of
any intent to move.
After receiving notice of a move, we shall review our parenting agreement
to try to reach a modified parenting agreement that shall be best for our
child(ren).
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8.
When one parent moves, the "Different Communities" part of this
agreement (Sec. 8) shall apply until we reach a modified parenting
agreement or the court decides a modification after one of us has filed a
Motion to Modify Custody.
The child(ren) shall remain with the non-moving parent until we reach a
modified parenting agreement or the court decides a modification after
one of us has filed a Motion to Modify Custody.
Parents Living in Different Communities - Custody Schedule.
Note: In deciding a custody schedule for child(ren) when parents live in different communities
one of the primary considerations is how many trips can the parents arrange and pay for each
year. Each trip by airplane requires a round trip for each child and a roundtrip for two escorts,
one each way, if escorts are used.
Example : Two children traveling Summer Break and Winter Break is 4 tickets a year (8
tickets with escorts)
Take the average cost of a ticket----$500, $600, $700 -- and multiply it times the number of
child(ren) and escort tickets times the number of trips per year to get the total cost and
evaluate what Mom and Dad can arrange and pay for each year.
Example: 2 kids x 2 trips [4 tickets] per year to Seattle at $500 per ticket = $2,000 ($4,000
with escorts)
If we have been living in the same community and one parent moves, the
child(ren) shall remain with the non-moving parent and the following
schedule for visits with the moving parent shall apply unless we agree
differently or the court modifies the custody.
We are or shall soon be living in different communities. Our child(ren)
shall be with
Dad
Mom except for the times agreed to below when
our child(ren) shall visit with
Dad
Mom.
Other:
8.1
Parents Living in Different Communities: Infant to Age 3 (or Older).
Our infant/toddler shall have the same visitation as we have arranged
for the siblings in the other part of this agreement.
Dad
Mom shall travel to the community that our child(ren) are in
times per year, with 30 days notice to the other parent, and shall have
daily visits of at least 4 hours and increasing to alternate day
overnights. The visiting parent shall provide information as to
schedule, location and telephone numbers for each visit.
Dad
Mom shall travel to the community that our child(ren) are in
times per year, with 30 days notice to the other parent. After a reacquaintance, the parent then may take our child(ren) for a trip. The
re-acquaintance visits shall be at least two 4-hour visits. Our child(ren)
may then travel for a visit with
Dad
Mom for up to
days. The
parent shall provide information as to schedules, locations and
telephone numbers for the visit at least ten days in advance.
Other:
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8.2
Parents Living in Different Communities: Summer Visits - At Least
Age 3 thru 6 Years (or Older).
Our child(ren), aged 3-6 years, shall have the same visitation we have
arranged for the siblings in the other part of this agreement.
Dad
Mom shall have summer visitation
3 weeks when age 3
4 weeks when age 4
5 weeks when age 5
6 weeks when age 6.
The visit shall not begin until at least one week after school is out and
shall end at least one week before school begins. No later than April 1
each year
Dad
Mom shall notify the other parent of the dates of the
summer visit and what the transportation arrangements will be. The parent
shall provide information as to schedules, locations and telephone
numbers for the visit at least ten days in advance of travel.
The summer visit shall continue to be 6 weeks every summer.
Beginning the summer of
(year), the summer visit shall be
as below (see Sec. 8.3).
Other:
8.3
Parents Living in Different Communities: Summer Visits - At Least
Age 6 thru School Age.
Dad
Mom shall have summer visitation from one week after school
is out until one week before school begins. No later than April 1 each
year
Dad
Mom shall notify the other parent of the dates of the
summer visitation and what the transportation arrangements will be.
The parent shall provide information as to the schedules, locations and
telephone numbers for the visit at least ten days in advance of travel.
Dad
Mom shall have summer visitation from one week after school
is out until one week before school begins. No later than
each year
Dad
Mom shall notify the other parent of the dates of
the summer visitation and what the transportation arrangements will
be. The parent shall provide information as to the schedules, locations
and telephone numbers for the visit at least
days in advance of travel.
Dad
Mom shall have summer visitation of 8 weeks each summer to
begin no earlier than one week after school is out and to end at least
one week before school begins. No later than April 1 each year
Dad
Mom shall notify the other parent of the dates of the summer visitation
and what the transportation arrangements will be. The parent shall
provide information as to the schedules, locations and telephone
numbers for the visit at least ten days in advance of travel.
Other:
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8.4
Parents Living in Different Communities: Failure to Give Notice / Loss of
Summer Visit.
The parent who is entitled to the summer visitation has the duty to notify
the other parent of their intention to have the child(ren) for summer
visitation by the date we agreed to above. If the parent has not given
notice of the dates they intend to exercise summer visitation, the parent
the child(ren) are with may choose the dates.
The parent who is entitled to the summer visitation has the duty to notify
the other parent of their intention to have the child(ren) for summer
visitation by the date we agreed to above. If the parent has not given
notice of their intention to exercise summer visitation, the parent the
child(ren) are with may assume there shall be no summer visit and make
other plans with the child(ren).
Other:
8.5
Parents Living in Different Communities: Winter School Break (Christmas).
Note: Consider that this school break is not exactly the same period every year and may be
as short as 12 days to as long as 20 days. Check your child(ren)’s school calendar each
year.
Definition:
defined as the day school is out until the day before school
starts.
defined as:
One parent every year:
Dad
Mom shall have all of Winter Break every year.
Other:
Parents all of break alternate years:
Dad
Mom shall have all of Winter Break in
even
odd years.
Dad
Mom shall have all of Winter Break in
even
odd years.
Parents half of break every year:
Dad
Mom shall have first half of Winter Break in
even
odd years and
Dad
Mom shall have first half of Winter Break in
even
odd years.
The other parent shall have the second half of Winter Break.
Away parent all of break plus one-half of break alternate years:
The parent who does not live in the same community with the child(ren)
shall have all of Winter Break in
even
odd years and the second half
of Winter Break beginning after Christmas Day in the alternate year.
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Parent travels:
The parent who does not live in the same community with the child(ren)
shall travel to the child(ren)'s community and shall have time with the
child(ren) as follows:
Other:
8.6
Parents Living in Different Communities: Spring Break.
Definition:
Spring break is the school break beginning on the last day of
school and ending on the day before school starts again.
Spring break is defined as:
Dad
Mom shall have Spring Break every year.
Dad
Mom shall have Spring Break in
even
odd years and the other
parent shall have Spring Break in
even
odd years.
The parent who does not live in the same community with the child(ren) shall
travel to the child(ren)'s community and shall have time with the child(ren) as
follows:
Other:
8.7
Parents Living in Different Communities: Other Holidays.
If the parent who does not live in the same community as the child(ren)
comes to visit, we agree to arrange reasonable time for our child(ren) to
be with the visiting parent. The visiting parent shall provide information as
to schedule, location, and telephone number where the child(ren) will be.
If we have the financial ability to pay and travel is reasonable, considering
the distance, time, school, and our child(ren)'s age, we may agree to visits
for other holidays not listed above.
Other:
8.8
Parents Living in Different Communities: Birthdays.
Dad's Birthday is:
(date)
Mom's Birthday is:
(date)
Parent’s Birthday:
When it is Dad’s or Mom’s birthday and the child(ren) are not with that
parent, the other parent shall assist the child(ren) in telephoning the
birthday parent.
Other:
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Child(ren)'s Birthday:
When it is our child(ren)'s birthday, the parent the child is not with shall
telephone the child and the other parent shall make the child available to
talk with the parent on their birthday.
Other:
9.
Parents Living in Different Communities: Transportation.
9.1
By Car
When we live in different communities where transportation will be by
car, we agree that
Dad
Mom shall provide transportation both
ways unless we agree differently.
Other:
9.2
By Airplane.
When we live in different communities where transportation will be by
airplane, we agree to assist our child(ren) by considering jet lag, settling in
times, and "best option in light of the price" schedules appropriate to our
child(ren)'s age and needs.
When we live in different communities where transportation will be by
airplane, we agree that we shall split the cost of the summer visit each
paying half.
Dad
Mom shall purchase the ticket and the other parent
shall reimburse within 30 days. Transportation for other visits shall be
paid by the away parent that does not live in the same community as the
child(ren).
When we live in different communities where transportation will be by
airplane, we agree that
Dad
Mom shall purchase all roundtrip tickets
for all trips and the other parent shall reimburse half of the cost of the
child(ren)'s ticket within 30 days.
When we live in different communities where transportation will be by
airplane, we agree that the costs of roundtrip tickets shall be paid by each
parent as follows:
Summer
Dad
Mom
Spring Break
Dad
Mom
Winter Break/Christmas
Dad
Mom
Other:
Dad
Mom
We agree that if a parent cannot financially pay for transportation, then the
other parent has the option of paying for the transportation for the visit to
take place.
When we live in different communities where transportation will be by
airplane, we agree that our child(ren) may miss school
half-day
1
day
2 days, if they are otherwise doing well in school, in order to
accommodate travel arrangements and be with the other parent.
Other:
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9.3
Airplane Escorts.
We agree to consult with each other about whether an escort is
appropriate for our child(ren) when they are going to be making an
airplane trip.
When we live in different communities where transportation will be by
airplane, we agree that the costs of roundtrip tickets for any escorts,
including for a parent, shall be split 50/50.
When we live in different communities where transportation will be by
airplane, we agree that the costs of roundtrip tickets for a parent escort
shall be paid by the parent doing the escort.
Other:
10.
Vacations and Travel by Child(ren).
We agree that either parent may travel with our child(ren) during their
custody time. The parent traveling with the child(ren) shall give the other
parent at least 30 days notice before traveling unless there is an
emergency, and shall provide the other parent with a schedule, locations
and phone numbers at least ten days before traveling.
We agree that our child(ren) may travel with others, such as a sports
team, church, or school activity, with relatives or similar travel as arranged
by the parent the child(ren) are with during that parent's time. We
understand that if our child(ren) are involved in a special activity, it may be
in their best interest for both parents to agree the child(ren) may travel
during one parent's time.
We agree that if our child(ren) are traveling with others, such as with a
sports team, church, or school activity, with relatives or similar travel for
more than
days, that we shall give the information to the other
parent in advance of the travel.
Other:
11.
Information About Events and Activities.
When we live in the same community each parent shall make a good faith
effort to give information to the other parent about events and activities in
our child(ren)'s lives like school programs, concerts, award ceremonies,
plays, sports events and other things our child(ren) are participating in.
Sometimes this information may be at the last minute but we recognize
this happens with child(ren) and shall make an effort to let the other parent
know so that they can attend or talk about it with our child(ren).
When we live in different communities each parent shall make a good
faith effort to send the other report cards, school calendars, school
pictures, copies of awards or programs from events and activities our
child(ren) are involved in.
Other:
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12.
Parent Traveling. (choose one)
If either parent is traveling, they shall let the other parent know in advance
where they can be reached in the event of an emergency or if the
child(ren) want to contact them.
If either parent is traveling, they shall leave information with another adult
in their home where they can be reached in the event of an emergency or
if the child(ren) want to contact them.
Other:
13.
Changes or Modification of the Agreement. (choose all that apply)
We understand that we can vary this agreement for special events,
changes in circumstances and to adjust to our child(ren)'s schedule when
we agree. However, when we do not agree to change something, this
agreement is in effect. Either of us may file a Motion to Modify Child
Custody with the court when we believe that there has been a substantial
change in circumstances such that it is in the best interest of our child(ren)
that the agreement be substantially modified by the court.
When we decide to make a substantial change in the agreement, such as
the custody arrangement, it shall be put in writing and signed by both of us
and filed with the court with a Motion to Modify.
We agree that minor changes in the agreement, such as travel times or
exchange times can be put in a writing, signed by both of us, for
clarification and for a record, but are not required to be.
We agree that any change in the agreement must be put in writing signed
by both of us.
Care of Our Child(ren).
14.1 Parent Remarks and Behavior.
14.
Note: It causes pain to your child(ren) when you criticize their other parent. Even
infants and toddlers pick up on a parent being disrespectful of their other parent.
Frustration with the other parent from time to time is not unusual but comments are
best saved for sharing with adult friends outside the presence of your child(ren).
We agree that our child(ren) have the right to be free of bad comments
and behavior by one parent about the other. We agree that we shall not
badmouth, criticize, roll our eyes, be sarcastic and otherwise be
disrespectful of the other parent in the presence of our child(ren) and we
shall not let others do this.
Other:
14.2
Child(ren) as Messengers.
We agree that all communications regarding the child(ren) shall be
between the parents and we shall not use the child(ren) as
messengers to convey information, ask questions or set up custody
changes.
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We shall keep a notebook that goes back and forth with the
child(ren) that gives information about their schedule, problems,
eating, sleeping, cute stories, new experiences and other
information for the other parent. We shall stop using the notebook
when we both agree.
Other:
14.3
14.4
15.
Discipline.
Either parent may use reasonable discipline techniques, but we
shall not use physical discipline.
Either parent may use reasonable discipline techniques, with
physical discipline as a last resort.
Either parent may use reasonable discipline techniques, including
physical discipline.
Other:
Education.
Both parents may participate in school conferences, events and
activities and may consult with teachers and other school
personnel. Each parent may contact the school to receive grades,
attendance, calendars, schedules, mailings and notices.
Other:
Decision-Making.
15.1 Communication Between Parents.
We shall communicate with each other: (choose all that apply)
in person
by telephone
by letter
by e-mail
other:
15.2 Day-to-Day Decisions.
Each parent shall make decisions regarding day-to-day care of
each child while the child is residing with that parent. Either parent
may make emergency decisions affecting the health and safety of
the child(ren).
Other:
15.3
Records.
Both parents shall have full access to school, day care, medical
and other records of our child(ren).
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Both parents shall have equal and independent authority to confer
with the child(ren)'s school, day care and other programs with
regard to the child(ren)'s educational, emotional and social
progress.
Other:
15.4 Braces.
We agree that if a dentist or orthodontist recommends braces for
our child(ren) that we shall provide them.
We agree that if a dentist or orthodontist recommends braces for
our child(ren) that we shall obtain a second opinion and if it
recommends also then we shall provide them.
We shall consider braces as any other non-emergency medical
decision.
Other:
16.
Disputes.
Whenever possible we shall discuss the issues and attempt to reach an
agreement based on what is best for our child(ren) at that particular time.
If we are unable to reach an agreement on an important issue about our
child(ren) after we have discussed it with each other, either parent may
initiate dispute resolution by:
arranging for us to meet with a counselor to discuss and try and
reach agreement.
arranging for us to meet with a trained mediator to try and reach an
agreement.
(name) has agreed to be an
arbitrator and after we each present what we think is best for our
child(ren) the arbitrator shall make the final decision.
Other:
17.
Contact with the Child(ren) When with the Other Parent.
17.1 Telephone. (choose all that apply)
We shall each try to maintain answering machines so that the
child(ren) can leave and receive our messages.
Our child(ren) may telephone the other parent whenever they want
to.
The parent the child(ren) are not with shall make an effort to talk at
least
times a
week
month by calling the child(ren) at
reasonable times.
The parent the child(ren) are not with shall telephone on the
following days and times:
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If a message is left from the parent the child(ren) are not with, the
other parent shall assist the child(ren) in returning the call.
Reasonable times to call the child(ren) at the other parent's home
are:
between 8am and 8pm
between ___ am and ___ pm
We agree that telephone calls and other communication shall not
be monitored by the other parent unless they believe in good faith
that the child is having a problem.
Other:
17.2
Mail. (choose all that apply)
Note: Child(ren) generally love to get mail. The parent the child(ren) are not with can
foster their relationship with the child(ren) by sending pictures, cards, postcards,
magazine pictures, stickers and letters. These make a child feel important and become
treasures of how important they are. Fax machines are a wonderful gift for a child and
an away parent. Homework can be faxed and corrected, edited and praised.
Certificates and awards can be sent. Preschool drawings can be faxed.
We agree that our child(ren) shall be given all mail and packages
sent by the other parent. If any mail is withheld the other parent
shall be informed immediately.
18.
We agree that our child(ren) and the other parent may
communicate by email when computers are available.
Either parent may send audio tapes, including story tapes and
video tapes to the child(ren).
Re-Involving A Parent.
Dad
Mom has not had frequent contact with our child(ren) for
approximately
, and wishes to
begin more actively participating in our child(ren)'s life. To make this
transition work for all of us, we agree: (check all that apply)
We shall both seek counseling to assist us in helping the child(ren)
with this transition and to receive advice about how to make the
transition work.
We shall begin contact with the child(ren) by having the following
schedule of contacts:
After the above schedule of contacts has been kept for
(time),
we shall reach an agreement about increasing the time the child(ren)
spend with the other parent.
Other:
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19.
Child Care.
19.1 Parents Living in Same Community - First Option Other Parent.
(choose one)
Each parent shall call the other parent and give them first option to
care for the child(ren) when they need childcare.
Each parent shall call the other parent and give them first option to
care for the child(ren) when we need childcare for more than:
2 hours
4 hours
6 hours
8 hours
Other:
19.2
19.3
20.
Parents Living in Different Communities - First Option Other Parent.
We agree that if the parent who the child(ren) are with will be
traveling, is ill, working out of town or otherwise unavailable to care
for the child(ren) for an extended period, that the other parent will
be given first option to care for the child(ren) in the child(ren)'s
home community or the other parent's community, depending on
what is best for the child(ren) at that time.
Other:
Child Care by Other People. (choose one)
We agree that we are each free to choose appropriate child care
providers.
We agree that any child care provider for our child(ren) shall be:
(choose all that apply)
a licensed child care provider.
a close relative or friend.
over the age of
.
Other:
Grandparents and Extended Family.
Each parent agrees that they shall provide the child(ren) with visitation
with the grandparents and extended family on their own side of the family
as they decide is in the child(ren)'s best interest during their custody time.
We agree that we shall cooperate to help the child(ren) attend special
events with grandparents and extended family by making reasonable
requests of each other, considering the school situation and the
child(ren)'s best interest and needs.
Other:
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21.
Parents Same Community or Different Communities: Transition Times.
Note: After parents separate, it is child(ren) who make the most day-to-day changes. They
are the ones who do the traveling, who have two different homes, two different sets of rules
and expectations and must adjust to the constant change. Parents can help by being aware
of the stress of these transitions and seeking to actively participate in helping the child(ren).
(choose all that apply)
We agree that when our child(ren) has to travel by air or car long
distances that we shall each reassure them, tell them about the schedule,
and use airline services that will help the child(ren).
We agree that we shall assist our child(ren) to have comfort items like
blankets, stuffed animals, and favorite things with them when they go from
one home to the other.
We agree that we shall give the other parent information about our
child(ren)'s homework, school projects, appointments and activities that
need attention while the child(ren) are with the other parent.
We agree to talk to each other about the child(ren)'s sleep and eating
schedule, any medications or health matters and their general condition
before exchanges.
We agree that when we are exchanging the child(ren) we shall not discuss
other issues and that we shall not fight, be sarcastic or demonstrate anger
during the exchange.
Other:
22.
Federal Taxes. (choose one)
Note: Any agreement regarding which parent has a child deduction is still subject to federal
tax law and Alaska Statutes 25.24.152 and 25.24.232
No agreements are made. Federal tax law applies.
Dad
Mom shall claim our child(ren) on their federal income taxes each
year.
We shall claim our child(ren) on our federal income taxes each year as
follows:
child:
Dad
Mom
child:
Dad
Mom
child:
Dad
Mom
child:
Dad
Mom
child:
Dad
Mom
Other:
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23.
Permanent Fund Dividend. (choose one)
Dad
Mom shall apply for the child(ren)'s Permanent Fund Dividend each
year and (1) may use half of the PFD in the best interest of the child(ren); (2)
shall place half of the PFD in an interest-bearing account; (3) shall provide the
other parent with proof of deposit of the PFD and an annual statement by
February 1 of each year; and (4) shall pay any taxes out of the child(ren)'s
account.
Dad
Mom shall apply for the child(ren)'s Permanent Fund Dividend each
year and (1) may use the money in the best interest of the child(ren) or save
it; (2) shall keep a written accounting of how the money was used; and (3)
shall pay any taxes.
Dad
Mom shall apply for the child(ren)'s Permanent Fund Dividend each
year and (1) place the money in an
interest-bearing account
investment
account; (2) shall provide the other parent with proof of deposit of the PFD
and an annual statement by February 1 each year; and (3) shall pay the taxes
from the child(ren)'s account. Withdrawals from this account may only be
made if both parents agree or by a court order.
Dad
Mom shall apply for the child(ren)'s Permanent Fund Dividend each
year and (1) shall place the money in an interest-bearing savings account that
is in the name of both parents and requires both parent's signatures for
withdrawal of funds; and (2) shall pay any taxes.
Other:
ACKNOWLEDGMENT
I acknowledge that I am signing this agreement freely and voluntarily for the purposes
stated therein.
Dad’s Signature
Mom’s Signature
Date
Acknowledged before me at
20
by
in
Date
,
, Alaska
Acknowledged before me at
20
by
in
,
, Alaska
Clerk of Court, Notary Public, or other
person authorized to administer oaths.
Clerk of Court, Notary Public, or other
person authorized to administer oaths.
My commission expires:
My commission expires:
(Seal)
(Seal)
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