251 Superior Court of Arizona in Maricopa County DRCV81f - ALL RIGHTS RESERVED Page 1 of 6 Person Filing: Address (if not protected): City, State, Zip Code: Telephone: Email Address: ATLAS Number: Representing Self, without a Lawyer or Attorney for Petitioner OR Respondent SUPERIOR COURT OF ARIZONA IN MARICOPA COUNTY Case Number: Petitioner / Party A Parent A ORDER FOR (Check one box only) LEGAL DECISION - M AKING (CUSTODY), PARENTING TIME, and CHILD SUPPORT, or LEGAL DECISION - MAKING (CUSTODY) AND PARENTING TIME (ONLY) Respondent / Party B THE COURT FINDS: 1.This case has come before this Court for a final order, and if necessary the Court has taken all testimonyneeded to enter a final Order. 2.This Court has jurisdiction over the parties under the law. 3.Where it has the legal power to do so and where it is applicable to the facts of this case, this Court hasconsidered, approved, and made an Order relating to Legal Decision-making (Legal Custody),Child Support, Parenting Time and expenses related to the birth(s) of the minor child(ren). . This order applies to the following child(ren): NAME(s) DATE(s) OF BIRTH(s) American LegalNet, Inc. www.FormsWorkFlow.com Case No. 251 Superior Court of Arizona in Maricopa County DRCV81f - ALL RIGHTS RESERVED Page 2 of 6 . PARENT INFORMATION PROGRAM A.Party A HAS attended the Parent Information Program as evidenced by the Certificate of Completion in the Court file, OR Party A HAS NOT attended the Parent Information Program and shall be denied any requested relief to enforce or modify this Order until Party A has completed the class. B. Party B HAS attended the Parent Information Program as evidenced by the Certificate of Completion in the Court file, OR Party B HAS NOT attended the Parent Information Program and shall be denied any requested relief to enforce or modify this Order until Party B has completed the class. . CHILD SUPPORT: The Court finds that Party A and Party B owe a duty to Support the child(ren)listed above. The required financial factors and any discretionary adjustment pursuant to the Arizona Worksheet for Child Support, attached hereto andincorporated by reference. . DEVIATION FROM CHILD SUPPORT. The Court, having considered the best interests of thechild(ren), deviates from the guidelines for the following reasons: Application of the guidelines is inappropriate. Application of the guidelines is unjust. The parties have signed a written agreement with knowledge of the amount of support that would have been ordered by the guidelines but for the agreement. THE COURT MAKES THE FOLLOWING FINDING REGARDING THE DEVIATION: The child support order would have been: $ The child support order after deviation is: $ All parties have signed the agreement free of duress and coercion. . PARENTING TIME ADJUSTMENT, COURT APPROVED DISCRETIONARYPARENTING TIME ADJUSTMENT AND/OR OTHER ADJUSTMENTS. (THE COURT MUST MAKE WRITTEN FINDINGS IF ANY OF THESE ADJUSTMENTS ARE MADE.) . SUPERVISED OR NO PARENTING TIME. (Check, if applicable, and explain.) Supervised parenting time or No parenting time between minor child(ren) and Party A OR Party B is in the best interests of the minor child(ren) for the following reasons: American LegalNet, Inc. www.FormsWorkFlow.com Case No. 251 Superior Court of Arizona in Maricopa County DRCV81f - ALL RIGHTS RESERVED Page 3 of 6 . DRUG or ALCOHOL CONVICTION WITHIN LAST TWELVE MONTHS: Party A or Party B has been convicted of driving under the influence of alcohol or drugs, or was convicted of any drug offense within 12 months of filing the request for legal decision-making (custody). BOTH Party A and Party B have been convicted of driving under the influence of alcohol or drugs, or was convicted of any drug offense within 12 months of filing the request for legal decision-making (custody). The legal decision-making (legal custody) and/or parenting time arrangement ordered by this Court appropriately protects the minor child(ren). If joint legal decision - making (joint legal custody) is ordered below , check A B explain. . DOMESTIC VIOLENCE. If the Court enters an order for joint authority for legal decision-making concerning the child(ren): A. There have been no significant acts of Domestic Violence under A.R.S. 247 13-3601 by either party, OR B. Domestic violence has occurred, but the domestic violence has not been or was committed by both parties. Explain why joint legal decision-making (joint legal custody) is in the best interest of the minor child(ren) even though domestic violence has occurred: THE COURT ORDERS: 1.PRIMARY RESIDENCE, PARENTING TIME, and LEGAL DECISION-MAKING(Legal Custody) A. PRIMARY RESIDENCE: NEITHER party Party A Party B American LegalNet, Inc. www.FormsWorkFlow.com Case No. 251 Superior Court of Arizona in Maricopa County DRCV81f - ALL RIGHTS RESERVED Page 4 of 6 B. PARENTING TIME: Reasonable parenting time rights as described in the Parenting Plan attached as Exhibit A and made a part of this decree, OR NO PARENTING TIME RIGHTS to Party A OR Party B, OR SUPERVISED PARENTING TIME to Party A OR Party B according to the terms of the Parenting Plan attached as Exhibit B and made part of this Decree. Parenting time may only take place in the presence of another person, named below or otherwise approved by the court. (IF supervised) Name of person to supervise (Optional): The cost of supervised parenting time shall be paid by the: Party A, Party B, OR Shared equally by the parties THE COURT FURTHER ORDERS: Restrictions on parenting time (if applicable): C. LEGAL DECISION-MAKING (LEGAL CUSTODY): 1. SOLE AUTHORITY FOR LEGAL DECISION-MAKING (SOLE LEGAL CUSTODY) over the minor children is awarded to: Party A Party B, OR 2. JOINT AUTHORITY FOR LEGAL DECISION-MAKING (JOINT LEGALCUSTODY) is awarded to Party A and Party B who agree to act as joint legal decision-makers regarding the minor child(ren), as set forth in the Joint Legal Decision-Making (LegalCustody) Agreement and Parenting Plan signed by both parties and attached to this Decreeas There having been no significant acts of Domestic Violence by eitherparty, or the Court having found it in the best interests of the minor child(ren), the Courtadopts the terms of the Joint Legal Decision-Making (Legal Custody) Agreement andParenting Plan, which is attached to and made part of this Decree. American LegalNet, Inc. www.FormsWorkFlow.com Case No. 251 Superior Court of Arizona in Maricopa County DRCV81f - ALL RIGHTS RESERVED Page 5 of 6 2.CHILD SUPPORT: The Child Support Order, , is attached hereto and incorporated by reference. (Date of Order) Party A, OR Party B shall pay child support to the other party in the amount of $ per month PAYABLE THE FIRST DAY OF THE MONTH after the date this Decree is signed by the judge until further order of the Court. All child support payments shall be made through the Support Payment Clearinghouse, PO Box 52107, Phoenix, Arizona 85072-7107 by income withholding order and must include the statutory fee for the Income Withholding Order signed this date. This Court cannot make a legal order, without personal service of the Petition for Dissolution, with respect to issues of child support, or medical, dental and vision care insurance for the minor child(ren). The court reserves jurisdiction to enter further orders at such time as the Court acquires personal jurisdiction over the responding party. 3.MEDICAL, DENTAL, VISION CARE and OTHER HEALTH EXPENSES FOR MINORCHILDREN: Party A is responsible for providing: medical dental vision care insurance. Party B is responsible for providing: medical dental vision care insurance. Medical, dental, and vision care insurance, payments and expenses are based on the information in the to and made part of this order. The party ordered to pay must keep the other party informed of the insurance company name, address and telephone number, and must give the other party the documents necessary to submit insurance claims. Non-Covered Expenses. Party A is ordered to pay %, AND Party B is ordered to pay % of all reasonable uncovered and/or uninsured medical, dental, vision care, prescription and other health care charges for the minor children, includin