JDF 1109 R 2 /1 9 TEMPORARY ORDERS AGREEMENT OR INFORMATION FOR THE COURT Page 1 of 4 District Court County, Colorado Court Address: In re: The Marriage of: The Civil Union of: Parental Responsibilities concerning: Petitioner: and Respondent/Co - Petitioner: COURT USE ONLY Attorney or Party Without Attorney (Name and Address): Phone Number: E - mail: FAX Number: Atty. Reg. #: Case Number: Division Courtroom TEMPORARY ORDERS AGREEMENT OR INFORMATION FOR THE COURT The Petitioner Respondent/Co - Petitioner or both state the following: Petitioner: Date of Birth: Social Security Number: Mailing Address: Residential Address: Phone Numbers: Home: Work: Cell: Respondent/Co - Pe titioner: Date of Birth: Social Security Number: Mailing Address: Residential Address: Phone Numbers: Home: Work: Cell: 1. The names(s), address(es), birth date(s) and social security numbers of the minor child(ren) is/are: Name Present Address Sex Date of Birth Soc. Sec. N o. 2. Allocation of temporary parental responsibilities (decision - making and parenting time). A. Decision - making should be as follows. Select only one of the 3 following options. 1. The Petitioner Respondent/Co - Petitioner (check one) will make all of the major decisions regarding the child(ren). 2. Both parties will make ALL major decisions regarding the child(ren) together. American LegalNet, Inc. www.FormsWorkFlow.com JDF 1109 R 2 /1 9 TEMPORARY ORDERS AGREEMENT OR INFORMATION FOR THE COURT Page 2 of 4 3. The parties will divide decision - making as set forth in the attached Parenting Plan or as identified below: Education issues shall be determined by Petitioner Respondent/Co - Petitioner Both Medical, dental and mental health issues shall be determined by Petitioner Respondent/Co - Petitioner Both Reli gious issues shall be determined by Petitioner Respondent/Co - Petitioner Both Extracurricular and recreational issues shall be determined by Petitioner Respondent/Co - Petitioner Both Other significant decisions (General Welfare, Driving, Car, Car Ins urance, College, etc.) shall be determined by Petitioner Respondent/Co - Petitioner Both B. Parenting time (visitation) should be (check all that apply): 1. As set forth in the attached Parenting Plan or select either 2, 3, or 4. 2. Petitioner every from to 3. Respondent/Co - Petitioner every from to 4. Other (include holidays, birthdays, special occa sions): 3. Child Support (A Child Support Obligation Worksheet must be filed.) Both parties agree on this issue. (If you agree, please indicate the terms of agreement below.) The Petitioner Respondent/Co - Petitioner shall pay child support to the Petitioner Respondent/Co - Petitioner (check one) in the sum of $ per month pursuant to the Colorado Child Support Guidelines, beginning on (date). Child support payments will be paid to: (check one) Family Support Registry P. O. Box 2171, Denver, CO 80201 - 2171. The Parties request that the Court order the payment to be made directly to the appropriate person. Child support pa yments will be paid as follows: Monthly Bi - weekly Weekly Other The parties do not agree on this issue. 4. Information on any prior child(ren), spousal/partner abuse allegations or protection/restraining order s: 5. Temporary maintenance ( spousal/partner support ) shall be paid by Petitioner Respondent/Co - Petitioner in the amount of $ per month, commencing on (date). American LegalNet, Inc. www.FormsWorkFlow.com JDF 1109 R 2 /1 9 TEMPORARY ORDERS AGREEMENT OR INFORMATION FOR THE COURT Page 3 of 4 6. A. The following debts shall be temporarily paid by the Petitioner: Creditor/Debt Account Number To by Paid by B. The following debts shall be temporary paid by the Co - Petitioner/Respondent: Creditor/Debt Account Number To by Paid by C. Each party shall provide proof to the other party of the above - stated payments made within days of payment date. 7. Property you need use of (home, car, business property, tools, etc.): Both parties agree on this issue. (If you agree, please indicate the terms of agreement below.) The parties do not agree on this issue. Petitioner: Respondent/C o - Petitioner: Property that needs immediate protection: 8. Other issues: American LegalNet, Inc. www.FormsWorkFlow.com JDF 1109 R 2 /1 9 TEMPORARY ORDERS AGREEMENT OR INFORMATION FOR THE COURT Page 4 of 4 I We believe this would be a fair and equitable division of our property and debts on a temporary basis and that the temporary allocation of parental responsibi lities is in the best interest of the child(ren). (Both parties must sign if this is an agreement.) I We have attached the required financial affidavits. I We have attached the required child support worksheets (A or B). By checking this box, I am acknowledging I am filling in the blanks and not changing anything else on the form. By checking this box, I am acknowledging that I have made a change to the original content of this form. SIGNATURE (printed name Petitioner) (printed name Co - Petitioner /Respondent ) Petitioner Signature Date Co - Petit ioner /Respondent Signature Date Co - IF ONLY ONE PARTY SIGNS THE TEMPORARY ORDERS AGREEMENT OR INFORMATION FOR THE COURT, COMPLETE TH E CERTIFICATE OF SERVICE BELOW. CERTIFICATE OF SERVICE I certify that on (date), a true and accurate copy of the TEMPORARY ORDERS AGREEMENT OR INFORMATION FOR THE COURT was served on the other party by: Hand Delivery, E - filed , Faxed to this number: , or By placing it in the United States mail, postage pre - paid, and addressed to the following: To: Your signature American LegalNet, Inc. www.FormsWorkFlow.com