251 Superior Court of Arizona in Maricopa County DRMC83f-01019 ALL RIGHTS RESERVED Page 1 of 4 Person Filing: (A) 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 No . Petitioner/Party A, (in original case) ATLAS No. and OR DER MODIFYING LEGAL DECISION - MAKING (LEGAL CUSTODY), PARENTING TIME and CHILD SUPPORT D E R M O D I F Y I N G L E G A L D E C I S I O N - M A K I N G ( Respondent/Party B (in original case) THE COURT FINDS: 1.This case has come before this Court to Change Legal Decision-Making (Legal Custody), Parenting Timeand Child Support. The Court has taken all testimony needed to enter a final Order. 2.This Court has jurisdiction to modify legal decision-making, parenting time, and support, and has jurisdictionover the parties under the law. Where it has the legal power to do so and where it is applicable to the factsof this case, this Court has considered, approved, and made Orders relating to legal decision-making,parenting time and support. 3.This Order applies to these minor child(ren): Name(s) of Child(ren) Date(s) of Birth(s) (Month/Day/Yr) 4.GROUNDS FOR CHANGING LEGAL DECISION-MAKING (LEGAL CUSTODY). (Checkone box and describe why the change is in the best interest of the minor child(ren).) The Order being changed was for joint or sole legal decision-making. At least one year has passed since the earlier joint or sole legal decision-making order was entered. There have been substantial, significant and continuing changes in circumstances that make a change in legal decision-making, parenting time and child support in the best interest of the minor child(ren) for the reasons described below: OR American LegalNet, Inc. www.FormsWorkFlow.com Case No. 251 Superior Court of Arizona in Maricopa County DRMC83f-010119 ALL RIGHTS RESERVED Page 2 of 4 The Order being changed was for joint legal decision-making. At least six months have passed since the Order was entered. One parent has not followed the Order and a change in legal decision-making, parenting time and child support is in the best interest of the minor child(ren) for the reasons described below. OR There has been domestic violence, spousal abuse, or child abuse as described below since the date of the earlier Order, and it is in the best interest of the minor child(ren) that the change is made for the reasons described below: (Include a description of the domestic violence.) OR Less than one year has passed since the Order was entered. The minor child(ren)'s current environment may seriously endanger the child(ren)'s physical, mental, moral or emotional health, the minor child(ren) is/are at risk under the current Order and it is in the best interest of the minor child(ren) that legal decision-making is changed for the reasons described below: (Include a description of the danger and risk here.) OR It is in the best interest of the minor child(ren) that no change to legal decision-making is made at this time for the reasons described below. REASONS: (Describe why the legal decision-making determination is in the best interest of the minor child(ren).) 5. SUPERVISED OR NO PARENTING TIME -: (if applicable) Supervised parenting time between the minor child(ren) and Party A or Party B, or No parenting time by Party A or Party B is in the best interests of the minor child(ren) for the following reasons: THE COURT ORDERS: The Order regarding legal decision-making, parenting time, and support dated is changed as follows: A. PARENTING TIME: Award parenting time as follows: Reasonable parenting time rights as described in the Parenting Plan, OR Supervised parenting time between the children and Party A OR Party B, OR American LegalNet, Inc. www.FormsWorkFlow.com Case No. 251 Superior Court of Arizona in Maricopa County DRMC83f-010119 ALL RIGHTS RESERVED Page 3 of 4 No parenting time rights to the Party A OR Party B Supervised or no parenting time is in the best interests of the child(ren) because: Explanation continues on attached pages made part of this document by reference. 1. Name this person to supervise: 2. Order cost of supervised parenting time (if applicable) to be paid by: Party A Party B Shared equally by the parties 3. Additionally restrict parenting time as follows: (Explain.) B. LEGAL DECISION-MAKING (legal custody): Award legal decision-making concerning the child(ren) as follows: AWARD SOLE LEGAL DECISION-MAKING (sole legal custody) to: Party A Party B OR AWARD JOINT LEGAL DECISION MAKING (joint legal custody) to BOTH PARENTS. Party A and Party B will agree to act as joint legal decision-makers concerning the minor child(ren) and will submit a Parenting Plan and Joint Legal Decision-Making -making, Arizona law, A.R.S. 247 25-403.03). C. CHILD SUPPORT. Party A or Party B shall pay child support to the other party in the amount of $ per month payable on the first day of each month, beginning the first day of month following the signing of this Order. Child Support is based on the information in the attached hereto and incorporated by reference. All child support payments shall be made through the Support Payment Clearinghouse, plus an applicable statutory fee by the attached . CHILD SUPPORT DEVIATION. The Court, having considered the best interests of the minor child(ren), deviates from the guidelines for the following reasons.: American LegalNet, Inc. www.FormsWorkFlow.com Case No. 251 Superior Court of Arizona in Maricopa County DRMC83f-010119 ALL RIGHTS RESERVED Page 4 of 4 D. MEDICAL, DENTAL, VISION CARE Party A shall provide: medical dental vision care insurance. Party B shall provide: medical dental vision care insurance. The costs of medical/dental/vision care expenses not paid by insurance shall be shared as follows: Party A % Party B %. Request for payment or reimbursement must be provided to the obligated parent(s) within 180 days after the services occurred. The obligated parent must pay or make payment arrangements within 45 days after receipt of the request. Medical, dental, and vision care insurance, payments and expenses are based on the information in the 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. E . TAX EXEMPTION: A parent required to pay child support is only entitled to claim minor child(ren ) as dependent for Federal Income Tax purposes if that parent has paid all of the child support due and owing for the year that party is entitled to the exemption. Beginning Tax Year: , the right to claim the minor child(ren) as a deduction for Federal A Party A B Party B . Parent entitled to claim: Name of Child Schedule A B Every Year Every Other A B Every Year Every Other A B Every Year Every Other A B Every Year Every Other F. OTHER ORDERS. This Court makes further Orders relating to this matter as follows: G. FINAL APPEALABLE ORDER. Pursuant to Arizona Rules of Family Law Procedure, Rule 78, this final judgment/decree is settled, approved and signed by the Court and shall be entered by the Clerk of Superior Court. H . DONE IN OPEN COURT : . JUDGE OR COURT COMMISSIONER American LegalNet, Inc. www.FormsWorkFlow.com