SUPERIOR COURT OF ARIZONA IN MARICOPA COUNTY Case Number: Name of Petitioner For Clerk's Use Only TEMPORARY ORDER FOR (Check all that apply) Name of Respondent Legal Decision Making (custody) Parenting Time Child Support Spousal Maintenance/Support Property and/or Debt Attorney Fees NOTICE: This is a Court Order that affects your legal rights and responsibilities. Read Carefully. If you disagree with or you do not understand this Order, you may consult an attorney for assistance. THE COURT FINDS: 1. 2. A sworn "Motion for Temporary Orders" was filed with the court. The court read the Motion, scheduled a hearing, took testimony as appropriate, considered all relevant matters, and issues a Temporary Order. This court has jurisdiction to enter temporary orders regarding legal decision making (custody), parenting time, child support, and/or spousal maintenance, property or debt, and has jurisdiction over the parties under the law. Where it has the legal power to do so and where it is applicable to the facts of this case, this court has considered, approved, and made Orders relating to legal decision making (custody), parenting time, child support, spousal maintenance, property, and debt. This order is based on the best interests of any minor children and/or the inability of one spouse to support him or her self or to maintain this action without financial assistance from the other spouse, and because the other spouse refuses to voluntarily provide support. The relation of the party who requested these temporary orders to any children involved in this case is: Mother Father Other Relation: and if "Other", the name of that Person is: . Where ever this Order refers to "Other" or "Other Person", it refers to the individual named above. This Order applies to the children named below. Month/Date/Year of Birth 3. 4. 5. TEMPORARY CHILD SUPPORT: The court, having considered the best interests of the minor child(ren), makes the following findings regarding payment of temporary child support: In accordance with the Arizona Child Support Guidelines, and based upon the Parent's Worksheet for Child Support, the person responsible for paying child support child support should pay $______________ per month, OR ©Superior Court of Arizona in Maricopa County ALL RIGHTS RESERVED DRT82f_022513 Page 1 of 4 American LegalNet, Inc. www.FormsWorkFlow.com ORD Case No. Deviation from the Child Support Guidelines is appropriate because: Application of the Guidelines is inappropriate or unjust. The parties have signed a written agreement, free of duress and coercion, with knowledge of the amount of support that would have been ordered by the guidelines but for the agreement. The child support order would have been: $ The child support order after deviation is: $ Other Reasons for Deviation from Guideline Amount: 6. TEMPORARY SUPERVISED OR NO PARENTING TIME: (if applicable) Supervised Parenting time between the minor child(ren) and Petitioner Petitioner No Parenting time between the minor child(ren) and the best interests of the mionor child(ren) for the following reasons: Respondent or Respondent or Other, OR Other, is in THE COURT ORDERS: A. CUSTODY Temporary Joint Legal Decision Making (Custody). There having been no significant acts of domestic violence, Petitioner and Respondent are hereby awarded temporary joint legal decision making (custody) of the minor child(ren) with parenting time and physical subject to the attached Parenting Plan, OR custody Temporary Sole Legal Decision Making and Physical Custody of the minors named below is awarded as indicated below: Petitioner Respondent Other Names of Minor Children B. TEMPORARY PARENTING TIME (or for non-parent, "visitation"). Reasonable parenting time to according to the Parenting Plan attached. (OR) Reasonable visitation time to according to the Parenting Plan attached for a person other than parent. (OR) Supervised parenting time (or visitation) to but only in the presence of the person named below or other person approved by the court. (OR) Name of Supervisor: Restrictions: ©Superior Court of Arizona in Maricopa County ALL RIGHTS RESERVED DRT82f_022513 Page 2 of 4 American LegalNet, Inc. www.FormsWorkFlow.com ORD Case No. The cost of supervised parenting time shall be paid by Petitioner or Respondent or Other:_____________________________ OR No parenting time rights to Petitioner or Respondent Other parenting time/visitation as Ordered by this Court: Other C. CHILD SUPPORT. Mother shall pay child support to the Father Other party Father shall pay child support to the Mother Other party per month, payable on the first day of each month beginning in the amount of $ the first day of month following the signing of this Order until further order of the court. All child support payments shall be made by Order of Assignment signed this date, along with the statutory handling fee, through the Support Payment Clearinghouse. Any time the full amount is not withheld, the "Obligor" (the person obligated to pay) remains responsible for the full monthly amount ordered, and shall make payments payable to and mail directly to: Support Payment Clearinghouse P. O. Box 52107 Phoenix, AZ 85072-2107 Payments must include the obligor's name, Social Security Number and ATLAS number. Payments not made through the Clearinghouse shall be considered gifts unless otherwise ordered by the Court. D. MEDICAL, DENTAL, VISION CARE FOR MINOR CHILDREN Father is responsible for providing: Mother is responsible for providing: medical medical dental dental vision care insurance. vision care insurance. Medical, dental, and vision care insurance, payments and expenses are based on the information in the Parent's Worksheet for Child Support attached and incorporated by reference. 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: Father is ordered to pay ________ %, AND Mother is ordered to pay ________ % of all reasonable uncovered and/or uninsured medical, dental, vision care, prescription and other health care charges for the minor child(ren), including co-payments. E. MEDICAL AND DENTAL CARE FOR OTHER SPOUSE Petitioner is responsible for providing: Respondent is responsible for providing: medical medical dental insurance (for other spouse). dental insurance (for other spouse). All uninsured medical and dental expense