Name: ___________________________________ Address: _________________________________ City, State, ZIP: ____________________________ Daytime Telephone No: ______________________ Representing Self, Without a Lawyer ARIZONA SUPERIOR COURT, PIMA COUNTY ______________________________________ Case No. _________________ Plaintiff and JUDGMENT AND ORDER FOR PATERNITY, CHILD CUSTODY, PARENTING TIME AND SUPPORT ______________________________________ Defendant THE COURT FINDS AS FOLLOWS: 1. This case has come before this court for a final Order. The Court has taken all testimony needed to enter final orders. 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 has considered, approved, and made orders relating to child custody, support, parenting time, and expenses related to birth of the child(ren). 4. Plaintiff and Defendant are natural parents of these children: NAME DATE OF BIRTH _________________________________________ _________________________________________ 5. NAME DATE OF BIRTH _________________________________________ _________________________________________ Check and complete only if supervised or no parenting time is ordered SUPERVISED PARENTING TIME between the children and the Plaintiff Defendant OR NO PARENTING TIME by the Plaintiff Defendant is in the best interests of the children because: (explain here reasons for the requirement of supervised parenting time or no parenting time): ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ 1 paternityjudgment-judgment and order.form Revised 01.03.08 American LegalNet, Inc. www.FormsWorkflow.com THE COURT ORDERS THAT: 1. PATERNITY: _____________________________, is declared to be the natural father of the minor child(ren). 2. BIRTH CERTIFICATE: The father’s name be added to each child's birth certificate. The records of the Office of Vital Records should be amended, if necessary, to reflect this adjudication of paternity. 3. LAST NAMES: The child(ren)'s last name shall be changed to the last name of 4. CHILD CUSTODY AND PARENTING TIME: Plaintiff . Defendant have completed the Domestic Relations Education on Children’s Issues Course SOLE CUSTODY of the minor child(ren) is awarded to: parenting time as follows: Plaintiff Defendant subject to Reasonable parenting time to the parent not having custody according to the terms of the Parenting Plan attached to and made a part of this Order . Supervised parenting time between the children and Plaintiff Defendant based on finding “5" above, according to the terms of the Parenting Plan attached to and made a part of this Judgment, but such parenting time is to take place only in the presence of another person named below or otherwise approved by the court. Name of supervising person: __________________________________________________ Restrictions to parenting time: _________________________________________________________________________ _________________________________________________________________________ The cost of supervised parenting time shall be paid by: Plaintiff Defendant shared equally by the parties. No parenting time rights to Plaintiff Defendant based on finding “5” above. OR: JOINT CUSTODY - Plaintiff and Defendant agree to act as joint custodians of the children, pursuant to A.R.S. § 25-403, as set forth in the Parenting Plan, signed by both parties and attached to and incorporated in this document as Part B, and made a part of this order. There have been no significant acts of domestic violence under A.R.S.§ 13-3601 by either parent. The court adopts the agreed terms of the Parenting Plan describing the custody and parenting time agreement between the parties. By attaching the Parenting Plan to this Order, the Parenting Plan becomes part of the final Order and carries the same legal weight as any other order of this court. 5. CHILD SUPPORT: Plaintiff Defendant shall pay child support to Plaintiff Defendant in the amount of $_____________ per month, beginning _________ 20__ , according to the Child Support Order signed by the court on ________ 20__. All child support payments shall be made through The Support Payment Clearinghouse. This support obligation shall end when a child reaches age 18, OR if still attending high school or a certified high school equivalency program, support shall continue to be provided while the child is actually attending high school or the equivalency program but only until the child reaches age 19, OR is otherwise emancipated, OR at his or her death. 2 paternityjudgment-judgment and order.form Revised 01.03.08 American LegalNet, Inc. www.FormsWorkflow.com Further, that costs for past child support and care for child(ren) in the amount of $_____________ shall be paid by Plaintiff Defendant in the amount of $ _________ each month until paid in full. Payments shall be made as stated above. 6. EXPENSES OF MOTHER: Plaintiff Defendant shall pay $ to Plaintiff Defendant to cover unreimbursed expenses incurred by the mother related to the birth of each child. 7. MEDICAL AND DENTAL INSURANCE, PAYMENTS, AND EXPENSES: Plaintiff Defendant is ordered to provide medical, dental insurance for the minor child(ren). Payment shall be according to the Child Support Order. The party ordered to pay shall keep other party informed of the insurance company name, address, and telephone number, and provide other party with documents necessary to submit insurance claims. Plaintiff is ordered to pay _______ % and Defendant is ordered to pay ________ % of all reasonable uncovered and/or uninsured medical, dental, prescription, and other health care charges for the minor child(ren), including co-payments. Costs for past medical expenses for child(ren) in the amount of $_____________ shall be paid by Plaintiff Defendant in the amount of $ _________ each month until paid in full. Payments shall be made as stated above. 8. FINANCIAL INFORMATION EXCHANGES: The parties shall exchange financial information (tax returns, spousal affidavits, earning statements and/or other related financial statements) every twenty-four months. 9. TAX EXEMPTION: The parties shall claim as income tax dependency exemptions on federal and state income tax returns as follows: Parent entitled to claim child Plaintiff Defendant Plaintiff Defendant Plaintiff Defendant Plaintiff Defendant 10. Name of child Current tax year Later tax years __________________________ __________________________ __________________________ __________________________ _______________ _______________ _______________ _______________ ______________ ______________ ______________ ______________ TESTING and COSTS: Plaintiff Defendant must pay all costs and expenses of this lawsuit under Arizona law, A.R.S. § 25-809, including the costs of blood tests or other genetic testing; filing each child’s birth certificate; attorney’s fees and court costs. 11. LIMITATION ON JURISDICTION: This court cannot make a legal order, without personal service on Defendant, with respect to issues of child support, medical and dental insurance, payments, expenses for the minor children or costs relating to birth of the child. 3 paternityjudgment-judgment and order.form Revised 01.03.08 American LegalNet, Inc. www.FormsWorkflow.com 12. OTHER ORDERS: The court further orders that: ____________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ________________________________________________________________________________ DATED_____________________ ______________________________________ Judge/Commissioner of the Superior Court 4 paternityjudgment-judgment and order.form Revised 01.03.08 American LegalNet, Inc. www.FormsWorkflow.com