Name: ___________________________________ Address: _________________________________ City, State, ZIP: ____________________________ Daytime Telephone No: ______________________ Representing Self, Without a Lawyer ARIZONA SUPERIOR COURT, PIMA COUNTY ______________________________________ Petitioner and Case No. _________________ ______________________________________ Respondent PROPOSED RESOLUTION STATEMENT OF: [ ] HUSBAND [ ] WIFE Date of Marriage: ____________________ The undersigned party provides the following positions on each of the issues in this case. 1. IV-D Case: [] I receive or have received public assistance which may include AFDC, TANF, or AHCCCS for my child(ren) or me. [] I have a case with the Division of Child Support Enforcement. Custody: The parties have the following natural or adopted child(ren) in common. (If there are no minor or disabled child(ren) common to the parties, skip to paragraph 3) Child(ren)'s Name(s) _____________________________________ _____________________________________ _____________________________________ _____________________________________ Date(s) of Birth _______________________ _______________________ _______________________ _______________________ Age(s) ______________________ ______________________ ______________________ ______________________ 2. The child(ren) should live primarily with [ ]Mother [ ]Father and have parenting time with [ ]Mother [ ] Father as follows (check all that apply): [ ] Generally in accordance with _______________ County Guildelines for reasonable parenting time. [ ] Model Parenting Time Plans (describe plan) _________________________________________________ [ } Every other weekend from ________________ at _____ a.m./p.m. to _______________ at ____a.m./p.m. [ ] One-half of the holidays on an alternating basis. [ ] For ______ weeks in the summer from ______________________ to ____________________(inclusive). [ ] Spring Break from school. [ ] Other: _______________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ [ ] Mother [ ] Father should have sole legal custody OR [ ] Mother and Father should have joint legal custody. 1 to-resolution.form Revised 02.24.12 American LegalNet, Inc. www.FormsWorkFlow.com 3. Child Support: (If there are no minor or disabled children common to the parties and were no minor or disabled children from the date the parties separated, skip to paragraph 5.) The financial factors necessary to calculate child support under the Arizona Child Support Guidelines are as follows (complete in full): Father's gross monthly income: $__________ Mother's gross monthly income: $__________ [ ] Father has _____ other child(ren) not listed above whom he is supporting who live(s) in his household. [ ] Father has _____ other child(ren) not listed above for whom he pays court-ordered child support in the amount of $___________ per month. [ ] Mother has _____ other child(ren) not listed above whom he is supporting who live(s) in his household. [ ] Mother has _____ other child(ren) not listed above for whom he pays court-ordered child support in the amount of $___________ per month. [ ] Medical insurance should be paid by [ } Mother { ] Father. Monthly cost for the child(ren) in this case is $__________. [ ] Dental insurance should be paid by [ } Mother { ] Father. Monthly cost for the child(ren) in this case is $__________. [ ] Vision insurance should be paid by [ } Mother { ] Father. Monthly cost for the child(ren) in this case is $__________. [ ] Monthly child care costs for _____ child(ren) in this case are $______________. [ ] Extra education expenses or extraordinary child adjustments ­ I believe the court should add the following to the child support calculation (leave blank if none claimed): Description of expense: Monthly amount: ________________________________________________________________ $_____________ ________________________________________________________________ $_____________ [ } Uninsured medical/dental/vision expenses should be paid: [ } Pro rata based upon each party's income, as provided in the guidelines; or [ ] Other: _________% paid by Father and _________% paid by Mother. [ ] Tax exemptions for the child(ren) should be divided: [ ] Pro rata bases upon each party's income, as provided in the guidelines; or [ ] Other: _____________________________________________________________________________ 4. Past support should be paid by [ ] Mother [ ] Father for the period of __________________________ through _______________________________ in the amount of $___________________. Spousal maintenance: My position on spousal maintenance is: [ ] No spousal maintenance need be paid by either me or my spouse. [ ] I should pay my spouse $_______________ per month for _______ months. [ ] I should receive from my spouse $_______________ per month for _______ months. Separate property: I believe the following property is my sole and separate property (describe): ________________________________________________________________________________________ ________________________________________________________________________________________ Community liens on separate property: I believe I have a community interest in the following sole and separate property of my spouse: ________________________________________________________________________________________ ________________________________________________________________________________________ Community property: I want to divide all of the community property (except tangible personal property) as follows: Directions: Column 1: List short description of each item or real and personal property. Column 2: List you estimate of the fair market value of each item of property. List the loan or encumbrance amount(s) on the line directly below its value. Column 3: List the amount of net value of each item you propose for Husband. 2 to-resolution.form Revised 02.24.12 American LegalNet, Inc. www.FormsWorkFlow.com 5. 6. 7. 8. Column 4: List the amount of net value of each items you propose for Wife. 1. Description 2. Fair Market Value 3. Proposed for (minus encumbrances) Husband Real Property $ $ 4. Proposed for Wife $ Personal Property (e.g. stocks, bonds, life insurance, etc.) IRAs, 401(k)s, Pensions (including survivor benefits) Vehicle(s) Boat(s) 9. Tangible p