Name: Mailing Address: Daytime Telephone: Representing Self, without a Lawyer IN THE SUPERIOR COURT OF ARIZONA, YAVAPAI COUNTY ) ) ) ) ) ) ) ) ) ) Petitioner Respondent DO ORDER OF [ ] Child Custody [ ] Parenting Time THE COURT FINDS: 1. This case has come before this Court for an Order of Custody and/or Parenting Time. The Court [ ] has taken all testimony needed to enter an Order, or [ ] has determined testimony is not needed to enter the Order. 2. This Court has jurisdiction over the parties under the law, and the provisions of this Order are fair and reasonable under the circumstances and are in the best interest of the minor child(ren) because . 3. The following minor children are the subject(s) of this Order. NAME OF CHILD 4. Date of Birth Child Support: (Select any that apply.) [ ] Child Support has been determined in accordance with the Arizona Child Support Guidelines, OR [ ] Application of the Arizona Child Support Guidelines in this case is inappropriate or unjust. The Court has considered the best interests of Superior Court of Arizona in Yavapai County January 2006 Page 1 of 5 American LegalNet, Inc. www.FormsWorkflow.com the child(ren) in determining that a deviation is appropriate and makes the following findings: [ ] The Court finds the Guidelines amount is inappropriate or unjust because: [ ] Attached written agreement incorporated AND [ ] All parties signed the agreement free of duress and coercion. [ ] Other The court makes the following findings regarding the deviation: The child support order would have been $ The child support order after deviation is $ [ ] Ability to Pay. The Court finds that the person responsible for paying child support has the ability to pay child support: [ ] In the amount entered on Line 35 of the Worksheet of $ OR [ ] In an adjusted amount calculated using the self-support reserve on the Parent's Worksheet for Child Support Amount of $ 8. Custody of the Minor Child(ren) [ ] If custody is awarded and A.R.S. 25-403.04 - 25-403.09 applies, this Court makes the following findings [ ] If sole custody is awarded, this Court makes the following findings [ ] Joint Custody. If joint custody is awarded the Court makes the following findings if applicable and as required under Arizona law: [ ] The custody order or agreement is in the best interests of the child(ren) for the following reasons DOMESTIC VIOLENCE [ ] Domestic violence has not occurred during this relationship, OR [ ] Domestic violence has not been significant. However, domestic violence has occurred as described in the Petition for Order of Protection(s) filed or as follows Superior Court of Arizona in Yavapai County January 2006 Page 2 of 5 American LegalNet, Inc. www.FormsWorkflow.com below [ ] Joint custody is in the best interest(s) of the child(ren) even though domestic violence has occurred because: Furthermore, the [ ] Petitioner AND/OR [ ] Respondent has/have taken classes, participated in counseling or taken steps to avoid further domestic violence as described here [ ] 9. Physical Custody Adjustment or other Adjustments Parenting Time: [ ] [ ] No parenting time by [ ] Petitioner OR of the child(ren) because [ ] 10. Supervised parenting time between the children and [ ] Petitioner OR [ ] Respondent is in the best interests of the child(ren) because Court Approved Discretionary Parenting Time Adjustment or other Adjustments [ ] Respondent is in the best interests Other THEREFORE, IT IS ORDERED: 1. 2. [ ] Temporary Orders entered (date) [ ] Terminated on (date) [ ] Extended until (date) are: for good cause [ ] CUSTODY OF THE MINOR CHILD(REN) SHALL BE AS FOLLOWS: [ ] SOLE CUSTODY: Sole custody of the minor child(ren) is awarded to: [ ] Petitioner OR [ ] Respondent OR [ ] Applicant subject to parenting time for the noncustodial person(s) as follows: Superior Court of Arizona in Yavapai County January 2006 Page 3 of 5 American LegalNet, Inc. www.FormsWorkflow.com [ ] according to the terms of the Parenting Plan attached made a part of this Order; [ ] pursuant to Yavapai County Child Access Guidelines; [ ] Supervised parenting time to [ ] Petitioner OR [ ] Respondent according to the terms of the Parenting Plan attached or as ordered by this Court. Parenting time may only take place in the presence of another person, named below or otherwise approved by the court. Name of supervisor: Restrictions on parenting time: The cost of supervised parenting time will be paid by [ ] Petitioner OR [ ] Respondent OR [ ] shared equally by the parties. [ ] [ ] No parenting time rights to [ ] Petitioner AND/OR [ ] Respondent. JOINT CUSTODY: Petitioner and Respondent agree to act as joint custodians of the children, as set forth in the Joint Custody Agreement/Parenting Plan signed by both parties and attached to this Order. There have been no significant acts of domestic violence by either parent. The Court adopts the terms of the Joint Custody Agreement/Parenting Plan describing the custody and parenting time agreement between the parties. By attaching the Joint Custody Agreement/Parenting Plan to the Order, the Agreement becomes part of the Order and carries the same legal weight as the Order. [ ] 3. Court Approved Discretionary Parenting Time Adjustment or other Adjustments PARENTING TIME. Awarded to [ ] Petitioner AND/OR [ ] Respondent AND/OR [ ] Applicant as follows: [ ] according to the terms of the Parenting Plan attached and made a part of this Order; [ ] pursuant to Yavapai County Child Access Guidelines; [ ] Supervised parenting time to [ ] Petitioner OR [ ] Respondent according to the terms of the Parenting Plan attached or as ordered by this Court. Parenting time may only take place in the presence of another person, named below or otherwise approved by the court. Name of supervisor: Restrictions on parenting time: The cost of supervised parenting time will be paid by [ ] Petitioner OR [ ] Superior Court of Arizona in Yavapai County January 2006 Page 4 of 5 American LegalNet, Inc. www.FormsWorkflow.com Respondent OR [ ] shared equally by the parties. [ ] 4. [ ] No parenting time rights to [ ] Petitioner AND/OR [ ] Respondent. CHILD SUPPORT: [ ] Petitioner OR [ ] Respondent shall pay child support to the other party in the amount of $ per month, beginning (date) following the date this Order is signed by the judge until further order of the court. Child support is based on the information in the Parent's Worksheet for Child Support Amount attached hereto and incorporated by reference. All child support payments shall be made by wage assignment (if applicable) through the Support Payment Clearinghouse and must include the statutory handling fee by the Order of Assignment . Payments will be made through an automatic wage assignment. Payments will be made in equal installments made on the 1st and 15th of each month. The support obligation will end for each child when that child reaches age 18, OR if that child is still attending high school until graduation or until the end of high school attendance, OR the child is otherwise emancipated, OR the child's death. 6. ATTACHED EXHIBITS/AGREEMENTS: The following Exhibits are attached hereto and made a part hereof: [ ] Custody and/or Parenting Plan/Agreement [ ] Other: [ ] None 7. Other DONE IN OPEN COURT this date , 20 . JUDGE/JUDGE PRO TEM OF THE SUPERIOR COURT Superior Court of Arizona in Yavapai County January 2006 Page 5 of 5 American LegalNet, Inc. www.FormsWorkflow.com