ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, address and telephone #): FOR COURT USE ONLY STATE BAR NO: ATTORNEY FOR (Name): MARIN COUNTY SUPERIOR COURT 3501 Civic Center Drive P.O. Box 4988 San Rafael, CA 94913-4988 PETITIONER: RESPONDENT: STATEMENT OF AGREEMENT/DISAGREEMENT WITH FAMILY COURT SERVICES RECOMMENDATIONS CASE NUMBER: Petitioner's Respondent's TIME: __________ AM / PM COURTROOM: _________ HEARING DATE: ______/______/______ THIS FORM MUST BE SERVED ON THE OPPOSING PARTY AND/OR HIS/HER ATTORNEY OF RECORD WHEN IT IS FILED WITH THE COURT. 1. Custody, Visitation and Timeshare We have an agreement regarding legal custody, visitation and timeshare. My understanding of the agreement is set forth in the attachment. We do not have an agreement regarding legal custody, visitation and timeshare. My position regarding these issues is set forth in item 3 below. 2. Resolution of issues in dispute. I would like: 3. a settlement conference. a private child custody evaluation. to attend private child custody mediation. an evidentiary hearing. I disagree with Family Court Services recommendations for the following reasons: FL027 (Rev. 10/1/13) STATEMENT OF AGREEMENT/DISAGREEMENT WITH FAMILY COURT SERVICES RECOMMENDATIONS Page 1 of 2 American LegalNet, Inc. www.FormsWorkFlow.com 3. continued: DATE SIGNATURE ATTORNEY FOR PETITIONER RESPONDENT OTHER FL027 (Rev. 10/1/13) STATEMENT OF AGREEMENT/DISAGREEMENT WITH FAMILY COURT SERVICES RECOMMENDATIONS Page 2 of 2 American LegalNet, Inc. www.FormsWorkFlow.com