District Court Denver Juvenile Court ___________________________ County, Colorado Court Address: In re: The Marriage of: Parental Responsibilities concerning: ______________________________________________________ Petitioner: COURT USE ONLY Case Number: and Co-Petitioner/Respondent: Division Courtroom ORDER APPOINTING DECISION-MAKER PURSUANT TO §14-10-128.3, C.R.S. This matter is before the Court on the parties’ Stipulation Regarding Appointment of Decision-Maker pursuant to §14-10-128.3, C.R.S. Finding in the best interests of the child(ren), the Court hereby appoints as Decision-Maker (DM): Name: ____________________________________________________________________________________ Mailing Address: _____________________________________________________________________________ Telephone #: ___________________ Fax #: ____________________ Email: _____________________________ Information about the child(ren): Full Name of Child Date of Birth Information about the Petitioner: Date of Birth: ___________________________ Name: ___________________________________________ Attorney: _______________________________ Mailing Address: ____________________________________________________________________________ City & Zip: _______________________________________________________ Home Phone #: ___________________ Work Phone #: __________________ Cell #: _____________________ Information about the Co-Petitioner/Respondent: Date of Birth: ___________________________ Name: ___________________________________________ Attorney: _______________________________ Mailing Address: ____________________________________________________________________________ City & Zip: _______________________________________________________ Home Phone #: ___________________ Work Phone #: __________________ Cell #: _____________________ Responsibilities of the Decision-Maker: 1. The DM shall comply with the requirements of §14-10-128.3, C.R.S., and any other applicable statutes or Chief Justice Directive(s), and any other practice or ethical standards established by rule, statute, or licensing board that regulates the Decision-Maker. You are required within seven days of your appointment, to disclose to each party, attorneys of record, and the court any familial, financial, or social relationship that the appointed person has or has had with the child, either party, the attorneys of record, or the judicial Officer. (JDF1338) JDF1327 R7-12 ORDER APPOINTING DECISION-MAKER PURSUANT TO §14-10-128.3, C.R.S. © 2012 Colorado Judicial Department for use in the Courts of Colorado Page 1 of 3 American LegalNet, Inc. www.FormsWorkFlow.com 2. The DM has binding authority to resolve disputes between the parties as to the implementation or clarification of existing orders concerning:  Parenting Time  Child support  Specific disputed parental decisions as described below: ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ as set forth in:  Temporary Order entered by the Court on _________________________ (date).  Permanent Order entered by the Court on _________________________ (date).  Post Decree Order entered by the Court on _________________________ (date).  Other _______________________________________________________________________________ 3. The DM’s decisions must be consistent with the substantive intent of the existing court order. 4. The DM’s procedures for making determinations shall be in writing and shall be approved by the parties prior to the time the DM begins to resolve a dispute of the parties. 5. Decisions of the DM shall be filed by the DM with the Court and mailed to the parties or to counsel for the parties, if any, no later than 21 days after the date the decision is issued. All decisions shall be effective immediately upon issuance and shall continue in effect until vacated, corrected, or modified by the DM or Court order. Responsibilities of the Parties: 1. Each party, or their counsel, shall initiate contact with the DM within ______ days from the date of this Order. Each party and counsel shall confer with the DM when and as the DM directs, and shall otherwise cooperate fully with the DM. 2. Counsel for ____________________ or the pro se party ______________________shall provide the DM with all court orders, and all documentation currently in the court file related to the issues before the DM. 3. The parties or their counsel are responsible for providing information concerning other cases which have a relationship to this case when requested to do so by the DM. Release of Confidential Information: The parties shall sign any releases necessary to assist the DM; and the DM may request the Court to issue any other necessary order for release of information. Immunity: The DM is granted quasi-judicial immunity while acting within the course and scope of his/her appointment. Termination of the Decision-Maker’s Appointment: 1. This appointment shall terminate on __________________________ (date). The Court shall maintain the discretion to terminate this appointment at any time for good cause. 2. Upon agreement of the parties, the Court may extend, modify, or terminate the appointment. The Court shall allow the DM to withdraw at any time. JDF1327 R7-12 ORDER APPOINTING DECISION-MAKER PURSUANT TO §14-10-128.3, C.R.S. © 2012 Colorado Judicial Department for use in the Courts of Colorado Page 2 of 3 American LegalNet, Inc. www.FormsWorkFlow.com Payment of Costs and Fees in Favor of the Decision-Maker: The Court hereby finds that the fees of the DM, plus mileage and costs are reasonable and necessary. Any objection to these fees and costs shall be made in writing and filed with the Court within 14 days of the date of this Order. The DM’s fees are in the nature of child support as the role of the DM is to work with the parties on parenting issues and/or child support issues that affect or may affect the best interests of the child(ren). After considering the financial resources and/or other equitable circumstances of the parties, the Court apportions the payment of the retainer, fees, and costs as follows: 1. The DM’s hourly rate is $____________ and he/she requires $_____________ for the initial retainer.  The Petitioner will pay the DM directly the amount of $__________ or ______ % to be applied toward the initial retainer on or before ___________________ (date).  The Co-Petitioner/Respondent will pay the DM directly the amount of $__________ or ______ % to be applied toward the retainer on or before ______________________ (date). 2. Thereafter, the DM shall bill his/her hourly rate of $__________ against the initial retainer, and fees and costs in excess shall remain apportioned as set forth above and shall be paid within 30 days of the date billed, unless otherwise ordered by the Court or agreed between the parties. The Court maintains the discretion to reallocate the appointment of fees. The Decision-Maker shall not commence work until the retainer is satisfied in full and the Decision-Maker shall apprise the Court within 14 days of his/her inability to proceed with the case because of nonpayment. Upon notification to the Court, the Court may set a forthwith hearing which will require the mandatory appearance of the non-paying party. Failure of either party to comply with this Order will result in sanction by the Court which may include up to six months in the County Jail or a $1,000.00 fine. Date: ________________________________ ______________________________________ Judge Magistrate CERTIFICATE OF SERVICE I certify that on __________________ (date), I mailed, faxed, e-filed, or hand-delivered a copy of this Order to the following:     Attorney for Petitioner or Petitioner pro se Attorney for Co-Petitioner/Respondent or Co-Petitioner/Respondent pro se Decision-Maker Other_______________________________ _____________________________________ Clerk JDF1327 R7-12 ORDER APPOINTING DECISION-MAKER PURSUANT TO §14-10-128.3, C.R.S. © 2012 Colorado Judicial Department for use in the Courts of Colorado Page 3 of 3 American LegalNet, Inc. www.FormsWorkFlow.com