Florida Supreme Court Approved Family Law Form 12.970(f), Order Granting Petition for Concurrent Custody by Extended Family (02/18) IN THE CIRCUIT COURT OF THE JUDICIAL CIRCUIT IN AND FOR COUNTY, FLORIDA Case No: Division: IN THE INTEREST OF Child(ren) , Petitioner, and , Respondent/, , Respondent/. ORDER GRANTING PETITION FOR CONCURRENT CUSTODY BY EXTENDED FAMILY This case came before this Court for a hearing on a Petition for Concurrent Custody by Extended Family. The Court, having reviewed the file and heard the testimony, makes these findings of fact and reaches these conclusions of law: SECTION I. FINDINGS: 1. The Court has jurisdiction over the subject matter and the parties. 2. The minor child(ren) at issue in this matter are: Name Date of Birth 3. The Petitioner, {full legal name} is the {extended family relationship} of the child(ren). American LegalNet, Inc. www.FormsWorkFlow.com Florida Supreme Court Approved Family Law Form 12.970(f), Order Granting Petition for Concurrent Custody by Extended Family (02/18) 4. The Petitioner currently has physical custody of the child(ren) and has had physical custody of the child(ren) for at least 10 days in any 30-day period within the last 12 months. 5. The Petitioner does not have signed, written documentation from the parent(s) which is sufficient to enable the custodian to do all the things necessary to care for the child(ren) which are available to custodians who have an order for temporary custody by extended family. 6. Parent {full legal name} of the child(ren): {Choose one only} Filed a Waiver and Consent Was served with the petition and failed to file an Answer Is deceased as evidenced by: 7. Parent {full legal name} of the child(ren): {Choose one only} Filed a Waiver and Consent Was served with the petition and failed to file an Answer Is deceased as evidenced by: 8. It is in the best interest of the child(ren) for the Petitioner to have concurrent custody. SECTION II: CONCURRENT CUSTODY 1. The Petitioner,, is granted concurrent custody of the minor child(ren). 2. The Petitioner shall have all the concurrent rights and responsibilities of a legal parent. 3. The Petitioner is authorized to make all reasonable and necessary decisions for the minor child(ren), including but not limited to: a. Consent to all necessary and reasonable medical and dental care for the child(ren), including nonemergency surgery and psychiatric care; American LegalNet, Inc. www.FormsWorkFlow.com Florida Supreme Court Approved Family Law Form 12.970(f), Order Granting Petition for Concurrent Custody by Extended Family (02/18) b. Secure copies of t third parties, that are necessary for the care of the child(ren), including, but not limited to: medical, dental, and psychiatric records; birth certificates and other records; and educational records; c. Enroll the child(ren) in school and grant or withhold consent for the child(ren) to be tested or placed in special school programs, including exceptional education; and d. Do all other things necessary for the care of the child(ren). SECTION III. CHILD SUPPORT {Insert the name or designation of the appropriate parent in the space provided} 1. The Petitioner did did not request the establishment of child support. 2. If child support is requested, the parents have received personal or substituted service of process, the petition requests an order for support of the child(ren), and there y to pay the support ordered. Parent {name or designation} and {if applicable} Parent {name or designation} has the present ability to pay child support. {Choose one only} a. The amounts in the Child Support Guidelines Worksheet, Florida Family Law Rules of Procedure Form 12.902(e) filed by Parent {name or designation} Parent {name or designation} are correct; OR b. The Court makes the following findings: Parent {name or designation} net monthly income is $, (Child Support Guidelines %). Parent {name or designation} net monthly income is $, (Child Support Guidelines %) Monthly child care costs are $. Monthly health/dental insurance costs are $. OR c.Parent {name or designation} is currently ordered to pay child support to the other parent in the amount of $ per as established in the case of (style of case and number} . American LegalNet, Inc. www.FormsWorkFlow.com Florida Supreme Court Approved Family Law Form 12.970(f), Order Granting Petition for Concurrent Custody by Extended Family (02/18) All of the child support or a portion of the child support in the amount of $ shall be redirected to the Petitioner. 3. Amount a. Parent {name or designation} Obligation Parent {name or designation} shall be obligated to pay child support at the rate of $ per month for the children minor or dependent children} commencing {month, day, year} and terminating {month, day, year}. Child support shall be paid in the amount of $ per {week, month, other} which is consistent with Parent {name or designation} current payroll cycle. amount of $ for the remaining children {total number of remaining children} shall be paid commencing {month, day, year} and terminating {month, day, year}. This child support shall be paid in the amount of $ per {week, month, other} consistent with Parent {name or designation} current payroll cycle. {Insert paragraph for the child support obligation, including the amount, and commencement and termination dates, for the remaining minor or dependent children, which shall be payable as the obligation for each child ceases.} Parent {name or designation} shall pay child support until all of the minor or dependent children: reach the age of 18, become emancipated, marry, join the armed services, die, or become self-supporting; or until further order of the court or agreement of the parties. The child support obligation shall continue beyond the age of 18 and until high school graduation for any child who is dependent in fact, between the ages of 18 and 19, and is still in high school, performing in good faith with a reasonable expectation of graduation before the age of 19. If the child support ordered deviates from the guidelines more than 5%, the factual findings which support that deviation are: . b. Parent {name or designation} Obligation Parent {name or designation} shall be obligated to pay child support at the rate of $ per month for the children minor or dependent children} commencing {month, day, year} and terminating {month, day, year}. Child support shall be paid in American LegalNet, Inc. www.FormsWorkFlow.com Florida Supreme Court Approved Family Law Form 12.970(f), Order Granting Petition for Concurrent Custody by Extended Family (02/18) the amount of $per {week, month, other} consistent with Parent {name or designation} current payroll cycle. child support in the amount of $ for the remaining children {total number of remaining children} shall be paid commencing {month, day, year} and terminating month, day, year}. This child support shall be paid in the amount of $ per {week, month, other} consistent with current payroll cycle. {Insert paragraph for the child support obligation, including the amount, and commencement and termination dates, for the remaining minor or dependent children, which shall be payable as the obligation for each child ceases.} Parent {name or designation} shall pay child support until all of the minor or dependent children: reach the age of 18; become emancipated, marry, join the armed services, die, or become self-supporting; or until further order of the court or agreement of the parties. The child support obligation shall continue beyond the age of 18 and until high school graduation for any child who is dependent in fact, between the ages of 18 and 19, and is still in high school, performing in good faith with a reasonable expectation of graduation before the age of 19. If the child support ordered deviates from the guidelines more than 5%, the factual findings which support that deviation are: . 4. Retroactive Child Support and/or Arrearages {If both parents are ordered to pay retroactive child support and/or arrearages, please include a separate paragraph for each parent.} a. Parent {name or designation} shall pay retroactive child suppor