STATE OF HAWAI`I FAMILY COURT FIRST CIRCUIT STATE OF HAWAI`I, (Name: First, Middle, Last) CASE NUMBER PROPOSED PARENTING PLAN FCThis document was prepared by: No. ~ CHILD SUPPORT ENFORCEMENT AGENCY, ~ Plaintiff vs. ~ Plaintiff/Petitioner ~ Defendant/Respondent ~ Caretaker/Other* ~ Attorney for: ~ Plaintiff/Petition ~ Defendant/Respondent Name ~ Defendant PLAINTIFF(S)/PETITIONER(S), Address (Name: First, Middle, Last) ~ Plaintiff ~ Plaintiff ~ Defendant City, State, Zip Code (Name: First, Middle, Last) ~ Defendant Telephone Number ~ and CHILD SUPPORT ENFORCEMENT AGENCY, STATE OF HAWAI`I, DEFENDANT(S)/RESPONDENT(S) *Relationship of Caretaker/Other to the child(ren): I will be relocating to on or about [If you are relocating, file one plan for before relocation and another plan for after relocation. ] ~ This plan is before relocation ~ This plan is for after relocation. 1. Child(ren): Child 1 Child 2 Child 3 Child 4 Child 5 Child 6 . ~ See attached sheet for additional children. Full Name Birth Date Gender School/Grade Is Child Protective Services Involved? ~M ~M ~M ~M ~M ~M ~F ~F ~F ~F ~F ~F ~ Yes ~ Yes ~ Yes ~ Yes ~ Yes ~ Yes ~ No ~ No ~ No ~ No ~ No ~ No 2. Legal Custody should be awarded to (person(s) making the major decisions, such as, school enrollment, medical, driver's license): ~ Plaintiff ~ Defendant ~ Jointly to both Plaintiff and Defendant ~ Caretaker 3. Physical Custody should be awarded to (the child(ren) will primarily live with this person): ~ Plaintiff ~ Defendant ~ Jointly to both Plaintiff and Defendant ~ Caretaker (State Parenting Time Below*) * Joint custody with the child(ren) will be shared between Plaintiff and Defendant as follows (even if you are suggesting joint custody, you can also use the checklists in Sections 5 and 6): FOR COURT USE ONLY In accordance with the Americans with Disabilities Act, as amended, and other applicable state and federal laws, if you require accommodation for a disability, please contact the ADA Coordinator at the First Circuit Family Court office by telephone at 954-8200, fax 954-8308, or via email at adarequest@courts.hawaii.gov at least ten (10) working days prior to your hearing or appointment date. Please call the Family Court Service Center at 954-8290 if you have any questions about forms or procedures. Page 1 of 4 Pages FC Adm 1/13/14 Proposed Parenting Plan American LegalNet, Inc. www.FormsWorkFlow.com 4. Special Concerns: (i.e., breast-feeding infant, special needs of child(ren) or disability of either parent: 5. Visitation Schedule: ~ Plaintiff ~ Defendant (check one) shall have visitation, which shall commence on ~ Reasonable visitation as agreed to by the parties. ~ Every other weekend ~ Every weekend from to (day of week) at (fill in date), as follows: (day of week) at ~a.m. ~p.m. ~ a.m. ~ p.m. (days of week) from p.m. to p.m. (Note: For Friday and Monday holidays, the child(ren) will stay with the parent who has the child(ren) for that weekend.) Summer Vacation: ~ Should be split as agreed to by Plaintiff and Defendant. ~ Plaintiff and Defendant shall each have one-half of the summer vacation with alternate weekends to the other parent. The child(ren) should be returned to the custodial parent at least one (1) week prior to the start of school. ~ Other: ~ Midweek dinner visits on Christmas and New Year Vacation: ~ Should be split as agreed to by Plaintiff and Defendant. ~ Plaintiff and Defendant shall each have one-half of the Christmas/New Year vacation. ~ Other: Intersession Vacations (Spring Break and Fall Break): ~ Each intersession break should be split as agreed to by Plaintiff and Defendant. ~ Each intersession break should be alternated yearly between Plaintiff and Defendant. ~ Plaintiff and Defendant shall have each have one-half of each intersession break. ~ Other: Child(ren)'s Birthday(s): ~ The child(ren)'s birthday(s) should be celebrated as agreed to by Plaintiff and Defendant. ~ A child's birthday will be spent with the parent who has the child on that day. ~ [ ] Plaintiff [ ] Defendant should have the child(ren) on the child(ren)'s birthday on even-numbered years. The other parent should have the child(ren) on the child(ren)'s birthday on odd-numbered years. ~ Plaintiff and Defendant will share the child(ren) for at least half the day on the child(ren)'s birthday. ~ Other: Extensive Visitation (if applicable) should be as follows: Out-of-State Visitation (if applicable) should be as follows: Page 2 of 4 Pages FC Adm 1/13/14 Proposed Parenting Plan American LegalNet, Inc. www.FormsWorkFlow.com 6. Detailed Holiday Schedule: Some cases work better if more details are listed. Use this as a checklist. You do not have to fill in everything. Anything that is left blank means that the child will spend the day with the parent who has the child on that day. (Note: For Friday and Monday holidays, the child(ren) will stay with the parent who has the child(ren)for that weekend.) Check "P" for Plaintiff and "D" for Defendant. An example is shaded in gray below. Holiday Example Holiday New Year's Eve New Year's Day Martin Luther King, Jr. Day President's Day Prince Kuhio Day (March 26th) Good Friday Memorial Day King Kamehameha Day (June 11th) Independence Day (July 4th) Statehood Day (Admissions Day) Labor Day Halloween (October 31st) Veterans' Day (November 11th) Thanksgiving Day Christmas Eve Christmas Day Mother's Day Father's Day Plaintiff's Birthday Defendant's Birthday Other: Other: 7. Childcare: These are the arrangements for childcare when I am at work (if you have agreed to joint custody, also state the arrangements of the other parent: 8. Parents covering each other: Time (Put a.m. or p.m.) 9 a.m. to 7 p.m. Every Year Even Years ~P ~P ~P ~P ~P ~P ~P ~P ~P ~P ~P ~P ~P ~P ~P ~P ~P ~P ~P ~P ~P ~P ~P ~D ~D ~D ~D ~D ~D ~D ~D ~D ~D ~D ~D ~D ~D ~D ~D ~D ~D ~D ~D ~D ~D ~D :P Odd Years ~P ~P ~P ~P ~P ~P ~P ~P ~P ~P ~P ~P ~P ~P ~P ~P ~P ~P ~P ~P ~P ~P ~D ~D ~D ~D ~D ~D ~D ~D ~D ~D ~D ~D ~D ~D ~D ~D ~D ~D ~D ~D ~D ~D ~D ~P ~P ~P ~P ~P ~P ~P ~P ~P ~P ~P ~P ~P ~P ~P ~P ~P ~P ~P ~P ~P ~P ~P ~D ~D ~D ~D ~D ~D ~D ~D ~D ~D ~D ~D ~D ~D ~D ~D ~D ~D ~D ~D ~D ~D ~D ~ If we cannot care for the child(ren) during a time assigned to us, we will ask the other parent to take care of the child(ren) before we ask anybody else. ~ It will be up to each parent who they ask for help during their assigned times. Page 3 of 4 Pages FC Adm 1/14/14 Proposed Parenting Plan American LegalNet, Inc. www.FormsWorkFlow.com 9. Transportation