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Permanent Parenting Plan Form. This is a Tennessee form and can be use in Hamilton Local County.
Tags: Permanent Parenting Plan, Tennessee Local County, Hamilton
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......... ..
:
Index No.
:
:
Plaintiff(s)
Calendar No.
JUDICIAL SUBPOENA
IN THE _______________ COURT FOR ___________________ COUNTY, TENNESSEE
-against:
*
:CASE NO. ___________________
*
:PARENTING PLAN
*
Defendant(s)*
:
. .______________________________________ . . . . *. . . . . .____PROPOSED PLAN
.........................................
.
PARENT
*
*
____FINAL PARENTING PLAN
______________________________________
PARENT
THE PEOPLE OF THE STATE OF NEW YORK
PERMANENT PARENTING PLAN
TO
This plan is
GREETINGS:
_____ Ordered by the court on the ____
day of _______________, 20_____,
_____ is a part of the Marital Dissolution Agreement,
_____ modifies an existing Parenting Plan or prior Court Order, dated the _____ day
WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before
of _________________________, 20__________.
,
the Honorable
at the
Court
located at
County of
CHILDREN:
inName
room
, on the
day of
, 20 Birthdate o'clock in the
, at
noon, and at any recessed
or_______________________________________
adjourned date, to testify and give evidence as a witness____________________________________
in this action on the part of the
_______________________________________
____________________________________
_______________________________________ punishable as a contempt of court and will make you liable to
____________________________________
Your failure to comply with this subpoena is
the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a
1.
RESIDENTIAL SHARING SCHEDULE:
result of your failure to comply.
The schedule below sets out which parent has responsibility for the child(ren) during the
week, weekends, holidays and vacations.
Witness, Honorable
, one of the Justices of the
A.
DAY TO DAY SCHEDULE:
Court in
County,
day of
, 20
The mother father will have responsibility for the care of the child(ren), except
the following times and days when the other parent shall have responsibility for the care of the
child(ren):
(Attorney must sign above and type name below)
From: __________________________________ to ____________________________
[Day/Time]
Every Week
[Day/Time]
AND
Every Other Week
Attorney(s) for
Other
From: __________________________________ to ____________________________
[Day/Time]
Every Week
[Day/Time]
Every Other Week
Other
Office and P.O. Address
Beginning ______ day of __________________________, 20 _____.
Telephone No.:
Facsimile No.:
E-Mail Address:
Mobile Tel. No.:
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:
Plaintiff(s)
-against-
B.
Calendar No.
:
JUDICIAL SUBPOENA
:
SCHEDULE OF HOLIDAYS RELEVANT TO YOUR FAMILY,
SCHOOL SCHEDULE or SPECIAL :OCCASIONS
Indicate when child(ren) will be with each parent.
:
[In ODD numbered years, EVEN numbered years of EVERY year.]
Defendant(s)
:
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .MOTHER. . . .
.........
Martin Luther King Day
_____________________
FATHER
______________________
President’s Day
_____________________
______________________
THE PEOPLE OF THE STATE OF NEW_____________________
YORK
Easter
______________________
Passover
TO
_____________________
______________________
Mother’s Day
_____________________
______________________
Memorial Day (if no school)
_____________________
______________________
_____________________
______________________
GREETINGS:
Father’s Day
thWE
COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before
_____________________
______________________
July 4
,
the Honorable
at the
Court
Labor Day
_____________________ ______________________
located at
County of
in room
, on the
, 20
, at
noon, and at any
Thanksgiving Day & Friday day of _____________________o'clock in the
______________________ recessed
or adjourned date, to testify and give evidence as a witness in this action on the part of the
Child(ren)’s Birthdays
_____________________
______________________
Other School Free Days
_____________________
______________________
Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to
Mother’s whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a
_____________________
______________________
the party on Birthday
result of your failure to comply.
Father’s Birthday
_____________________
______________________
Other Witness, Honorable
Court in
County,
_____________________
day of
______________________
, one of the Justices of the
, 20
A Holiday shall begin at 6:00 p.m. on the night preceding the Holiday and end at 6:00 p.m. the
night of the Holiday, unless otherwise noted:
__________________________________________________________________
(Attorney must sign above and type name below)
SCHEDULE FOR WINTER HOLIDAY VACATION:
The Mother Father shall have the child(ren) in even years from
the day school is dismissed at _____ p.m. until December 25 at ____ a.m.
Attorney(s) for
The other parent will have the child(ren) from December 25 at _____ a.m.
until 6:00 p.m. on the evening before school resumes.
OR as agreed upon by the parents as follows:
_________________________________________________________________
Office and P.O. Address
_________________________________________________________________
C.
D.
SCHEDULE FOR SPRING VACATION:
The Mother and Father shall share Telephone No.:
or alternate Spring Break as follows:
2
Facsimile No.:
E-Mail Address:
Mobile Tel. No.:
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:
___________________________________________________________
JUDICIAL SUBPOENA
Plaintiff(s)
___________________________ Beginning: ______________________
-against-
:
:
:
E.
SUMMER SCHEDULE:
Defendant(s)
:
. . . . . . . . . . . . . . . . . . . . . The. . . . . Mother . . . . . . .Father . . .shall be responsible for the care of the
... .
.......
.
......
child(ren) during the summer, except for the following days and times when
the other parent will be responsible for the care of the child(ren):
THE PEOPLE OF THE STATE OF NEW YORK
TO
Same as school year schedule
Two weeks every month
Two weeks
Six weeks
One monh
Other:
____________________________________________________________
Beginning:
________________________________________________
GREETINGS:
WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before
,
the Honorable
at the
Court
located at
County of
F.on theTRANSPORTATION ARRANGEMENTS:
in room
,
day of
, 20
, at
o'clock in the
noon, and at any recessed
or adjourned date, to testify and give evidence as a witness in the child(ren), betweenthe
this action on the part of parents shall be as
Transportation arrangements for
follows:
________________________________________________
____________________________________________________________
Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to
the party on whose behalfLong Distance Transportation Costs: penalty of $50 and all damages sustained as a
this subpoena was issued for a maximum [If applicable]:
____________________________________________________________
result of your failure to comply.
Witness, Honorable
G. County,
OTHER: day of
Court in
, one of the Justices of the
, 20
The following special provisions apply to the schedules or residential
considerations of the child(ren). _________________________________
____________________________________________________________
(Attorney must sign above and type name below)
2.
DECISION MAKING:
A.
Attorney(s) for
DAY TO DAY DECISIONS:
Each parent shall make decisions regarding the day-to-day care and control of
each child while the child is residing with that parent. Regardless of the
allocation of decision making in this parenting plan, either parent may make
emergency decisions affecting the health andsafetyAddresschild(ren).
Office or P.O. of the
B.
CHILD NURTURE:
3
Telephone No.:
Facsimile No.:
E-Mail Address:
Mobile Tel. No.:
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Mother and Father will behave with : respect to each other and the child(ren)
JUDICIAL SUBPOENA
Plaintiff(s)
so as to provide a loving, stable, consistent and nurturing relationship with
-against:
the child(ren) even though they, themselves, are being divorced. Mother and
Father agree they will not speak badly of each other or the members of the
:
family of the other parent. They will encourage the child to continue to love
the other parent and be comfortable in both new families.
:
Defendant(s)
:
. . . . . . . . . . . . . . .C. . . . . MAJOR. DECISIONS: . . . . . . . . . . . . .
..
....... ............
Major decisions regarding each child shall be made as follows:
Educational Decisions
Mother Father Joint
Non-Emergency Health Care
Mother Father Joint
Religious Upbringing
Mother Father Joint
Extracurricular Activities
Mother Father Joint
__________________________
Mother Father Joint
THE PEOPLE OF THE STATE OF NEW YORK
TO
GREETINGS:
__________________________
laid aside, Father of you
WE COMMAND YOU, that all business and excuses beingMother you and eachJoint attend before
,
the Honorable
at the
Court
located at
County of
in room
, on
day S
, at
noon, and at any recessed
ND
[Optional]
D. thePRIVATEof CHOOL A, 20 COLLEGE: o'clock in the
or adjourned date, to testify andparties agree as a witness regarding private school [elementary and high
The give evidence as follows in this action on the part of the
school] and college or vocational training after high school:
____________________________________________________________
Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to
____________________________________________________________
the party on whose behalf[If parents wish towas issued for a list of the plans for special$50 and all damages sustained as a
this subpoena include a detailed maximum penalty of or private schooling, they
may attach a separate sheet.]
result of your failure to comply.
3.
FINANCIAL SUPPORT FOR CHILD(REN):
Witness, Honorable
Court in A.
, one of the Justices of the
County,
day of
, 20
CHILD SUPPORT PER TENNESSEE GUIDELINES OR DEVIATIONS:
The Mother Father will pay child support, in accordance with the Tennessee
Child Support Guidelines, in the amount of $__________________ per
(Attorney must sign above and type name two
week month twice per month (semi-monthly), or everybelow) weeks
(bi-weekly), plus $ _________ as 5% clerk’s fee [if applicable] for a total amount of:
$ ___________________
Attorney(s) of
Beginning the _____ dayfor _____________, 20___.
Deviations: _______________________________________________________
This support shall be paid:
Office and P.O. Address
Directly to the other parent.
4
Telephone No.:
Facsimile No.:
E-Mail Address:
Mobile Tel. No.:
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:
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:
To the Central Child Support Receipting Unit, P. O. Box 305200, Nashville,
JUDICIAL SUBPOENA
Plaintiff(s)
Tennessee 37229, and sent to the other parent at:___________
-against:
___________________________________________________________
ADDRESS:
:
Direct deposit to the other parent at _____________________ Bank.
:
By Wage Assignment Order (ATTACH ORDER)
Defendant(s)
:
. . . . . . . . The. parties .affirmatively acknowledge that. Court .approval must be obtained before child
... ...... .......................... ..... ..
support can be reduced or modified, unless such payments are automatically reduced or terminated
under the terms of the Parenting Plan.
THE PEOPLE OF THE STATE OF NEW YORK
*ATTACH SWORN STATEMENT OF INCOME IF THIS IS A PROPOSAL PLAN.
TO
B.
TAX DEDUCTION:
The
mother
father shall receive the tax deduction for the child(ren), so long
as the child support is current on the 15th day of January of each year in:
GREETINGS:
alternate years starting ___________
each year
WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before
other: _________________________________________________________
,
the Honorable
at the
Court
located at
County of
C.
TAX RETURN NOTICE:
in room
, on the
, 20
, at
The parent(s)day of child support shall send too'clock in the
paying
the other parent noon, and at any recessed
by or before April
or adjourned date, to testify and give evidence as a witness in this action on the part of the
15 of every year [OR August 15, if an extension is sought], a copy of their respective
W-2(s), 1099(s), and the first two (2) pages of their tax return.
Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to
D.
HEALTH INSURANCE:
the party on whose behalf this subpoena was issued formaintain medical/hospital insurance on the minor as a
The
mother
father will a maximum penalty of $50 and all damages sustained
result of your failure to comply. he/she shall provide proof of continuing coverage annually.
child(ren) and
Witness, Honorable medical expenses, which include deductibles orof the Justices of the
, one co-payments, eyeglasses,
Uncovered
Court in
County,
day of
, 20
contact lens, routine annual physicals, will be paid by the:
mother
Other:
father OR
divided equally by the parties.
_______________________________________________________
(Attorney must sign above
[THIS MAY ALSO INCLUDE A PROVISION FOR COUNSELING]and type name below)
After insurance has paid its portion, the parent receiving the bill will send the bill to
the other parent within 10 days. The other parent will pay his/her share within thirty
Attorney(s) for
(30) days of receipt of the bill.
E.
LIFE INSURANCE [OPTIONAL FOR PARENT NOT PAYING CHILD SUPPORT]:
father shall insure his own life in the minimum amount of $_____________,
Office and P.O. Address
whole or term.
mother shall insure her own life in the minimum amount of $____________,
Telephone No.:
whole or term.
Facsimile No.:
5
E-Mail Address:
Mobile Tel. No.:
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The policy(ies) shall name:
JUDICIAL SUBPOENA
Plaintiff(s)
the other parent.
:
Other-against-as trustee of the funds to serve without bond or accounting, as
parent
beneficiary for the support of the children.
:
Other: ________________________________________________________
:
F. DENTAL/ORTHODONTIC CARE:
Defendant(s)
If available to either parent through their work, the
mother
father will
:
......................................................
maintain dental/orthodontic care on the minor child(ren). Uncovered dental and
orthodontic expenses will be paid by:
mother
father
divided equally by the parties.
THE PEOPLE OF THE STATE OF NEW YORK
TO
4.
DESIGNATION SOLELY FOR STATE AND FEDERAL STATUTES:
The children named in this parenting plan are scheduled to reside the majority of the time
with the
mother
father. SOLELY for purposes of any other state and federal statutes which
require a designation or determination of parental responsibility, this parent is designated the “Custodian of
GREETINGS:
the Child”. If the parents are joint decision makers as listed in Section 2, for purposes of obtaining health or
other insurance, they shallYOU, that all businessCustodians”. being laid aside, you and each of you AFFECT
WE COMMAND be considered “Joint and excuses THIS DESIGNATION SHALL NOT attend before
EITHER PARENT’S RIGHTS AND RESPONSIBILITIES UNDER THIS PARENTING PLAN.
,
the Honorable
at the
Court
located at
County of
in room
, on the
day of
, 20
, at
o'clock in the
noon, and at any recessed
DISAGREEMENTS ABOUT J a witness in this action the MODIFICATIONS OF
or5.
adjourned date, to testify and give evidence as OINT DECISIONSonOR part of the
PLAN:
Should a disagreement arise about the Parenting Plan or the parties wish to modify the
plan, the parties shall make a good faith effort to resolve the issue through the dispute resolution
Your failure to comply with
process, before returning to court.this subpoena is punishable as a contempt of court and will make you liable to
the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a
result of your failure to comply.
Unless a limiting factor listed in T.C.A. §36-6-406 precludes a dispute resolution process
prior to court action, or an emergency court action is necessary to protect the welfare of the
Witness, Honorable
, one of the Justices of the
child(ren) or a party, the parties agree to the following dispute resolution method:
Court in
County,
day of
, 20
Disputes between the parties, other than the child support disputes, shall be submitted to:
Mediation by Rule 31 Mediator.
(Attorney must
Arbitration by Arbitrator Selected by Parties or the Court.sign above and type name below)
Settlement Conference with Judge Not Presiding in Parents’ Case.
Court process DUE TO ORDER OF PROTECTION OR RESTRICTIONS.
Attorney(s) for
The costs of this process shall be assessed to the parties by the Court based upon their
incomes. The out-of-court process shall be commenced by notifying the other party and the
Court by:
Office and P.O. Address
written request
certified mail
In the dispute resolution process:
6
Other: _______________
Telephone No.:
Facsimile No.:
E-Mail Address:
Mobile Tel. No.:
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(a)
Preference shall be given to carrying :out this Parenting Plan.
JUDICIAL SUBPOENA
(b)
-against:
The parents shall use the designated process to resolve disputes relating to
implementation of the plan.
Plaintiff(s)
:
(c)
A written record shall be prepared of any agreement reached in the
:
mediation, arbitration or settlement conference and shall be provided to each
party to be draftedDefendant(s) order of modification.
into a consent
:
......................................................
(d)
If the Court finds that a parent willfully failed to appear at a scheduled
dispute resolution process without good reason, the Court, upon motion, may
award attorney YORK
THE PEOPLE OF THE STATE OF NEW fees and financial sanctions to the prevailing parent.
TO
VI.
STANDARD PARENTING ORDERS:
GREETINGS:
Pursuant to Tennessee Code Annotated, §36-6-101(a), both parents are entitled to the following
rights: WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before
,
the Honorable To unimpeded telephone conversations with the child at least twice each week at
at the
Court
1.
located for a reasonable duration;
at
County of
reasonable times and
in room
, on the
day of
, 20
, at
o'clock in the
noon, and at any recessed
or adjourned date,To testifymail give evidence as a witness in this action on the part of and will not censor;
to send and to the child which the other parent shall not open the
2.
3.
To receive notice and relevant information as practical (but within 24 hours) in the
event comply with this subpoena is punishable as contempt of
Your failure to of hospitalization, major illness, or deathaof the child; court and will make you liable to
the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a
4.
To receive directly from the school, upon written request, which includes a current
result of your failure to comply.
mailing address and upon payment of reasonable costs of duplicating, copies of the
child’s report cards, attendance records, names of teachers, classof schedules,
Witness, Honorable
, one of the Justices the
standardized testday of
scores, and any20
other records customarily made available to
Court in
County,
,
parents;
5.
Unless otherwise provided by law, the right to receive copies of the child’s medical,
(Attorney must sign above and type name below)
health or other treatment records directly from the physician or health care provider
who provided such treatment or health care upon written request which contains a
current mailing address and upon payment of reasonable costs of duplication;
Attorney(s) for
provided, that no person who receives the mailing address of a parent as a result of
this requirement shall provide such address to the other parent or a third person.
6.
To be free of derogatory remarks made about such parent or such parent’s family by
Office and
the other parent to or in the presence of the child; P.O. Address
7
Telephone No.:
Facsimile No.:
E-Mail Address:
Mobile Tel. No.:
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Index No.
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To be given at least forty-eight (48) hours: notice, whenever possible, of all extra
JUDICIAL SUBPOENA
Plaintiff(s)
curricular activities, and the opportunity to participate or observe, including, but not
-against:
limited to the following:
(i)
School activities
:
(ii)
Athletic activities
(iii) Church activities, and
:
(iv)
Other activities as to which parental participation or observation
would be appropriate.
Defendant(s)
:
......................................................
8.
To receive from the other parent, in the event the other parent leaves the state with
the minor child(ren) for more than two (2) days, an itinerary including telephone
numbers for use NEW YORK
THE PEOPLE OF THE STATE OFin the event of an emergency.
TO
9.
Access and participation in education, including the right of access to the minor child
or children for lunch and other activities, on the same basis that is provided to all
parents, provided the participation or access is reasonable and does not interfere with
day-to-day operations or with the child’s educational performance.
GREETINGS:
WE COMMAND YOU, that all PROPOSED PARENTING aside, OR FOR FINAL
SIGNATURE OF PARTY(IES) FOR business and excuses being laidPLAN you and each of you attend before
,
the ARENTING PLAN:
Honorable
at the
Court
P
located at
County of
inIroom
, on OATH THAT THIS PLAN HAS at
day of
, 20
, BEEN PROPOSED IN GOOD and at any recessed
o'clock in the
noon, FAITH AND
HEREBY MAKE the
orTHAT IT date, to testify BEST INTEREST a witness inCHILD(REN).the(NOTARY REQUIREMENT FOR
adjourned IS IN THE and give evidence as OF THE this action on
part of the
PROPOSED PLAN ONLY)
Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to
______________________________________
the party on whose behalf this subpoena was issued for a ____________________________________
maximum penalty of $50 and all damages sustained as a
MOTHER
DATE AND PLACE OF SIGNATURE
result of your failure to comply.
Witness, Honorable
Court in
County,
FATHER
______________________________________
day of
, one of the Justices of the
____________________________________
, 20
DATE AND PLACE OF SIGNATURE
SWORN TO AND SUBSCRIBED BEFORE ME THIS ______ DAY OF ______________________, below)
(Attorney must sign above and type name 20_____.
___________________________________________
NOTARY PUBLIC
Attorney(s) for
MY COMMISSION EXPIRES: _______________
Office and P.O. Address
8
Telephone No.:
Facsimile No.:
E-Mail Address:
Mobile Tel. No.:
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