COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : Index No. IN THE FOURTH CIRCUIT COURT OF KNOX COUNTY TENNESSEE : _______________________ Mother/Father Docket # ___________ Plaintiff(s) _______________________-againstFather/Mother Calendar No. : JUDICIAL SUBPOENA : : TEMPORARY PARENTING PLAN : This plan was proposed to the Court on __________ [ ] by mother [ ] by father [ ] by both. Defendant(s) This plan was ordered by the Court on _________________. : . .This .parenting .plan applies to the. following.child(ren):. . . . . . . . . . . ... ....... ............. ....... ....... Name Birth Date ______________________________________ _________________________________ THE PEOPLE OF THE STATE OF NEW YORK ______________________________________ _________________________________ TO RESIDENTIAL SHARING SCHEDULE: The [ ]mother [ ] father shall be responsible for the child(ren) , except for the following days and times when the other parent shall be responsible for the child (ren): From:_____________________________ to: ________________________________ GREETINGS: (Day/Time) (Day/Time) [ ] every week [ ] every other week [ ] other: ___________________________ WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before , the Honorablefrom:__________________________ to:________________________________ at the Court and located at County of (Day/Time) (Day/Time) in room [ ] every,week [ ] every other week [ ]other:___________________________ noon, and at any recessed on the day of , 20 , at o'clock in the or adjourned date, to testify and give evidence as a witness in this action on the part of the 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. The parents shall otherwise confer with each other. 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 HOLIDAY AND VACATION SCHEDULE DURING THE NEXT THREE MONTHS: __________________________ result of your failure to comply. ____________________________________________________________________________________________ Witness, Honorable one of the Justices of than TRANSPORTATION ARRANGEMENTS: Transportation arrangements,for the child(ren), other the costs, Court inbetween parents shall be as follows:_______________________________________________________ County, day of , 20 ____________________________________________________________________________________________ STANDARD PARENTING ORDERS: Pursuant to Tennessee Code Annotated §36-6-101(a), both (Attorney must sign above and type name below) parents are entitled to the following rights: 1. To unimpeded telephone conversations with the child at least twice each week at reasonable times and for a reasonable duration; Attorney(s) for 2. To send mail to the child which the other parent shall not open and will not censor; 3. To receive notice and relevant information as soon as practical (but within 24 hours) in the event of hospitalization, major illness, or death of the child; 4. To receive directly from the school, upon written request which includes a current mailing address, and upon payment of reasonable costs of duplicating, copies of the child’s report Office and P.O. Address cards, attendance records, names of teachers, class schedules, standardized test scores, and any other records customarily made available to parents. 5. Unless otherwise provided by law, the right to receive copies of the child’s medical, health, Telephone No.: or other treatment records directly from the physician or health care provider who provided Facsimile contains a current mailing such treatment or health care, upon written request which No.: address and upon payment of reasonable costsE-Mail Address: of duplication; provided, that no person who receives the mailing address of a parent asMobile Tel. No.: a result of this requirement shall provide American LegalNet, Inc. www.USCourtForms.com COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : Index No. : Calendar No. 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 the JUDICIAL SUBPOENA Plaintiff(s) other parent to or in the presence of the child. -against: 7. To be given at least forty-eight (48) hours notice, whenever possible, of all extra curricular activities, and the opportunity to participate or observe, including, but not limited to, the : following: (I) School activities; : (ii) Athletic activities; (iii) Church activities; and Defendant(s) : (iv) Other activities as to which parental participation or observation would be ...................................................... appropriate. 8. To receive from the other parent, in the event the other parent leaves the state with the minor child or children for more than two (2) days, an itinerary including telephone numbers for use in the event of an YORK THE PEOPLE OF THE STATE OF NEW emergency. 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, TO provided the participation or access is reasonable and does not interfere with day-to-day operations or with the child’s educational performance. SUPPORT OF GREETINGS: CHILD(REN): The [ ] mother [ ] father will pay child support, in accordance with the Tennessee Child Support Guidelines, in the amount of $________ [ ] per week [ ] per month [ ] twice per month [ WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before ] every two weeks [ ] plus ______ as 5% clerk’s fee, for a total amount of $____________, beginning ______ day of __________________, 20___. the support shall be paid: , the Honorable at This Court [ ] Directly located at parent to the other County of [ ] To the Clerk of the Court and sent to the other parent at _______________________ in room , on the day of , 20 , at o'clock in the noon, and at any recessed [ ] Wage assignment (to be prepared and submitted for entry) or adjourned date, to testify and give evidence as a witness in this action on the part of the SPOUSAL SUPPORT (IF APPLICABLE): [ ] Mother [ ] Father shall pay additional support in the amount of _______ per month beginning ____ day of _____________,20__ . [ ] In the alternative, to comply with this subpoena is punishable as household billscourt and will make you liable to Your failure [ ] Additionally, he/she shall pay the following a contempt of as spousal support:_______________________________________________________________________________________ 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. ____________________________________________________________________________________________ one of in effect at the the HEALTH,Witness, HonorableINSURANCE AND UNCOVERED EXPENSES: All ,policies the Justices of time of DENTAL AND LIFE Court in County, day shall 20 separation or filing, whichever is earlier, of remain in ,effect during the duration of the divorce proceedings. The policies shall name the spouse and or child(ren) as beneficiaries of the policies. All uncovered medical, dental, and __________________ costs will be split between the parties. _____________________________ Mother or Attorney _____________________________ Father or Attorney (Attorney must sign above and type name below) __________________________ Date and Place of Signature ___________________________ Attorney(s) for Date and Place of Signature IT IS SO ORDERED, ADJUDGED, AND DECREED. Enter, this ____ day of _______________, 20___: Office and P.O. Address __________________________________ Telephone No.: Facsimile No.: JUDGE E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com