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Temporary Parenting Plan Form. This is a Tennessee form and can be use in Parenting Plan Statewide.
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Tags: Temporary Parenting Plan, Tennessee Statewide, Parenting Plan
IN THE
COURT OF
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)
)
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_______________________
Mother/Father
v.
_______________________
Father/Mother
COUNTY TENNESSEE
Docket No. ______________
[ ] Proposed Plan by [ ] Mother [ ] Father
OR
[ ] Agreed Plan
TEMPORARY PARENTING PLAN
This plan was [ ] presented to [ ] ordered by the Court on ______________________, 20_____.
This parenting plan applies to the following children:
Name
Birthdate
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
(Day/Tim e)
[ ] every week [ ] every other week
(Day/Tim e)
[ ] other
and from:
to
(Day/Tim e)
[ ] every week [ ] every other week
(Day/Tim e)
[ ]other:
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
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with each other.
HOLIDAY and VACATION SCHEDULE DURING THE NEXT THREE MONTHS
TRANSPORTATION ARRANGEMENTS: Transportation arrangements for the child[ren], other than
costs, between parents shall be as follows:
STANDARD PARENTING ORDERS: Pursuant to Tennessee Code Annotated, section 36-6-101(a)
both 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;
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 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 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; 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 the other
parent to or in the presence of the child;
7.
To be given at least forty-eight (48) hours notice, whenever possible, of all extra curricular
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activities, and the opportunity to participate or observe, including, but not limited to, the
following:
(I)
(ii)
Athletic activities;
(iii)
Church activities; and
(iv)
8.
School activities;
Other activities as to which parental participation or observation would be appropriate;
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 emergency; and
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.
SUPPORT OF CHILDREN:
Father’s gross monthly income is $ _______
Mother’s gross monthly income is $ ________
1. The temporary child support order is as follows:
a. The 9 mother 9 father shall pay to the other parent as regular child
support the sum of $_____________ 9 weekly 9 monthly 9 twice per month
9 every two weeks. The Child Support Worksheet shall be attached to this Order as an
Exhibit.*
If this is a deviation from the Child Support Guidelines, explain why:
_________________________________________________________________
3. Payments shall begin on the _____ day of _____________, 20___.
*Child Support Worksheet can be found on DHS website at
http://www.state.tn.us/humanserv/is/incomeshares.htm or at your local child support offices.
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This support shall be paid:
9 directly to the other parent.
9 to the Central Child Support Receipting Unit, P. O. Box 305200, Nashville, Tennessee 37229, and
sent to the other parent at:_____________________________________.
9 by direct deposit to the other parent at ____________________________ Bank for deposit in account
no. ________________. A Wage Assignment Order is attached to this Parenting Plan.
9 other:________________________________________________________________.
The parents acknowledge that court approval must be obtained before child support can be reduced or
modified.
HEALTH, DENTAL AND LIFE INSURANCE and UNCOVERED EXPENSES: These policies shall
remain in effect during the duration of the divorce proceedings. The beneficiaries 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.
MISCELLANEOUS: If a parent fails to comply with a provision of this plan or support order, the other
parent’s obligations under the plan or the support order are not affected. Failure to comply with a
provision in the plan or support order may result in a finding of contempt.
* * * * *
Under penalty of perjury under the laws of the State of Tennessee, I declare this plan has been proposed
in good faith and is in the best interest of the child(ren) and that the statements herein are true and
correct.
[ ] Submitted by:
OR
[ ] Agreed to by:
[ ]Mother [ ] Mother’s Attorney
Date and Place of Signature
[ ]Father [ ] Father’s Attorney
Date and Place of Signature
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It is so ORDERED this the ________ day of ____________, ______.
Judge or Chancellor
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