CAUSE NO. _______________________ IN THE MATTER OF: ) IN THE ________ DISTRICT COURT ______________________________________ ) OF COLLIN COUNTY, TEXAS JUDGES MEMORANDUM Temporary ______ Final ______ (When appropriate child means children) [ ] AGREEMENT [ ] DEFAULT [ ] RULING after hearing [ ] Reporter present ___________________________ 1. APPEARANCES: Father:____________________________ and Attorney:___________________________ Mother:____________________________ and Attorney:___________________________ Other:____________________________ and Attorney:___________________________ 2. [ ] JOINT TEMPORARY MANAGING CONSERVATORS: Primary physical residence of child: ________ [ ] Childs residence restricted to: [ ] Collin County [ ] Collin and contiguous counties [ ] Other __________ 3. TEMPORARY SOLE MANAGING CONSERVATOR: [ ] Father [ ] Mother [ ] Other _______ 4. TEMPORARY POSSESSORY CONSERVATOR: [ ] Father [ ] Mother [ ] Other ___________ 5. ACCESS & POSSESSION: [ ] Per Sec.153.311-153.317 TFC [ ] see attached page [ ] History of Family Violence YES/NO ______________________________________________________________________________ ______________________________________________________________________________ 6. SUPPORT: [ ] Father [ ] Mother to pay $__________ per ___________ with first payment due _____________ and each ________________ thereafter by WAGE WIT HHOLDING through [ GUARDIAN AD LITEM [ ] Payment directly to other parent authorized [ ] ATTORNEY GENERALS OFFICE [ ] Reduce to $__________ per ___________ per Sec. 154.001 TFC [ ] Reduce to $__________ per ___________ 6a. [ ] Father [ ] Mother required to maintain health insurance on child/spouse. [ ] Father ordered to pay ___%; Mother ordered to pay ____ % of non-covered health expenses. 6b. Support includes $_________ additional contribution to cover other parent maintaining health insurance. 7. SUPPORT FINDINGS: Net Resources Net Resources Percent Actually Amount if Number of Reason varies Number of Number of other (Obligor) (Obligee) applied to Net percent applied children before from guidelines children not children for Resources to first $6,000 the Court before Court Obligor to residing with support by Obligor Court order 8., MUTUAL INJUNCTIONS: [ ] persons/property [ ] removal of child(ren) from [ ] jurisdiction OR [ ] Collin & contiguous counties [ ] Use of [ ] alcohol [ ] illegal substances w/in 8 hrs of or dof oupporingsite sex possession in ho m[ e [ ] Discussing litigation/disparage other party in presence/hearing of child(ren) [ ] __________________________________________________ American LegalNet, Inc. www.USCourtForms.com>>>> 29. Protective orders: [ ] applies to [ ] father [ ] mother [ ] both [ ] agreed [ ] default [ ] family violence occurre d [ ] party prohibited from [ ] removing child from other parent [ ] removing child from jurisdiction of Court [ ] encumbering or disposing of property [ ] exclusive possession of residence awarded to ____________________ (if family violence occurred) [ ] complete battering intervention program [ ] _____________attend and complete counseling with __________________ [ ] _______________enjoined from [ ] committing family violence [ ] communicating with the other party or family member [ ] going near the residence or employment of ________________________ or a member of the household [ ] going near a schoochl or ild care facility a child normally attends [ ] possessing a firearm [ ] suspension to caof licenserry a concealed weapon [ ] Duration of order: __________________________________________________________ 10. Classes and studies: [ ] Psychological evaluation with _______________ [ ] Counseling with ________________; persons participating in counseling _______ [ ] Practical parent education classes: ____________ [ ] Social Study [ ] Drug Test Ordered [ ] Other _________________________________________________________________________ [ ] Fees split; father ______%; mother _______ %; others ________ % 11. Mediation with: ___________________________no later than:____________ Costs; father _____ %; mother _____%; other _______%. 12. USE OF PROPERTY: [ ] Husband [ ] Wife to have temporary use and possession of [ ] residence and [ ] contents. Auto/vehicle to Husband: _____________________ Auto/vehicle to Wife: __________________ Other Property Orders: __________________________________________________________________________ _____________________________________________________________________________________________ 13. INVENTORY/PRODUCTION: Each party to file/exchange Inventory & income information on or before: ____________________________________________________________________________________________ ____________________________________________________________________________________________ 14. DEBTS FOR WHICH HUSBAND RESPONSIBLE: __________________________________________________ _____________________________________________________________________________________________ _____________________________________________________________________________________________ 15. DEBTS FOR WHICH WIFE RESPONSIBLE: _____________________________________________________ _____________________________________________________________________________________________ _____________________________________________________________________________________________ }Husband [ ] Wife through [ ] Child Support Office [ ] direct, [ ]ter minating on ______________ [ ] subject to review after _________________ 17. This memorandum is not a written order. Th meis morandum will be reduced to a written order by ___________________ on or before _________________, 200___. 18. OTHER ORDERS: _________________________________________________________________________ __________________________________________________________________________________________ _________________________________________________________________________________________ ____________________________ _____________________________________ Date J udge ______________________ ____________________ ___________________ __________________ Agreed Agreed Agreed Agreed [ ] SUBJECT TO PROOF OF SERVICE American LegalNet, Inc. www.USCourtForms.com