Cause No: IN RE: § IN THE DISTRICT COURT OF § FORT BEND COUNTY, TEXAS § 328TH JUDICIAL DISTRICT HEARING/TRIAL BY ASSOCIATE JUDGE AGREED ORDER/ I understand that I have a right to a jury trial and to a record of testimony in this case, and I do hereby waive my right to a jury and a record of the testimony. I further understand that the orders given by the Associate Judge are binding and, upon adoption by the District Judge of this court, are final. I hereby waive any right of appeal to the referring court pursuant to Section 201.015(g) Texas Family Code. The following represents the agreement of all parties: Signed this day of , . Petitioner Respondent Attorney for Petitioner Attorney for Respondent Ad Litem Ad Litem NATURE OF PROCEEDING: 1. Conservatorship of minor child(ren) (Names): Temporary: Final: Managing Conservator Petitioner Respondent Other: Possessory conservator Petitioner Respondent Other: Joint Managing conservators Petitioner Respondent Other: Joint Conservator Who determines domicile: Petitioner Respondent 2. Domicile: No restriction Restrict to 3. Rights duties and powers of parents: Petitioner Respondent to have Texas Family Code 153.132 Petitioner Respondent Other: to have Texas Family Code 153.132 Petitioner Respondent Other: to have Texas Family Code 153.074 4. Possession: At All Reasonable Times Agreed To By Parties Standard Possession Order as Defined by Texas Family Code 153.311 - 153.317 Other/Elections: Possession Commences: 5. Child Support: Petitioner Respondent to pay Direct Wage Withholding Order through Texas Child Support Disbursement Unit, P.O. Box 659791, San Antonio, Texas 78265 – 9941, Child Support payable as follows: Medicial/Dental Insurance for child(ren) by: Petitioner Respondent and paid by Petitioner Respondent Uninsured Health Expenses: 6. Spousal support (if applicable):by: 7. Property: Possession G:/MSOffice/Template/Forms Form116 – Associate Judge’s Report 328th District Court Revised: 2007/02 To: Ownership Hearing/Trial By Associate Judge Page 1 American LegalNet, Inc. www.FormsWorkflow.com Petitioner: Respondent: 8. Injunctions: Temporary Permanent Mutual Persons as set out in Texas Family Code 6.502 (1) (2) (3) (4) (5) Property as set out in Texas Family Code 6.502 (6) (7) (8) (9) (10) Other: 9. Inventory: Each party to file inventory no later than: 10. Debts/Expenses to be timely paid by: Petitioner: Respondent: 11. Additional Orders: 12. Parties to attend Parent Education Program no later than: 13. Parties to attend MEDIATION no later than: . Entry Date at , 20 , 20 AM/PM on . . Agreement of Parties approved by Associate Judge. Divorce Granted on No Fault Grounds. Signed this the day of , 20 . APPROVED: HONORABLE WALTER ARMATYS Associate Judge, 328th District Court HONORABLE RONALD R. POPE Judge, 328th District Court Date: Hearing/Trial By Associate Judge Page 2 American LegalNet, Inc. www.FormsWorkflow.com