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Declaration In Support Of Parenting Plan Form. This is a Washington form and can be use in Domestic Relations Statewide.
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Tags: Declaration In Support Of Parenting Plan, DR 04.0120, Washington Statewide, Domestic Relations
Superior Court of Washington
County of
In re:
No.
Petitioner,
and
Respondent.
Declaration in Support
of Parenting Plan
(DCLSPP)
(Complete a separate form for each child and use additional pages, if necessary)
Complete this declaration with current information. You may also include past information related to the
proposed temporary residential schedule.
This declaration is made by the [ ] petitioner [ ] respondent.
1.
(Name of child(ren)) ____________________________________________________ has/have
resided with the following person(s):
Length of Time
Child(ren) Resided With
This Person
Name
2.
(a)
The petitioner’s performance of parenting functions relating to the daily needs of the
child(ren) (RCW 26.09.004(3)):
(b)
The petitioner’s work schedule:
Decl in Support of Parenting Plan (DCLSPP) - Page 1 of 2
WPF DR 04.0120 Mandatory (6/2008) - RCW 26.09.194(1)
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3.
(a)
The respondent’s performance of parenting functions relating to the daily needs of the
child(ren) (RCW 26.09.004(3)):
(b)
The respondent’s work schedule:
4.
The child’s schedule including child care, school, and other activities:
5.
Information regarding circumstances under RCW 26.09.191 that are likely to pose a serious risk
to the child(ren) and that warrant limitation on the award to a parent of temporary residence or
time with the child(ren) pending entry of a permanent residential schedule:
6.
Other information for the court to consider:
I declare under penalty of perjury under the laws of the state of Washington that the foregoing is true and
correct.
Signed at (city) ________________________, (state) ___________ on (date) _____________________.
Signature of Party
Print Name
Decl in Support of Parenting Plan (DCLSPP) - Page 2 of 2
WPF DR 04.0120 Mandatory (6/2008) - RCW 26.09.194(1)
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