Fillable Printable Parenting Form - Florida

Parenting Form - Florida

Instructions for Florida Supreme Court Approved Family Law Form 12.995(a), Parenting Plan (10/11)

INSTRUCTIONS FOR FLORIDA SUPREME COURT APPROVED FAMILY LAW

FORM 12.995(a), PARENTING PLAN (10/11)

When should this form be used?

A Parenting Plan is required in all cases involving time-sharing with minor child(ren), even whentime-

sharing is not in dispute. This form or a similar form should be used in the development of a Parenting

Plan. If the case involves supervised time-sharing, the Supervised/Safety Focused Parenting Plan,

Florida Supreme Court Approved Family Law Form 12.995 (b) or a similar form should be used. If the

case involves relocation, pursuant to Section 61.13001, Florida Statutes, then a Relocation/Long

Distance Parenting Plan, Florida Supreme Court Approved Family Law Form 12.995(c) or a similar form

should be used.

This form should be typed or printed in black ink. Please either delete or strike-through terms or

paragraphs that are inappropriate or in applicable to your agreement. If an agreement has been

reached, bothparties must sign the Parenting Plan and have their signatures witnessed by a notary

public or deputy clerk. After completing this form, you should file the original with the clerk of the

circuitcourt in the county where the petition was filed and keep a copy for yourrecords. You should

then refer to the instructions for your petition, answer, or answer and counterpetition concerning the

procedures for setting a hearing or trial (final hearing). If the parents have not reached an agreement, a

proposed Parenting Plan may be filed by either parent at the time of or any time prior to the final

hearing. If an agreed Parenting Plan is not filed by the parties, the court shall establish a Plan.

Where can I look for more information?

Before proceeding, you should read “General Information for Self-Represented Litigants” found at the

beginning of these forms.The words that are in “bold underline” in these instructions are defined

there. For further information, see chapter 61, Florida Statutes, and the instructions for the petition

and/or answer that were filed in this case.

Special notes...

At a minimum, the Parenting Plan must describe in adequate detail:

How the parties will share and be responsible for the daily tasks associated with the upbringing

of the child(ren),

The time-sharing schedule arrangements that specify the time that the minor child(ren) will

spend with each parent,

A designationof who willbe responsible for any and all forms ofhealth care,school-related

matters, including the address tobeused for school-boundary determinationandregistration,

other activities, and

The methods and technologies that the parents will use to communicate with the child(ren).

Instructions for Florida Supreme Court Approved Family Law Form 12.995(a), Parenting Plan (10/11)

The best interests of the child(ren) is the primaryconsideration in the Parenting Plan. In creating the

Parenting Plan, all circumstances between the parents, including their historic relationship, domestic

violence, and other factors must be taken into consideration. Determination of the best interests of the

child(ren) shall be made by evaluating all of the factorsaffectingthe welfare and interestof the

particular minor child(ren)and the circumstances ofthat family, as listed in section 61.13(3), Florida

Statutes, including, but not limited to:

The demonstrated capacity and disposition of each parent to facilitate and encourage a close

and continuingparent-child relationship, tohonor the time-sharing schedule, and to be

reasonable when changes are required;

The anticipated division of parental responsibilities after the litigation, includingthe extent to

which parental responsibilities will be delegated to third parties;

The demonstrated capacityand disposition of each parent to determine, consider, and act upon

the needs of the child(ren) as opposed to the needs or desires of the parent;

The length of time the child(ren) has lived in a stable, satisfactory environment and the

desirability of maintaining continuity;

The geographic viability of the parenting plan, with special attention paid to the needs of school-

age children and the amount of time to be spent traveling to effectuate the parenting plan. This

factor does not create a presumption for or against relocation of either parent with a child(ren);

The moral fitness of the parents;

The mental and physical health of the parents;

The home, school, and community record of the child(ren);

The reasonable preference of the child(ren), if the court deems the child(ren) tobe of sufficient

intelligence, understanding, and experience to express a preference;

The demonstrated knowledge, capacity, and disposition of each parent to be informed of the

circumstancesof the minor child(ren), including, but not limited to,the child(ren)’s friends,

teachers, medical care providers, daily activities, and favorite things;

The demonstrated capacity and disposition of each parent to provide a consistent routine for

the child(ren), such as discipline, and daily schedules for homework, meals, and bedtime;

The demonstrated capacity of each parent to communicate with and keep the other parent

informed of issuesand activities regardingthe minor child(ren), and the willingness of each

parent to adopt a unified front on all major issues when dealing with the child(ren);

Evidence of domestic violence, sexual violence, child abuse, child abandonment, or child

neglect, regardless of whether a prior or pending action relating to those issues has been

brought. If the court accepts evidence of prior or pending actions regardingdomestic violence,

sexual violence, child abuse, child abandonment, or child neglect, the court must specifically

acknowledge in writing that such evidencewas considered when evaluatingthe best interests of

the child(ren);

Evidence that either parent has knowingly provided false informationto the court regardingany

prior or pending action regarding domestic violence, sexual violence, child abuse, child

abandonment, or child neglect;

The particular parenting tasks customarily performed by each parent andthe division or

parental responsibilities before the institution of litigation andduringthe pending litigation,

including the extent to which parenting responsibilities were undertaken by third parties;

Instructions for Florida Supreme Court Approved Family Law Form 12.995(a), Parenting Plan (10/11)

The demonstratedcapacity and disposition of each parent to participate and be involved in the

child(ren)’s school and extracurricular activities;

The demonstrated capacity and disposition of each parent to maintain an environment for the

child(ren) which is free from substance abuse;

The capacity and disposition of each parent to protectthe child(ren) from the ongoing litigation

as demonstrated by not discussing the litigation with the child(ren), not sharing documents or

electronic media related to the litigationwith the child(ren), and refraining from disparaging

comments about the other parent to the child)ren); and

The developmental stages and needs of the child(ren)and the demonstrated capacity and

disposition of each parent to meet the child(ren)’s developmental needs.

This standard form does not include every possible issue that may be relevant to the facts of your case.

The Parenting Plan should be as detailed as possible to address the time-sharing schedule. Additional

provisions should be added to address all of the relevant factors. The parties should give special

consideration to the age and needs of each child.

In developing the Parenting Plan, you may wish to consult or review other materials which are available

at your local library, law library or through national and state family organizations.

Remember, a person who is NOT an attorney is called a nonlawyer. If a nonlawyer helps you fill out

these forms, that person must give you a copy of a Disclosure from Nonlawyer, Florida Family Law Rules

of Procedure Form 12.900 (a), before he or she helps you. A nonlawyer helping you fill out these forms

also must put his or her name, address, and telephone number on the bottom of the last page of every

form he or she helps you complete.

Florida Supreme Court Approved Family Law Form 12.995(a), Parenting Plan (10/11)

IN THE CIRCUIT COURT OF THE _____________________ JUDICIAL CIRCUIT

IN AND FOR _________________ COUNTY, FLORIDA

Case No: _____________________

Division: _____________________

_______________________________

Petitioner,

and

_______________________________

Respondent.

PARENTING PLAN

This parenting plan is: (Choose only one)

[ ] A Parenting Plan submitted to the court with the agreement of the parties.

[ ] A proposed Parenting Plan submitted by or on behalf of:

{Parent’s Name}_______________________________________________.

[ ] A Parenting Plan established by the court.

This parenting plan is: (Choose only one)

[ ] A final Parenting Plan established by the court.

[ ] A temporary Parenting Plan established by the court.

[ ] A modification of a prior final Parenting Plan or prior final order.

I.PARENTS

Mother

Name:__________________________________________________________________

Address: ________________________________________________________________

Telephone Number:______________________________________________________

E-Mail:_________________________________________________________________

( ) Address Unknown: (Please indicate here if mother’s address is unknown)

( ) Address Confidential: (Please indicate here if mother’s address and phone numbers are

confidential pursuant toeither a ( ) Final Judgment for Protection Against Domestic Violence,

or ( ) other court order ______________________________________________________).

Father

Name:__________________________________________________________________

Address: ________________________________________________________________

Telephone Number:______________________________________________________

E-Mail:_________________________________________________________________

( ) Address Unknown: (Please indicate here if father’s address is unknown)

Florida Supreme Court Approved Family Law Form 12.995(a), Parenting Plan (10/11)

( ) Address Confidential: (Please indicatehere if father’s address and phone numbers are

confidential pursuant to either a ( ) Final Judgment for Protection Against Domestic Violence or

( ) other court order)__________________________________________________________.)

II.CHILDREN: This parenting plan is for the following child(ren) born to, or adoptedby the parties:

(add additional lines as needed)

Name Date of Birth

_______________________________________________________________________

III.JURISDICTION

The United States is the country of habitual residence of the child(ren).

The State of Florida is the child(ren)’s home state for the purposes of the Uniform Child Custody

Jurisdiction and Enforcement Act.

This Parenting Plan is a childcustody determination for the purposes of the Uniform Child Custody

Jurisdiction and Enforcement Act, the International Child Abduction Remedies Act, 42 U.S.C.

Sections 11601 et seq., the Parental Kidnapping Prevention Act, and the Convention on the Civil

Aspects of International Child Abduction enacted at the Hague on October 25, 1980, and for all

other state and federal laws.

Other: ___________________________________________________________________________.

IV.PARENTAL RESPONSIBILITYAND DECISION MAKING

1.Parental Responsibility (Choose only one)

[ ] Shared Parental Responsibility.

It is in the best interestsof the child(ren) that the parents confer and jointlymake all

major decisions affecting the welfare of the child(ren). Major decisions include, but are

not limited to, decisionsabout the child(ren)’s education, healthcare, andother

responsibilities unique to this family.

[ ] Shared Parental Responsibility with Decision Making Authority

It is in the best interests of the child(ren) that the parents confer and attempt to agree

on the major decisions involving the child(ren). If the parents are unable to agree, the

authority for making major decisions regarding the child(ren) shall be as follows:

Florida Supreme Court Approved Family Law Form 12.995(a), Parenting Plan (10/11)

Education/Academic decisions [ ] Mother[ ] Father

Non-emergency health care [ ] Mother[ ] Father

___________________________ [ ] Mother[ ] Father

[ ] Sole Parental Responsibility:

It is in the best interests of the child(ren) that the [ ] Mother [ ] Father shallhave sole

authority to make major decisionsfor the child(ren.) It is detrimental to the child(ren) to

have shared parental responsibility.

2.Day-to-Day Decisions

Unless otherwise specified in this plan, each parent shall make decisions regarding day-to-

day care and control of each child while the child is with that parent. Regardless of the

allocation of decision making in the parenting plan, either parent may make emergency

decisions affecting the health or safety of the child(ren) when the child is residing with that

parent. A parent who makes an emergency decision shall share the decision with the other

parent as soon as reasonably possible.

3.Extra-curricular Activities ( Choose all that apply)

[ ] Either parent may register the child(ren) and allow them to participate in the activity of

the child(ren)’s choice.

[ ] The parents must mutually agree to all extra-curricular activities.

[ ] The parent with the minor child(ren) shall transport the minor child(ren) to and/or from

all mutually agreed upon extra-curricular activities, providing all necessary uniforms and

equipment within the parent’s possession.

[ ] The costs of the extra-curricular activities shall be paid by:

Mother ______% Father __________ %

[ ] The uniforms and equipment required for the extra-curricular activities shall be paid by:

Mother _______ % Father ____________%

[ ] Other: _____________________________________________________ .

V.INFORMATION SHARING. Unless otherwise indicated or ordered by the Court:

Unless otherwise prohibited by law, each parent shall have access to medical and school records

and information pertaining to the child(ren) and shall be permitted to independently consult

Florida Supreme Court Approved Family Law Form 12.995(a), Parenting Plan (10/11)

with any and all professionals involved with the child(ren). The parents shall cooperate with

each other in sharing information related to the health, education, and welfare of the child(ren)

and they shall sign any necessary documentation ensuring that both parents have access to said

records.

Each parent shall be responsible for obtaining records and reports directly from the school and

health care providers.

Both parents have equal rights to inspect and receive governmental agency and law

enforcement records concerning the child(ren).

Both parents shall have equal and independent authority to confer with the child(ren)’s

school, day care, health care providers, and other programs with regard to the child(ren)’s

educational, emotional, and social progress.

Both parents shall be listed as “emergency contacts” for the child(ren).

Each parent has a continuing responsibility to provide a residential, mailing, and contact address

and contact telephone number to the other parent. Each parent shall notify the other parent in

writing within 24 hours of any changes. Each parent shall notify the court in writing within seven

(7) days of any changes.

Other: _________________________________________________________________

________________________________________________________________.

VI.SCHEDULING

1.School Calendar

If necessary, on or before ______________ of each year, both parents should obtain a copy

of the school calendar for the next school year. The parents shall discuss the calendars and

the time-sharing schedule so that any differences or questions can be resolved.

The parents shall follow the school calendar of: (Choose all that apply)

[ ] the oldest child

[ ] the youngest child

[ ] the school calendar for ______________ County

[ ] the school calendar for _________________ School

2.Academic Break Definition

When defining academic break periods, the period shall begin at the end of the last

scheduled day of classes before the holiday or break and shall start on the first day of

regularly scheduled classes after the holiday or break.

3.Schedule Changes (Choose all that apply)

Florida Supreme Court Approved Family Law Form 12.995(a), Parenting Plan (10/11)

[ ] A parent making a request for a schedule change will make the request as soon as

possible, but in any event, except in cases of emergency, no less than

________________before the change is to occur.

[ ] A parent requesting a change of schedule shall be responsible for any additional child

care, or transportation costs caused by the change.

[ ] Other ______________________________________________________.

VII.TIME-SHARING SCHEDULE

1.Weekday and Weekend Schedule

The following schedule shall apply beginning on ________________________ with the

[ ] Mother [ ] Father and continue as follows:

A.The child(ren) shall spend time with the Mother on the following dates and times:

WEEKENDS: [ ] Every [ ] Every Other [ ] Other (specify) _____________________

From____________________________ to _________________________________

WEEKDAYS: Specify days_______________________________________________

From _____________________________ to _______________________________

OTHER: (Specify) _____________________________________________________

___________________________________________________________________

___________________________________________________________________.

B.The child(ren) shall spend time with the Father on the following dates and times:

WEEKENDS: [ ] Every [ ] Every Other [ ] Other (specify) ____________________

From____________________________ to _________________________________

WEEKDAYS: Specify days_______________________________________________

From _____________________________ to _______________________________

OTHER: (Specify) _____________________________________________________

___________________________________________________________________

___________________________________________________________________.

C.Please indicate if there is a different time sharing schedule for any child. Complete a

separate Attachment for each child for whom there is a different time sharing

schedule.

[ ] There is a different time-sharing schedule for the following child(ren) in Attachment

____.

______________________________, and _________________________.

(Name of Child) (Name of Child)

2.Holiday Schedule (Choose only one)

Florida Supreme Court Approved Family Law Form 12.995(a), Parenting Plan (10/11)

[ ] No holiday time sharing shall apply. The regular time-sharing schedule set forth above

shall apply.

[ ] Holiday time-sharing shall be as the parties agree.

[ ] Holiday time-sharing shall be in accordance with the following schedule. The Holiday

schedule will take priority over the regular weekday, weekend, and summer schedules.

Fill in the blanks with Mother or Father to indicate where the child(ren) will be for the

holidays. Provide the beginning and ending times. If a holiday is not specified as even,

odd, or every year with one parent, then the child(ren) will remain with the parent in

accordance with the regular schedule

Holidays Even YearsOdd Years Every Year Begin/End Time

Mother’s Day______________________________________________

Father’s day__________ ___________________ _________________

President’s Day______________________________________________

Martin Luther King Day __________ _________ __________ _________________

Easter __________ _________ __________ _________________

Passover__________ _________ __________ _________________

Memorial Day Weekend ______________________________________________

of July __________ _________ __________ _________________

Labor Day Weekend__________ _________ __________ _________________

Columbus Day Weekend _____________________________________________

Halloween__________ _________ __________ _________________

Thanksgiving__________ _________ __________ _________________

Veteran’s Day__________ _________ __________ _________________

Hanukkah__________ _________ __________ _________________

Yom Kippur__________ _________ __________ _________________

Rosh Hashanah__________ _________ ___________________________

Child(ren)’s Birthdays______________________________________________

_______________ ______________________________________________

This holiday schedule may affect the regular Time-Sharing Schedule. Parents may wish to specify

one or more of the following options:

[ ] When the parents are using an alternating weekend plan and the holiday schedule

would result in one parent having the child(ren) for three weekends in a row, the

parents will exchange the following weekend, so that each has two weekends in a row

before the regular alternating weekend pattern resumes.

[ ] If a parent has the child(ren) on a weekend immediately before or after an unspecified

holiday or non-school day, they shall have the child(ren) for the holiday or non-school

day.

Florida Supreme Court Approved Family Law Form 12.995(a), Parenting Plan (10/11)

3.Winter Break

A.Entire Winter Break (Choose only one)

[ ] The [ ] Mother [ ] Father shall have the child(ren) from the day and time school is

dismissed until December _____ at ___ a.m./p. m in [ ]odd-numbered years [ ] even-

numbered years [ ] every year. The other parent will have the children for the second

portion of the Winter Break. The parties shall alternate the arrangement each year.

[ ] The [] Mother [ ] Father shall have the child(ren) for the entire Winter Break during

[ ] odd-numbered years [ ] even-numbered years [] every year.

[ ] Other: ______________________________________________________________

______________________________________________________________

______________________________________________________________.

B.Specific Winter Holidays

If not addressed above, the specific Winter Holidays such as Christmas, New Year’s Eve,

Hanukkah, Kwanzaa, etc. and shall be shared as follows:

______________________________________________________________________

______________________________________________________________________.

4.Spring Break (Choose only one)

[ ] The parents shall follow the regular schedule.

[ ] The parents shall alternate the entire Spring Break with the Mother having the

child(ren) during the [ ]odd-numbered years [ ]even numbered years.

[ ] The [ ] Father [ ] Mother shall have the child(ren) for the entire Spring Break every year.

[ ] The Spring Break will be evenly divided. The first half of the Spring Break will go to the

parent whose regularly scheduled weekend falls on the first half and the second half

going to the parent whose weekend falls during the second half.

[ ] Other:_________________________________________________________________.

5.Summer Break(Choose only one)

[ ] The parents shall follow the regular schedule through the summer.

[ ] The [ ] Mother [ ] Father shall have the entire Summer Break from __________ after

school is out until _______________ before school starts.

Florida Supreme Court Approved Family Law Form 12.995(a), Parenting Plan (10/11)

[ ] The parents shall equally divide the Summer Break. During [ ] odd-numbered years

[ ] even numbered years, the [ ] Mother [] Father shall have the children from

________ after school is out until ________. The other parent shall have the child(ren)

for the second one-half of the Summer Break.The parents shall alternate the first and

second one-halves each year unless otherwise agreed. During the extended periods of

time-sharing, the other parent shall have the child(ren)

______________________________.

[ ] Other:__________________________________________________________________

_______________________________________________________________________.

6.Number of Overnights:

Based upon the time-sharing schedule, the Mother has a total of _____ overnights per year

and the Father has a total of _____ overnights per year. Note: The two numbers must

equal 365.

7.[ ] If not set forth above, the parties shall have time-sharing in accordance with the

schedule which is attached and incorporated herein.

VIII.TRANSPORTATION AND EXCHANGE OF CHILD(REN)

1.Transportation (Choose only one)

[ ] The [ ] Mother [ ] Father shall provide all transportation.

[ ] The parent beginning their time-sharing shall provide transportation for the child(ren).

[ ] The parent ending their time-sharing shall provide transportation for the child(ren).

[ ] Other: _________________________________________________________________.

2.Exchange

Both parents shall have the child(ren) ready on time with sufficient clothing packed and

ready at the agreed upon time of exchange. If a parent is more than ______ minutes late

without contacting the other parent to make other arrangements, the parent with the

child(ren) may proceed with other plans and activities. (Choose only one):

[ ] Exchanges shall be at Mother’s and Father’s homes unless both parents agree to a

different meeting place.

[ ] Exchanges shall occur at __________________________________________________