Fillable Printable Proposed Parenting Plan Form - Hawaii

Proposed Parenting Plan Form - Hawaii

STATE OF HAWAII

FAMILY COURT

First Circuit

PROPOSED PARENTING PLAN

CASE NUMBER

FC- NO. ________

G CHILD SUPPORT ENFORCEMENT AGENCY,

STATE OF HAWAI‘I,

____________________________________________

(Name: First Middle Last) G Mother G Father

PLAINTIFF(S)/PETITIONER(S),

vs.

____________________________________________

(Name: First Middle Last) G Mother G Father G Caretaker

____________________________________________

(Name: First Middle Last) G Mother G Fathe r G Caretaker

G and CHILD SUPPORT ENFORCEMENT AGE NCY,

STATE OF HAWAI‘I,

DEFENDANT(S)/RESPONDENT(S).

This document was prepared by:

[ ] Plaintiff/Petitioner

[ ] Defendant/Respondent

[ ] Caretaker/Other*

[ ] Attorney for:

[ ]Petitioner/Plaintiff [ ]Defendant/Respondent

_______________________________________________

Name

_______________________________________________

Address

______________________________ _________________

City, State, Zip Code

_______________________________________________

Telephone Number

* Relationship of Caretaker/Other to the child(ren):

_______________________________________________

I will be relocating to _________________________________ on or about _________________.

[If you are relocating, file one plan for before relocation and another plan for after relocation.]

G This is the plan for before relocation. G This is the plan for after relocation.

1. Child(ren): G See attached sheet for additional children. Is CPS*

Full Name Birth Date Gender School/Grade Involved?

Child 1 / / GM GF GYes GNo

Child 2 / / GM GF GYes GNo

Child 3 / / GM GF GYes GNo

Child 4 / / GM GF GYes GNo

Child 5 / / GM GF GYes GNo

Child 6 / / GM GF GYes GNo

*CPS stands for Child Protective Services

2. Legal Custody should be awarded to (person(s) making the major decisions, such as, school enrollment,

medical, driver’s license):

G Mother G Father G Jointly to both Mother and Father G Caretaker

3. Physical Custody should be awarded to (the child(ren) will primarily live with this p erson):

G Mother G Father G Jointly to both Mother and Father G Caretaker

(State Parenting Time Below*)

* Joint custody with the child(ren) will be shared between Mother and

Father as follows (even if you are suggesting joint custody, you can also use

the checklists in Sections 5 and 6.):

________________________________________________________________

FOR COURT USE ONLY

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4. Special Concerns: (i.e. breastfeeding infant, special needs of child(ren) or disability of either parent:

___________________________________________________________________________________

5. Visitation Schedule: G Father GMother (check one) shall have visitation, which shall commence on

(fill in date), as follows:

G Reasonable visitation as agreed to by the partie s.

G Every other weekend G Every weekend

from (day of the week) at ________ GA.M. GP.M. to (day of the

week)______________________ at GA.M. GP.M.

G Midweek dinner visits on (days of the week) from P.M. to _______P.M.

(Note: For Friday and Monday holidays, the child(ren) will stay with the parent who has the child(ren)

for that weekend.)

Summer Vacation:

G Should be split as agreed to by Father and Mother.

G Father and Mother shall each have one-half of the summer vacation with alternate weekends to the other

parent. The child(ren) should be returned to the custodial parent at least one (1) week prior to the start o

school.

G Other: __________________________________________________________________________

Christmas and New Year Vacation:

G Should be split as agreed to by Father and Mother

G Father and Mother shall each have one-half of the Christmas/New Year vacation.

G Other: __________________________________________________________________________

Intersession Vacations (Spring Break and Fall Break):

G Each intersession break should be split as agreed to by Father and Mother.

G Each intersession break should be alternated yearly between by Father and Mother.

G Father and Mother shall each have one-half of each intersession break.

G Other: __________________________________________________________________________

Child(ren)’s Birthday(s):

G The child(ren)’s birthday(s) should be celebrated as agreed to by Father and Mother.

G A child’s birthday will be spent with the parent who has the child on that day.

G [ ]Father [ ]Mother should have the child(ren) on the child(ren)’s birthday on even-numbered years. The

other parent should have the child(ren) on the child(ren)’s birthday on odd-numbered years.

G Father and Mother will share the child(ren) for at least half the day on the child(ren)’s birthday.

G Other: __________________________________________________________________________

Extensive Visitation (if applicable) should be as follows: _____________________________________

____________________________________________________________________________________

Out-of-State visitation (if applicable) should be as follows: ___________________________________

____________________________________________________________________________________

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6. Detailed Holiday Schedule: Some cases work better if more details are listed. Use this as a checklist. You do

not have to fill in everything. Anything that is lef t blank means that the child will spend the day with the parent

who has the child on that day. (Note: For Friday and Monday holidays, the child(ren) will stay with the parent

who has the child(ren) for that weekend.)

Check “M” for Mother and “F” for Father. An example is shaded in gray.

Holiday

Time (Put a.m. or p.m.)

Every Year Even Years Odd Years

Example Holiday 9 a.m. to 7 p.m.

GM GF :M GF GM :F

New Year’s Eve

GM GF GM GF GM GF

New Year’s Day

GM GF GM GF GM GF

Martin Luther King, Jr. Day MONDAY HOLIDAY (see above note)

President’s Day MONDAY HOLIDAY (see above note)

Prince Kuhio Day (March 26

)

GM GF GM GF GM GF

Good Friday FRIDAY HOLIDAY (see above note)

Memorial Day MONDAY HOLIDAY (see above note)

King Kamehameha Day (June 11

)

GM GF GM GF GM GF

Independence Day (July 4

)

GM GF GM GF GM GF

Statehood Day (Admissions Day) FRIDAY HOLIDAY (see above note)

Labor Day MONDAY HOLIDAY (see above note)

Veterans’ Day (November 11

)

GM GF GM GF GM GF

Thanksgiving Day

GM GF GM GF GM GF

Christmas Eve

GM GF GM GF GM GF

Christmas Day

GM GF GM GF GM GF

Mother’s Day

GM GF GM GF GM GF

Father’s Day

GM GF GM GF GM GF

Mother’s Birthday

GM GF GM GF GM GF

Father’s Birthday

GM GF GM GF GM GF

Halloween (October 31

)

GM GF GM GF GM GF

Other:

GM GF GM GF GM GF

Other:

GM GF GM GF GM GF

7. Childcare:

These are the arrangements for childcare when I am at work (if you have agreed to joint custody, also state the

arrangements of the other parent): ____________________________________________________________

________________________________________________________________________________________

8. Parents covering each other:

G If we cannot care for the child(ren) during a time assigned to us, we will ask the other parent to take care of

the child(ren) before we ask anybody else.

G It will be up to each parent who they ask for help during their assigned times.

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9. Transportation:

G The parents will agree to who can transport the child(ren).

G Only the following people can help the parents with transportation: ____________________________

__________________________________________________________________________________

10. Communication and Information Sharing:

G The parent without the child(ren) can call the child(ren) (check only one): G At reasonable hours OR

G Everyday from a.m./p.m. to a.m./p.m.

G E-Mail at this email address: ____________________ G Other: _________________________

G Parents will share information with each other G Parents must get information from the source (e.g., Dr., school)

11. Supervised Visitation/No Visitation: G Father G Mother

G Will have supervised visitation with the child(ren):

G at PACT Visitation Center G Under the supervision of __________________________________

G Will have no visitation.

(State the reason why supervised or suspended visitation is necessary) ___________________________

____________________________________________________________________________________

12. Modifications to the visitation schedule:

G Any additional visitation or changes to the visitation schedule can be agreed upon by the parents/caretaker

with at least 24-hour notice.

G If the non-custodial parent fails to arrive at the appointed time, then the custodial parent/caretaker will wait

for minutes before considering the visitation cancelled.

G Other: ___________________________________________________________________________

_________________________________________________________________________________

G No modifications allowed except by a court order.

13. Mediation and Solving Disagreements:

G The parties should mediate any unresolved issues or future disagreements at:

G The Mediation Center of the Pacific G Other: _________________________________________

G Mediation is inappropriate because: G Domestic Violence/TRO G Other: ___________________

G Before going to court, the parents will ask the following person to help them solve disagreements:

________________________________________________________________________________

(list name, relationship, address, phone no.)

14. Counseling:

List present counselors for:

Mother: _____________________ Father: _____________________ Child(ren): _____________________

Under penalty of perjury, I/we declare that this plan is proposed in good faith and is in the best interest of the

child(ren) listed in Section 1.

__________________________________________ __________________________________________

Print Attorney’s Name Party’s Signature Date

__________________________________________ __________________________________________

Attorney’s Signature Date Party’s Signature Date

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