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Fillable Printable Sample Parenting Plan - Georgia

Fillable Printable Sample Parenting Plan - Georgia

Sample Parenting Plan - Georgia

Sample Parenting Plan - Georgia

__________________COUNTY SUPERIOR COURT
STATE OF GEORGIA
)
Plaintiff, ) Civil Action
) Case Number ________________
vs. )
)
)
Defendant. )
PARENTING PLAN
( ) The parties have agreed to the terms of this plan and this information has been furnished by both
parties to meet the requirements of OCGA Section 19-9-1. The parties agree on the terms of the
plan and affirm the accuracy of the information provided, as shown by their signatures at the end of
this order.
( ) This plan has been prepared by the judge.
This plan ( ) is a new plan.
( ) modifies an existing Parenting Plan dated ___________.
( ) modifies an existing Order dated __________________.
Child’s Name Date of Birth
I. Custody and Decision Making:
A. Legal Custody shall be (choose one:)
( ) with the Mother
( ) with the Father
( ) Joint
B. Primary Physical Custodian
For each of the children named below the primary physical custodian shall be:
d/o/b: ( ) Mother ( ) Father ( ) Joint
d/o/b: ( ) Mother ( ) Father ( ) Joint
d/o/b: ( ) Mother ( ) Father ( ) Joint
d/o/b: ( ) Mother ( ) Father ( ) Joint
d/o/b: ( ) Mother ( ) Father ( ) Joint
WHERE JOINT PHYSICAL CUSTODY IS CHOSEN BY THE PARENTS OR ORDERED BY
THE COURT, A DETAILED PLAN OF THE LIVING ARRANGEMENTS OF THE
CHILD(REN) SHALL BE ATTACHED AND MADE A PART OF THIS PARENTING PLAN.
C. Day-To-Day Decisions
Each parent shall make decisions regarding the day-to-day care of a child while the child is
residing with that parent, including any emergency decisions affecting the health or safety
of a child.
D. Major Decisions
Major decisions regarding each child shall be made as follows:
Educational decisions ( ) mother ( ) father ( ) joint
Non-emergency health care ( ) mother ( ) father ( ) joint
Religious upbringing ( ) mother ( ) father ( ) joint
Extracurricular activities ( ) mother ( ) father ( ) joint
_____________________ ( ) mother ( ) father ( ) joint
_____________________ ( ) mother ( ) father ( ) joint
E. Disagreements
Where parents have elected joint decision making in Section I.D above, please explain how
any disagreements in decision-making will be resolved.
II. Parenting Time/Visitation Schedules
A. Parenting Time/Visitation
During the term of this parenting plan the non-custodial parent shall have at a minimum the
following rights of parenting time / visitation (choose an item):
( ) The weekend of the first and third Friday of each month.
( ) The weekend of the first, third, and fifth Friday of each month.
( ) The weekend of the second and fourth Friday of each month.
( ) Every other weekend starting on .
( ) Each starting at a.m./p.m. and ending a.m./p.m.
( ) Other: .
( ) and weekday parenting time / visitation on (choose an item):
( ) None
( ) Every Wednesday Evening
( ) Every other Wednesday during the week prior to a non-visitation weekend.
( ) Every
and evening.
( ) Other:
For purposes of this parenting plan, a weekend will start at a.m./p.m. on [Thursday /
Friday / Saturday / Other: ] and end at a.m./p.m. on [Sunday /
Monday / Other: ].
Weekday visitation will begin at a.m./p.m. and will end [at p.m. /
when the child(ren) return(s) to school or day care the next morning / Other:
].
This parenting schedule begins:
( ) ____________________ OR ( ) date of the Court’s Order
(day and time)
B. Major Holidays and Vacation Periods
Thanksgiving
The day to day schedule shall apply unless other arrangements are set forth:
beginning _____________________.
Winter Vacation
The ( ) mother ( ) father shall have the child(ren) for the first period 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 child(ren) for
the second period from the day and time indicated above until 6:00 p.m. on the evening
before school resumes. Unless otherwise indicated, the parties shall alternate the first and
second periods each year.
Other agreement of the parents:
.
Summer Vacation
Define summer vacation period: _______________________________________________
The day to day schedule shall apply unless other arrangements are set forth:
beginning _____________________.
Spring Vacation (if applicable)
Define:___________________________________________________________________
The day to day schedule shall apply unless other arrangements are set forth:
beginning _____________________.
Fall Vacation (if applicable)
Define:___________________________________________________________________
The day to day schedule shall apply unless other arrangements are set forth:
beginning _____________________.
C. Other Holiday Schedule (if applicable)
Indicate if child(ren) will be with the parent in ODD or EVEN numbered years or indicate
EVERY year:
MOTHER FATHER
Martin Luther King Day _________________ _________________
Presidents’ Day _________________ _________________
Mother’s Day _________________ _________________
Memorial Day _________________ _________________
Father’s Day _________________ _________________
July Fourth _________________ _________________
Labor Day _________________ _________________
Halloween _________________ _________________
Child(ren)’s Birthday(s) _________________ _________________
Mother’s Birthday _________________ _________________
Father’s Birthday _________________ _________________
Religious Holidays: _________________ _________________
_________________ _________________ _________________
_________________ _________________ _________________
_________________ _________________ _________________
_________________ _________________ _________________
Other: _________________ _________________ _________________
_________________ _________________ _________________
_________________ _________________ _________________
_________________ _________________ _________________
_________________ _________________ _________________
Other: _________________ _________________ _________________
Other: _________________ _________________ _________________
_________________ _________________
D. Other extended periods of time during school, etc. (refer to the school schedule)
E. Start and end dates for holiday visitation
For the purposes of this parenting plan, the holiday will start and end as follows (choose
one):
( ) Holidays that fall on Friday will include the following Saturday and Sunday
( ) Holidays that fall on Monday will include the preceding Saturday and Sunday
( ) Other: _______________________________________________________
F. Coordination of Parenting Schedules
Check if applicable:
( ) The holiday parenting time/visitation schedule takes precedence over the regular
parenting time/visitation schedule.
( ) When the child(ren) is/are with a parent for an extended parenting time/visitation period
(such as summer), the other parent shall be entitled to visit with the child(ren) during the
extended period, as follows:
G. Transportation Arrangements
For visitation, the place of meeting for the exchange of the child(ren) shall be:
The will be responsible for transportation of the child at the
beginning of visitation.
The will be responsible for transportation of the child at the
conclusion of visitation.
Transportation costs, if any, will be allocated as follows:
Other provisions:
H. Contacting the child
When the child or children are in the physical custody of one parent, the other parent will
have the right to contact the child or children as follows:
( ) Telephone
( ) Other:
( ) Limitations on contact:
I. Supervision of Parenting Time (if applicable)
( ) Check here if Applicable
Supervised parenting time shall apply during the day-to-day schedule as follows:
Place:
Person/Organization supervising:
Responsibility for cost: ( ) mother ( ) father ( ) both equally
J. Communication Provisions
Please check:
( ) Each parent shall promptly notify the other parent of a change of address, phone number
or cell phone number. A parent changing residence must give at least 30 days notice of the
change and provide the full address of the new residence.
( ) Due to prior acts of family violence, the address of the child(ren) and victim of family
violence shall be kept confidential. The protected parent shall promptly notify the other
parent, through a third party, of any change in contact information necessary to conduct
visitation.
III. Access to Records and Information
Rights of the Parents
Absent agreement to limitations or court ordered limitations, pursuant to O.C.G.A. § 19-9-1
(b) (1) (D), both parents are entitled to access to all of the child(ren)’s records and
information, including, but not limited to, education, health, extracurricular activities, and
religious communications. Designation as a non-custodial parent does not affect a parent’s
right to equal access to these records.
Limitations on access rights:
Other Information Sharing Provisions:
IV. Modification of Plan or Disagreements
Parties may, by mutual agreement, vary the parenting time/visitation; however, such agreement
shall not be a binding court order. Custody shall only be modified by court order.
Should the parents disagree about this parenting plan or wish to modify it, they must make a good
faith effort to resolve the issue between them.
V. Special Considerations
Please attach an addendum detailing any special circumstances of which the Court should be aware
(e.g., health issues, educational issues, etc.)
VI. Parents’ Consent
Please review the following and initial:
1. We recognize that a close and continuing parent-child relationship and continuity in the
child’s life is in the child’s best interest.
Mother’s Initials: ___________ Father’s Initials: ____________
2. We recognize that our child’s needs will change and grow as the child matures; we have
made a good faith effort to take these changing needs into account so that the need for
future modifications to the parenting plan are minimized.
Mother’s Initials: ____________ Father’s Initials: ____________
3. We recognize that the parent with physical custody will make the day-to-day decisions
and emergency decisions while the child is residing with such parent.
Mother’s Initials: __________Father’s Initials: _____________
( ) We knowingly and voluntarily agree on the terms of this Parenting Plan. Each of us
affirms that the information we have provided in this Plan is true and correct.
Father’s Signature Mother’s Signature
ORDER
The Court has reviewed the foregoing Parenting Plan, and it is hereby made the order of this Court.
This Order entered on _____________________________________, 20 _____ .
JUDGE
COUNTY SUPERIOR COURT
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