Stipulated Permanent Parenting Plan - Montana - Edit, Fill, Sign Online

FORM #232– STIPULATED PERMANENT PARENTING PLAN Page 1 of 16

4th Judicial District Forms - Pro se Petition for Parenting Plan (Revision Date: 3/10)

_______________________________

FORM #232

Name

_____________________________________

Address

Exhibit A

_____________________________________

City State Zip Code

_____________________________________

Phone Number

_____________________________________

Email Address

CO-PETITIONER, MOTHER

_______________________________

Name

_____________________________________

Address

_____________________________________

City State Zip Code

_____________________________________

Phone Number

_____________________________________

Email Address

CO-PETITIONER, FATHER

MONTANA FOURTH JUDICIAL DISTRICT COURT

MISSOULA COUNTY

In re the Parenting of:

____________________________________,

Initials of Minor Child(ren),

___________________________________,

Co-Petitioner,

and

___________________________________,

Co-Petitioner.

Cause No.: _________________

Department No.: ____________

STIPULATED PERMANENT

PARENTING PLAN

1. Identification of the Parties

a. Petitioner-(Mother) Name: ____________________________________________

Address: __________________________________________________________

b. Petitioner-(Father) Name: ____________________________________________

Address: __________________________________________________________

2. Identification of the Child(ren)

FORM #232- STIPULATED PARENT ING PLAN Page 2 of 16

4th Judicial District Forms - Pro se Petition for Parenting Plan (Revision Date: 3/10)

This parenting plan applies to the following minor child(ren) of the parties:

Name (first and last) Age State of residence for

Last 6 months

3. Objectives of the Parenting Plan

a. To protect the best interest(s) of the minor child(ren);

b. To provide for the physical care of the minor child(ren);

c. To maintain the child(ren)’s emotional stability and minimize the child(ren)’s

exposure to parental conflict;

d. To provide for the minor child(ren)’s changing needs as they grow and mature;

e. To set forth the authority and responsibilities of each parent with respect to the

minor child(ren);

f. To help the parents avoid expensive future court battles over the minor child(ren).

4. Residential Schedule for the Child(ren) The provisions set forth below in Paragraphs

4(a)-(i) are one way to write your residential schedule. This schedule is designed to

provide for the child(ren)’s changing needs as they grow and mature. It specifies the

periods of time during which the child(ren) will reside with each parent, including

holidays, vacations, and other special occasions. If you choose not to use the provisions

provided, you may write your own schedule in Paragraph 4(j) below.

a. Pre-School Schedule (Choose One):

[ ] There are no child(ren) under school age.

[ ] There are child(ren) under school age, but the school schedule set forth in

4(b) below shall apply to the child(ren) regardless of their age(s).

[ ] Prior to enrollment in school, the child(ren) shall reside primarily with the

[ ] Mother [ ] Father, except for the following days and times when the

other parent shall have parenting time with the child(ren):

________________________

____________________________________________________________

______

______________________________________________________

____________

Or

FORM #232– STIPULATED PERMANENT PARENTING PLAN Page 3 of 16

4th Judicial District Forms - Pro se Petition for Parenting Plan (Revision Date: 3/10)

[ ] Describe the residential schedule for the minor child(ren) prior to their enrollment

in school: __________________________________________________________

____________ .

b. School Schedule (Choose One):

[ ] Upon enrollment in school, the child(ren) shall reside with the

[ ] Mother [ ] Father, except for the following days and times when the other

parent shall have parenting time with the child(ren): _______________________

____________

.

or

[ ] Describe the residential schedule for the minor child(ren):

_____________

_

___________________________________________________________________

c. Holiday and Special Occasion Schedule

[ ] No holiday and special occasion schedule shall apply. The school year or pre-

school schedule set forth above shall apply.

or

[ ] The following schedule shall apply for the holidays and special occasions listed

below:

Following is the customary visitation schedule when children are over 5 years old and parents

reside less than 200 miles apart. Parents may consult Local Rule 12(f) for further guidance.

(http://www.montanacourts.org/dcourt/rules/local/4th.pdf)

(Specify Odd or Even)

HOLIDAY

MOTHER FATHER

Thanksgiving

(Wed. 5:30 p.m. – Sun. 7:00 p.m.)

Christmas Eve

(Chr. Eve Noon -- Chr. Day Noon)

Christmas Day

(Noon to 9:00 p.m .)

New Years

(NY Eve Noon -- NY Day Noon)

Easter Weekend

(Fri. 5:30 p.m. – Sun. 7:00 p.m.)

Memorial Day Weekend

(Fri. 5:30 p.m. – Mon. 7:00 p.m.)

Labor Day Weekend

(Fri. 5:30 p.m. – Mon. 7:00 p.m.)

Fourth of July

Halloween

FORM #232– STIPULATED PERMANENT PARENTING PLAN Page 4 of 16

4th Judicial District Forms - Pro se Petition for Parenting Plan (Revision Date: 3/10)

HOLIDAY

MOTHER FATHER

Mother’s Day Weekend

(Fri. 5:30 p.m. – Sun. 7:00 p.m.)

Father’s Day Weekend

(Fri. 5:30 p.m. – Sun. 7:00 p.m.)

Child(ren)’s Birthday

Mother’s Birthday

Father’s Birthday

The child(ren)’s school attendance shall take priority over the holiday and special day

schedule. The child(ren) shall not miss school because of the holiday or special occasion

schedule.

d. Winter Vacation (Choose One):

[ ] No winter vacation schedule shall apply. The school year or pre-school schedule

set forth above shall apply.

or

[ ] (i) The parent exercising parenting time with the child(ren) on Christmas Eve

(as outlined above) shall have the following additional parenting time with

the child(ren) over winter vacation:

_____________________________________________________________

____________________________________________________________.

(ii) The parent exercising parenting time with the child(ren) on Christmas Day

(as outlined above) shall have the following additional parenting time with

the child(ren) over winter vacation:

_____________________________________________________________

____________________________________________________________.

or

[ ] Describe the residential schedule fo r the child(ren)’s winter vacation:

___________________________________________________________

__________________________________________________________________

__________________________________________________________________.

e. Summer Vacation (Choose One):

[ ] No summer vacation schedule shall apply. The school year or pre-school schedule

set forth above shall apply.

or

[ ] The child(ren) shall reside with the [ ] Mother [ ] Father during summer

vacations, except for the following days and times when the child(ren)

shall be with the other parent: __________________________________________

__________________________________________________________________.

or

[ ] Describe the residential schedule for the child(ren)’s summer vacation:

___________________________________________________________________

FORM #232– STIPULATED PERMANENT PARENTING PLAN Page 5 of 16

4th Judicial District Forms - Pro se Petition for Parenting Plan (Revision Date: 3/10)

___________________________________________________________________

f. Spring Break (Choose One):

[ ] No Spring Break schedule shall apply. The school year or pre-school schedule set

forth above shall apply.

or

[ ] The child(ren) shall reside with the [ ] Mother [ ] Father during Spring

Break, except for the following days and times when the ch ild(ren) shall

be with the other parent: ______________________________________

__________________________________________________________.

or

[ ] Describe the residential schedule for the child(ren)’s Spring Break:

___________________________________________________________

___________________________________________________________.

g. Other Vacations with Parents

Describe the schedules for any other vacations with the parents:

________________________________________________________________________

h. Priorities under the Residential Schedule

If the residential schedule outlined above results in a conflict where the child(ren) are

scheduled to be with both parents at the same time, the conflict shall be resolved by

priority being given as follows:

[ ] Rank the order of priority, with 1 being the highest priority

____ Preschool and School Schedule

Holidays/Special Occasions

Winter/Summer/Spring Break Vacations

Other Vacations with Parents

or

[ ] Other:

___________________________________________________________

_ .

i. Supervised and Limited Visitation (Choose One):

[ ] The residential schedule listed above is not subject to any additional restrictions or

limitations on parenting time.

or

[ ] (i) The [ ] Mother’s [ ] Father’s parenting time shall be supervised or

limited because he/she has exhibited the following behavior which is not in

the best interest(s) of the minor child(ren):

______________________________________________________

FORM #232– STIPULATED PERMANENT PARENTING PLAN Page 6 of 16

4th Judicial District Forms - Pro se Petition for Parenting Plan (Revision Date: 3/10)

_____________________________________________________.

(ii) It is in th e best interest(s) of the minor child(ren) that the

[ ] Mother’s [ ] Father’s parenting time be subject to the following

conditions:

How Often/ For How Long: _______________________________

Where: .

Supervised by Whom: .

(iii) The supervised and limited visitation conditions shall take priority over any

other terms of the residential schedule above.

(iv) If the [ ] Mother [ ] Father has completed the following and has followed

through with any and all recommendations by the evaluator, treatment

counselor, and/or other professional recommendations, the [ ] Mother [ ]

Father agrees to consider a modification to allow less restricted visitation

after ______ months of supervised and limited visitation. (Check All That

Apply):

[ ] Alcohol / drug evaluation

[ ] Substance abuse treatment

[ ] Psychological evaluation

[ ] Anger management counseling

[ ] Parenting classes

[ ] Other: .

j. Other: ___________________________________________________________

_________________________________________________________________

_________________________________________________________________.

5. Designation of Primary Parent

For the purpose of all other state and federal statutes which require a designation or determination

of parenting, the [ ] Mother [ ] Father shall be designated the primary parent. However, this

designation shall not affect either parent’s rights and responsibilities under this parenting plan.

6. Transportation Arrangements (Choose All That Apply):

[ ] Transportation arrangements for the child(ren) b etween parents shall be as follows:

_______________________________________________________________

[ ] Unless both parents agree upon a different meeting place, the exchange of the child(ren)

shall be at: .

[ ] Transportation costs shall be distributed as follows:

.

FORM #232– STIPULATED PERMANENT PARENTING PLAN Page 7 of 16

4th Judicial District Forms - Pro se Petition for Parenting Plan (Revision Date: 3/10)

[ ] If the [ ] Mother [ ] Father is more than ____ minutes late to pick the child(ren) up for a

visit, that visit shall be canceled.

7. Telephone Contact (Choose One):

[ ] While the child(ren) reside with one parent, the other parent shall be permitted to speak

with the child(ren) at reasonable times.

or

[ ] While the child(ren) reside with one parent, the other parent shall be permitted to

speak with the child(ren) at the following times only: ______________________

_________________________________________________________________.

8. Co-Parenting Guidelines (Choose All That Apply):

[ ] Each parent shall promote a healthy, beneficial relationship between the child(ren) and the

other parent and shall not demean or speak out negatively in any manner that would

damage the relationship between either parent and the child(ren).

[ ] Each parent shall notify the other parent at least days in advance when a

particular parenting time shall not be exercised. The missed time shall not be substituted

unless mutually agreed to by both parents. The parents are expected to fairly modify

visitation when family necessities, illnesses, or other commitments reasonably so require.

The requesting parent shall act in good faith and give as much notice as circumstances

permit.

[ ] Each parent shall supply the appropriate child(ren)’s cloth i ng with them for their sched u led

time with the other parent. These clothes are to be considered the child(ren)’s clothes and

shall be returned with the child(ren).

[ ] Each parent shall provide separate clothes for the child(ren) at their own residence, unless

mutually agreed to by both parents. In the cold months of the year, both parents are

required to have adequate boots, gloves, hats, and jackets for the child(ren), unless

mutually agreed to by both parents.

[ ] If a parent plans a special activity that requires clothing and/or equipment that would

normally not be with the child(ren), it is that parent’s responsibility to check to see if the

child(ren) have such clothing and/or equipment with the other parent, to ask that the

clothing and/or equipment travels with the child(ren), and to ensure that the clothing and/or

equipment returns the same with the child(ren).

[ ] Each parent shall be responsible for ensuring that the child(ren) attend regularly scheduled

activities, including but not limited to sports and extra-curricular activities, while the

child(ren) are with that parent.

[ ] Neither parent shall permit the child(ren) to be subjected to:

(Choose All That Apply):

[ ] Persons abusing alcohol or using illegal drugs within 24 hours of contact with the

child(ren). This includes the abuse of alcohol or the use of illegal drugs by the

FORM #232– STIPULATED PERMANENT PARENTING PLAN Page 8 of 16

4th Judicial District Forms - Pro se Petition for Parenting Plan (Revision Date: 3/10)

parent.

[ ] Smoking environment.

[ ] Use of profane language.

[ ] Removal of the child(ren) from Montana, except as authorized by the Court or

mutually agreed to by both parents.

[ ] Other: .

[ ] Any violation of these terms will result in the immediate termination of that

parent’s contact with the child(ren).

[ ] Relationships between th e child(ren) and relatives and family friends on both sides of the

family shall be protected and encouraged. The parents shall have their child(ren) maintain

ties with both the maternal and paternal relatives. In Montana, grandparents have a legal

right to request a court to order reasonable visitation with their grandchild(ren), if it is in

the best interest(s) of the child(ren). Usually the child(ren) will visit with the paternal

relatives during times the child(ren) are with their father and with the maternal relatives

during times they are with their mother.

9. Decision Making

a. Day-to-Day Decisions

Each parent shall be authorized to make decisions regarding the day-to-day care and

control of the child(ren ) while the child(ren) are residing with that parent, unless or except

as provided below (Choose All That Apply):

[ ] Sole decision making shall be granted to the [ ] Mother [ ] Father for the

following reasons: ____________________________________________

____________________________________________________________

___________________________________________________________.

[ ] Major decisions concerning the child(ren)’s education shall be made by

[ ] the Mother [ ] the Father [ ] both parents jointly.

[ ] Major decisions concerning the non-emergency health care of the child(ren) shall

be made by [ ] the Mother [ ] the Father [ ] both parents jointly.

[ ] Major decisions concerning the spiritual development of the child(ren) shall be

made by [ ] the Mother [ ] the Father [ ] both parents jointly.

[ ] The consent of both parents shall be required before any minor child(ren) shall be

permitted to (Choose All That Apply):

[ ] Get a tattoo

[ ] Pierce any body part

[ ] Marry

[ ] Enlist in the armed services

[ ] Other: _______________________________________________

b. Emergency Decisions

Regardless of the allocation of decision making in this parenting plan, each parent shall be

authorized to make emergency decisions affecting the health or safety of the child(ren).

FORM #232– STIPULATED PERMANENT PARENTING PLAN Page 9 of 16

4th Judicial District Forms - Pro se Petition for Parenting Plan (Revision Date: 3/10)

10. Access to Information

a. As required by M.C.A. § 40-4-225, both parents shall have access to all information

relating to their child(ren) including, but not limited to, school records, counseling records,

medical and dental records.

b. As required by M.C.A. § 40-4-204(6)(a), both parents shall update each other and the

Court with written notice of changes to the following information:

(i) Residential and mailing addresses;

(ii) Telephone number;

(iii) Social Security number;

(iv) Driver’s license number;

(v) Name, address, and phone number of employers;

(vi) Health insurance coverage for the child(ren);

(vii) Health insurance available through either parent’s employer which could cover the

minor child(ren).

[ ] It is appropriate that the personal information of the [ ] Mother [ ] Father shall remain

confidential and shall not be provided to the other parent because:

________________________________________________________________

________________________________________________________________.

11. Residential Changes

As required by M.C.A. § 40-4-217, if a parent’s change in residence will significantly affect the

other parent’s contact with the child(ren), written notice shall be served personally or sent by

certified mail to the other parent not less than 30 days before the proposed change in residence and

must include a proposed revised residential schedule. Proof of service must be filed with the court

that adopted the parenting plan. Failure of the parent who receives notice to respond to the written

notice or to seek amendment of the residential schedule within the 30-day period constitutes

acceptance of the proposed revised residential schedule.

12. Review of Parenting Plan (Optional)

[ ] The parents will review this parenting plan at the following times:

_______________________________________________________________

_______________________________________________________________.

13. Dispute Resolution

The following shall apply when disputes arise between the parents in carrying out or amending

this parenting plan (Choose One):

[ ] No alternative dispute resolution process, except court action, shall apply unless ordered at

the discretion of the Court.

[ ] No alternative dispute resolution process is appropriate. The following limiting factors

exist, as provided in M.C.A. § 40-4-219(9) (Choose All That Apply):

[ ] This is a case of physical abuse or threat of physical abuse by one parent against

the other parent or the child(ren).

[ ] A parent has been convicted of deliberate homicide, mitigated deliberate homicide,

FORM #232– STIPULATED PERMANENT PARENTING PLAN Page 10 of 16

4th Judicial District Forms - Pro se Petition for Parenting Plan (Revision Date: 3/10)

sexual assault, sexual intercourse without consent, deviate sexual conduct with an

animal, incest, aggravated promotion of prostitution of a child, endangering the

welfare of children, partner or family member assault, or sexual abuse of children.

or

[ ] a. Disputes between the parents shall be submitted to mediation, counseling,

or arbitration by: ____________________________________________

__________________________________________________________.

b. The cost of this process shall be allocated between the parents as follows

(Choose One):

[ ] Based on each parent’s proportional share of income as determined from the

child support worksheet.

[ ] As determined in the dispute resolution process.

[ ] Mother: _______ % , Father: ________%.

c. A parent will begin the dispute resolution process by notifying the other parent by

written request sent by certified mail.

d. In the dispute resolution process:

(i) Preference shall be given to carrying out this parenting plan.

(ii) Unless an emergency exists, the parents shall use the designated process to

resolve disputes relating to implementation of the plan, except those related

to financial support.

(iii) A written record shall be prepared of any agreement or arbitration award

reached in counseling or mediation, and a copy shall be provided to each

parent.

(iv) If the court finds that a parent has used or frustrated the dispute resolution

process without good reason, the court may award attorney’s fees and

financial sanctions to the other parent.

(v) The parents have the right of review from the dispute resolution process to

the district court.

14. Other Provisions:

15. Child Support: The parties agree to the proposed child support order attached as Exhibit “B.”

16. Medical Support: The parties agree to the proposed medical support order attached as Exhibit

“C.”

WARNING: One parent’s failure to comply with a provision of the parenting plan will not affect

the other parent’s obligation to comply with the parenting plan. Violation of any provision of this

order with actual knowledge of its terms is p unishable by contempt of court and may be a criminal

offense under M.C.A. §§ 45-5-631 or 45-7-309. Violation of the Final Parenting Plan may subject a

FORM #232– STIPULATED PERMANENT PARENTING PLAN Page 11 of 16

4th Judicial District Forms - Pro se Petition for Parenting Plan (Revision Date: 3/10)

violator to arrest and a fine up to $500 or imprisonment in the county jail.

DATED this _______ day of ____________________, 20___.

_____________________________________

Petitioner, Pro se

STATE OF MONTANA )

) ss.

COUNTY OF ______________________ )

SUBSCRIBED AND SWORN to before me this _____ day of _______________, 20___.

__________________________________________

Name (printed): ____________________________

(Seal) Notary Public for the State of Montana

Residing at ________________________________

My Commission Expires _____________________

DATED this _______ day of ____________________, 20___.

_____________________________________

Respondent, Pro se

STATE OF MONTANA )

) ss.

COUNTY OF ______________________ )

SUBSCRIBED AND SWORN to before me this _____ day of _______________, 20___.

__________________________________________

Name (printed): ____________________________

(Seal) Notary Public for the State of Montana

Residing at ________________________________

My Commission Expires _____________________

Fillable Printable Stipulated Permanent Parenting Plan - Montana

Fillable Printable Stipulated Permanent Parenting Plan - Montana

Stipulated Permanent Parenting Plan - Montana