District CourtDenver Juvenile Court County, Colorado Court Address:In re:The Marriage of: Parental Responsibilities concerning: Petitioner:andRespondent/Co-Petitioner:COURT USE ONLYAttorney or Party Without Attorney (Name and Address):Case Number:Phone Number:E-mail: FAX Number:DivisionCourtroomAtty. Reg. #:TEMPORARY ORDERS AGREEMENT ORINFORMATION FOR THE COURTThePetitionerRespondent/Co-Petitioner orboth state the following:Petitioner:Date of Birth: Social Security Number: Mailing Address: Residential Address: Phone Numbers: Home: Work: Cell: Respondent/Co-Petitioner: Date of Birth: Social Security Number: Mailing Address: Residential Address: Phone Numbers: Home: Work: Cell: 1. The names(s), address(es), birth date(s) and social security numbers of the minor child(ren) is/are:NamePresent AddressSex Date of Birth Soc. Sec. No.2. Allocation of temporary parental responsibilities (decision-making and parenting time).A. Decision-making should be as follows. Select only one of the 3 following options. 1.Respondent/Co-Petitioner (check one) will make all of the major decisions regarding the child(ren).PetitionerThe2.Both parties will make ALL major decisions regarding the child(ren) together.Page 1 of 4JDF 1109 R6/04 TEMPORARY ORDERS AGREEMENT OR INFORMATION FOR THE COURTAmerican LegalNet, Inc. www.USCourtForms.com3.The parties will divide decision-making as set forth in the attached Parenting Plan or as identified below: Education issues shall be determined byPetitionerRespondent/Co-PetitionerBoth Medical, dental and mental health issues shall be determined byPetitionerRespondent/Co-PetitionerBoth Religious issues shall be determined byPetitionerRespondent/Co-PetitionerBoth Extracurricular and recreational issues shall be determined byPetitionerRespondent/Co-PetitionerBoth Other significant decisions (General Welfare, Driving, Car, Car Insurance, College, etc.) shall be determined byPetitionerRespondent/Co-PetitionerBoth B. Parenting time (visitation) should be (check all that apply): 1.As set forth in the attached Parenting Plan or select either 2, 3, or 4. 2.Petitioner every from to 3.Respondent/Co-Petitioner every from to 4.Other (include holidays, birthdays, special occasions): 3. Child Support (A Child Support Obligation Worksheet must be filed.)Both parties agree on this issue. (If you agree, please indicate the terms of agreement below.) ThePetitionerRespondent/Co-Petitioner shall pay child support to the Petitioner Respondent/Co-Petitioner (check one) in the sum of $ per month pursuant to the Colorado Child Support Guidelines, beginning on (date).Child support payments will be paid to: (check one) Family Support Registry P. O. Box 2171, Denver, CO 80201-2171. The Parties request that the Court order the payment to be made directly to the appropriate person. Child support payments will be paid as follows: MonthlyBi-weeklyOther WeeklyThe parties do not agree on this issue.4. Information on any prior child(ren), spousal abuse allegations or protection/restraining orders: Page 2 of 4JDF 1109 R6/04 TEMPORARY ORDERS AGREEMENT OR INFORMATION FOR THE COURTAmerican LegalNet, Inc. www.USCourtForms.com5. Temporary maintenance (alimony) shall be paid byPetitionerRespondent/Co-Petitioner in the amount of $per month, commencing on (date).For combined gross incomes of $75,000.00 or less per year, use the formula on page 4 or double click the box above if completing this form electronically. 6. A. The following debts shall be temporarily paid by the Petitioner:Creditor/DebtAccount NumberTo by Paid byB. The following debts shall be temporary paid by the Co-Petitioner/Respondent:Creditor/DebtAccount NumberTo by Paid byC. Each party shall provide proof to the other party of the above-stated payments made within days of payment date. 7. Property you need use of (home, car, business property, tools, etc.):Both parties agree on this issue. (If you agree, please indicate the terms of agreement below.) The parties do not agree on this issue. Petitioner:Respondent/Co-Petitioner: Property that needs immediate protection: Page 3 of 4JDF 1109 R6/04 TEMPORARY ORDERS AGREEMENT OR INFORMATION FOR THE COURTAmerican LegalNet, Inc. www.USCourtForms.com8. Other issues: IWe believe this would be a fair and equitable division of our property and debts on a temporary basis and that the temporary allocation of parental responsibilities is in the best interest of the child(ren). (Both parties must sign if this is an agreement.) IWe have attached the required financial affidavits. IWe have attached the required child support worksheets (A or B).I swear/affirm under oath that I have read the foregoing temporary agreement/information and that the statements set forth therein are true and correct to the best of my knowledge.Petitioner SignatureDateCo-Petitioner SignatureDatePetitioner's Attorney Signature, if anyCo-Petitioner's Attorney Signature, if anySubscribed and affirmed, or sworn to before meSubscribed and affirmed, or sworn to before me in the County of ,in the County of , State of , this State of , this day of , 20 .day of , 20 .My commission expires: My commission expires: Notary Public/ClerkNotary Public/ClerkNOTE:COMBINEDINCOMEMUSTBE$75,000ORLESSPERYEARTOUSETHISWORKSHEET.PresumedTemporaryMaintenanceCalculation (enterallinformationbelowordoubleclicktocompleteelectronically)-$1. Husband'sGrossMonthlyIncome -$a. Husband'spre-existingMaintenancePayments(actuallypaidandnotinthismarriage) -$b. Husband'spre-existingChildSupportPayments(actuallypaidandnotinthismarriage) -$2. Wife'sGrossMonthlyIncome -$a. Wife'spre-existingMaintenancePayments(actuallypaidandnotinthismarriage) -$b. Wife'spre-existingChildSupportPayments(actuallypaidandnotinthismarriage) -$3.Husband'sMonthlyIncomelesspre-existingmaintenanceorchildsupport(1-(1a+1b)) -$4. Wife'sMonthlyIncomelesspre-existingmaintenanceorchildsupport(2-(2a+2b)) -$5. 40%ofincomefromhigherearningspouse(highestincometimes.40) -$6. 50%oftheincomefromlowerearningspouse(lowestincometimes.50)$Line5minusLine6(ifthisnumberislessthanorequaltozero,notemporarymaintenanceawarded)Page 4 of 4JDF 1109 R6/04 TEMPORARY ORDERS AGREEMENT OR INFORMATION FOR THE COURTAmerican LegalNet, Inc. www.USCourtForms.com
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