Proposed Parenting Plan {Form 230}

Rule 17.200--Form 230: Proposed Parenting Plan Use this form if you and your spouse do not agree to all child custody and visitation arrangements Do not use this form if both spouses agree to everything in this plan. Instead, use form 229 to tell the court what you both want your plan to be. If you do not understand how to use this form, or if you should use this form, talk to an attorney. In the Iowa District Court for County where you are filing this Parenting Plan County Upon the Petition of Equity case no. Proposed Parenting Plan Petitioner Full name: first, middle, last and concerning Respondent I am Check one A. B. Full name: first, middle, last Petitioner Respondent 1. Information for the Court A. Children List all children born to or adopted by Petitioner and Respondent. First, middle, & last initials of each child (1) (2) (3) (4) (5) (6) Present age Gender M F School Grade Check this box if you are attaching a separate sheet listing additional children. B. Information about the children (1) (2) (3) The children listed in A are the only children born to or adopted by these parents. One or more of the children is in a juvenile court case. If you check (2), attach a copy of the order that allows the district court to order child custody and visitation. There are children of Petitioner or Respondent not listed in B. Explain If there are children born before the marriage, who are not the children of Petitioner or of Respondent, check (3) and explain. December 2013 Rule 17.200--Form 230 Page 1 of 9 American LegalNet, Inc. www.FormsWorkFlow.com Rule 17.200--Form 230: Proposed Parenting Plan, continued If there are children of Petitioner and Respondent, but the parental rights have been terminated, check (3) and explain. C. Special concerns about the children Check all that are true (1) (2) (3) Breastfeeding infant Child with a disability Other Explain D. Information about the parents Check all that are true (1) (2) (3) (4) (5) (6) Petitioner receives public assistance, Title XIX, or FIP. Respondent receives public assistance, Title XIX, or FIP. Petitioner plans to move within the next year. Respondent plans to move within the next year. This is the Parenting Plan for before the move. This is the Parenting Plan for after the move. E. Special concerns about the parents Check all that are true (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) Petitioner has an alcohol or drug problem. Respondent has an alcohol or drug problem. Petitioner does not have a driver's license. Respondent does not have a driver's license. Petitioner's home environment is not suitable. Explain in 11. Respondent's home environment is not suitable. Explain in 11. Petitioner is in jail or a mental health institution. Explain in 11. Respondent is in jail or a mental health institution. Explain in 11. Petitioner is protected under a Domestic Abuse Protective Order. Explain in 11. Respondent is protected under a Domestic Abuse Protective Order. Explain in 11. Explain: December 2013 Rule 17.200--Form 230 Page 2 of 9 American LegalNet, Inc. www.FormsWorkFlow.com Rule 17.200--Form 230: Proposed Parenting Plan, continued 2. Plan A. Read these definitions of legal custody and physical care: (1) Legal custody means a parent has legal rights and responsibilities for the child. These include making decisions about medical care, education, extracurricular activities, and religious instruction. (2) Joint legal custody means both parents have equal legal rights and responsibilities for the child. These include making decisions about medical care, education, extracurricular activities, and religious instruction. (3) Physical care means providing the main home for the child and taking care of the child. (4) Joint physical care means both parents have equal rights and responsibilities for providing the main home for the child and taking care of the child. B. Legal custody should be Check one (1) (2) (3) (4) Joint legal custody to both parents To Petitioner To Respondent To other person Full name of other person: first, middle, last C. Physical care should be Check one (1) (2) (3) (4) To Petitioner If you check (1), use D for Respondent's visitation. To Respondent If you check (2), use D for Petitioner's visitation. Joint physical care to both parents care schedule. To other person Full name of other person: first, middle, last If you check (3), use D(12) to explain the joint physical D. Visitation Use D only if one parent will have physical care. This is the schedule for the other parent to see the children. (1) Visitation for Check one a. b. Petitioner Respondent (2) Visitation permission Check a, b, or c. a. Visitation should not be allowed because: b. Visitation should be supervised because: December 2013 Rule 17.200--Form 230 Page 3 of 9 American LegalNet, Inc. www.FormsWorkFlow.com Rule 17.200--Form 230: Proposed Parenting Plan, continued The supervisor for visitation should be Supervisor's full name: first, middle last c. Regular unsupervised visitation schedule as the parents agree: Check all that apply i. ii. Reasonable visitation as the parents agree. Mid-week visitation on these days: M Tu W Th F From Every weekend From at a.m. to a.m. p.m. to p.m. a.m. at p.m. iii. Day of week iv. Every other weekend From at Time a.m. Day of week p.m. to at Time a.m. p.m. Day of week v. Other Describe Time Day of week Time vi. Visitation will start on , 20 Month (3) Detailed holiday schedule Day Year This schedule tells on whch holidays the children will be with either Petitioner or Respondent. You do not have to fill in everything. Any day that is left blank means the children will spend that day with the parent who already has the children on that day. P = Petitioner Holiday New Year's Eve New Year's Day Martin Luther King, Jr. Day President's Day Memorial Day Independence Day July 4th Labor Day Veterans' Day November 11th Thanksgiving Day Christmas Eve Christmas Day December 2013 R=Respondent Odd years P R Time Every year P R a.m. p.m. a.m. p.m. a.m. p.m. a.m. p.m. a.m. p.m. a.m. p.m. a.m. p.m. a.m. p.m. a.m. p.m. a.m. p.m. a.m. p.m. Even years P R : : : : : : : : : : : Rule 17.200--Form 230 Page 4 of 9 American LegalNet, Inc. www.FormsWorkFlow.com Rule 17.200--Form 230: Proposed Parenting Plan, continued Mother's Day Father's Day Petitioner's Birthday Respondent's Birthday Halloween October 31st : : : : : : : a.m. p.m. a.m. p.m. a.m. p.m. a.m. p.m. a.m. p.m. a.m. p.m. a.m. p.m. Other: Describe Other: Describe (4) Special rul