Fill and Sign the Additional Provisions Physical Custody Attachment Form

                                       P ETIT IO NER :CASE N UM BER FL-341(D) (D) RESPO NDEN T:ADDITIONAL PROVISIONS-PHYSICAL CUSTODY ATTACHMENTTOP etit io n o r A pplic atio n f o r O rd erF in din gs a n d O rd er A fte r H earin g o r J u dgm en tS tip ula tio n a n d O rd er f o r C usto dy a n d/o r V is it a tio n o f C hild re n1 .days o f a n y c h ange in h is o r h erN otif ic atio n o f p are n t's c u rre n t a d dre ss. E ach p are nt m ust n otif y t h e o th er p are nt o f h is o r h er c u rre nt a ddre ss an d t e le ph one n um ber w it h in ( s p ecif y n um ber):a. address forre sid encem ailin gw ork .b. telephone/message number athom eworkth e c h ild re n's s ch ools .N eit h er p are nt m ay u se s u ch in fo rm atio n f o r t h e p urp ose o f h ara ssin g, a nnoyin g, o r d is tu rb in g t h e p eace o f t h e o th er o r inva din g t h e o th e r's p riv a cy. I f a p are nt h as a n a ddre ss w it h t h e S ta te o f C alif o rn ia 's S afe a t H om e c o nfid entia l a ddre ss pro gra m , n o r e sid ence o r w ork a ddre ss is n eeded.2.d ays p rio rN otif ic atio n o f p ro posed m ove o f c h ild . E ach p are nt m ust n otif y t h e o th er p are nt ( s p ecif y n um ber): to a n y p la nned c h a nge in r e sid ence o f t h e c h ild re n. T he n otif ic a tio n m ust s ta te , t o t h e e xte nt k n ow n, t h e p la nned a ddre ss of t h e c h ild re n, in clu din g t h e c o unty a nd s ta te o f t h e n ew r e sid ence . T he n otif ic a tio n m ust b e s e nt b y c e rtif ie d m ail, r e tu rn re ce ip t r e queste d.3.C hild c a rea .b.T he c h ild re n m ust n ot b e le ft a lo ne w it h out a ge-a ppro pria te s u perv is io n. The p are nts m ust le t e ach o th er k n ow t h e n am e, a ddre ss, a nd p hone n um ber o f t h e c h ild re n's r e gula r c h ild -c a re pro vid ers .4 .R ig ht o f f ir s t o ptio n o f c h ild c are . I n t h e e ve nt e it h er p are nt r e quir e s c h ild c a re f o r ( s p ecif y n um ber):h ours o r m orew hile t h e c h ild re n a re in h is o r h er c u sto dy, t h e o th er p are nt m ust b e g iv e n f ir s t o pportu nit y , w it h a s m uch p rio r n otic e a s possib le , t o c a re f o r t h e c h ild re n b efo re o th er a rra ngem ents a re m ade. U nle ss s p ecif ic a lly a gre ed o r o rd ere d b y t h e c o urt, th is o rd er d oes n ot in clu de r e gula r c h ild c a re n eeded w hen a p are nt is w ork in g.5.C an cele d p are n tin g t im ea.If t h e n on cu sto dia l p are nt f a ils t o a rriv e a t t h e a ppoin te d t im e a nd f a ils t o n otif y t h e c u sto dia l p are nt t h at h e o r s h e will b e la te , t h en t h e c u sto dia l p are nt n eed w ait f o r o nly ( s p ecif y n um ber):m in ute s b efo re c o n sid erin g t h evis it a tio n c a nce le d.b.In t h e e ve nt a n oncu sto dia l p are nt is u nable t o e xe rc is e v is it a tio n o n a g iv e n o cca sio n, h e o r s h e m ust n otif y t h ecu sto dia l p are nt a t t h e e arlie st p ossib le o pportu nit y .c.T he c u sto dia l p are nt m ust g iv e t h e n oncu sto dia l p are nt a s m uch n otic e a s p ossib le if t h e c h ild re n a re ill a nd u nable t op artic ip ate in s ch edule d t im e w it h t h e o th er p are nt.A d octo r's e xcu se is r e quir e d.6.P hone c o nta ct b etw een p are n ts a n d c h ild re na.T he c h ild re n m ay h ave t e le phone a cce ss t o t h e p are ntsa nd t h e p are nts m ay h ave t e le phon e a cce ss t o t h echildren at reasonable times, for reasonable durations.b .T he s ch edule d p hone c o nta ct b etw een p are nts a nd t h e c h ild re n is ( s p ecif y ):c.N eit h er p are nt n or a ny o th er t h ir d p arty m ay lis te n t o o r m onit o r t h e c a lls .7.N o n eg ativ e c o m men ts . N eit h er p a re nt w ill m ake o r a llo w o th ers t o m ake n egativ e c o m ments a bout t h e o th er p are nt o r the o th er p are nt's p ast o r p re se nt r e la tio nsh ip s, f a m ily , o r f r ie nds w it h in h earin g d is ta nce o f t h e c h ild re n.8.N o u se o f c h ild re n a s m essen gers . T he p are nts w ill c o m munic a te d ir e ctly w it h e ach o th er o n m atte rs c o nce rn in g t h e child re n a n d m ay n ot u se t h e c h ild re n a s m esse ngers b etw een t h em .9.A lc o hol o r s u bsta n ce a b use. T hepetit io nerrespondent may not consume alcoholic beverages,narc o tic s, o r r e str ic te d d angero us d ru gs ( e xce pt b y p re scrip tio n) w it h in ( s p ecif y n um ber):h ours p rio r t o o r d urin gperio ds o f t im e w it h t h e c h ild re nand m ay n ot p erm it a ny t h ir d p arty t o d o s o in t h e p re se nce o f t h e c h ild re n.10.N o e xp o su re t o c ig are tte s m oke. T he c h ild re n w ill n ot b e e xp ose d t o s e co ndhand c ig are tte s m oke w hile in t h e h om e o r c a r of e it h er p are nt.P age 1 o f 2F orm A ppro ve d fo r O ptio nal U se Ju dic ia l C ouncil o f C alif o rn ia FL -3 41 ( D ) [R ev. J a nuary 1 , 2 005] ADDITIONAL PROVISIONS-PHYSICAL CUSTODY ATTACHMENT F am ily C ode, § § 3 003, 3 024 , 3 083ele ctr o nic f o rm  2 005 WWW.LawCA.com La w P ublis h ers              CASE N UM BERP ETIT IO NER :RESPO NDEN T:11.N o i n te rfe re n ce w it h s ch ed ule o f o th er p are n t w it h out t h at p are n t's c o nsen t. N eit h er p are nt w ill s ch edule a ctiv it ie s f o r t h e child re n d u rin g t h e o th er p are nt's s ch edule d p are ntin g t im e w it h out t h e o th er p are nt's p rio r a gre em ent.1 2.T hir d -p arty c o nta cta.b.T he c h ild re n w ill h ave n o c o nta ct w it h ( s p ecif y n am e): Th e c h ild re n m ust n ot b e le ft a lo ne in t h e p re se nce o f ( s p ecif y n am e):1 3.C hild re n 's c lo th in g a n d b elo ngin gsa.E ach p are nt w ill m ain ta in c lo th in g f o r t h e c h ild re n s o t h at t h e c h ild re n d o n ot h ave t o m ake t h e e xch anges w it ha ddit io nal c lo th in g.b.T he c h ild re n w ill b e r e tu rn ed t o t h e o th er p are nt w it h t h e c lo th in g a nd o th er b elo ngin gs t h ey h ad w hen t h ey a rriv e d.14.L og b ook. T he p are nts w ill m ain ta in a ''l o g b ook'' a nd m ake s u re t h at t h e b ook is s e nt w it h t h e c h ild re n b etw een t h eir t w o hom es. U sin g b u sin esslik e n ote s ( n o p ers o nal c o m ments ), p are nts w ill r e co rd in fo rm atio n r e la te d t o t h e h ealt h , e duca tio n, and w elf a re is su es t h at a ris e d urin g t h e t im e t h e c h ild re n a re w it h t h em .15.T erm s a n d c o ndit io ns o f o rd er m ay b e c h an ged . T he t e rm s a nd c o ndit io ns o f t h is o rd er m ay b e a dded t o o r c h anged a s the n eed s o f t h e c h ild re n a nd p are nts c h ange. S uch c h anges w ill b e in w rit in g, d ate d a nd s ig ned b y b oth p are nts -, e ach pa re nt w ill r e ta in a c o py. I f t h e p are nts w ant a c h ange t o b e a c o urt o rd er, it m ust b e f ile d w it h t h e c o urt in t h e f o rm o f a c o urt do cu m ent.1 6.O th er ( s p ecif y ):F L-3 41 ( D ) [R ev. J a nuary 1 , 2 005]ADDITIONAL PROVISIONS-PHYSICAL CUSTODY ATTACHMENTPage 2 o f 2e le ctr o nic f o rm  2 005 WWW.LawCA.com La w P ublis h ers