Fill and Sign the Co Decision Maker Form

 District Court  Denver Juvenile Court ________________________________ County, Colorado Court Address: In re:  The Marriage of:  The Civil Union of:  Parental Responsibilities concerning: ______________________________________________________ Petitioner: and Co-Petitioner/Respondent: ▲ COURT USE ONLY ▲ Attorney or Party Without Attorney (Name and Address): Phone Number: E-mail: FAX Number: Atty. Reg. #: Case Number: Division Courtroom STIPULATION REGARDING APPOINTMENT OF DECISION-MAKER PURSUANT TO § 14-10-128.3, C.R.S. The parties stipulate to the appointment of a Decision-Maker (DM), pursuant to 14-10-128.3, C.R.S. as follows:  That ___________________________________________________ shall be appointed as DM in this matter. or  That a DM be appointed but request that the Court determine who will serve as a DM in this matter. or  The following DM’S are submitted to the Court for consideration: ____________________________________________________________________________________ _______________________________________________________________________________________ _________________________________________________________________________________ 1. The parties understand that the DM has binding authority to resolve disputes between the parties as to the implementation or clarification of existing orders concerning:  Parenting Time  Child support  Other specific disputed parental decisions as described below: ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ as set forth in:  Temporary Order entered by the Court on _________________________ (date).  Permanent Order entered by the Court on _________________________ (date).  Post Decree Order entered by the Court on _________________________ (date).  Other _____________________________________________________________________________ JDF 1326 R8/17 STIPULATION REGARDING APPOINTING DECISION-MAKER © 2017 Colorado Judicial Department for use in the Courts of Colorado Page 1 of 2 2. The parties stipulate to the following regarding payment of the DM’s retainer, fees, and costs: 1. The DM’s hourly rate is $____________ and he/she requires $_____________ for the initial retainer.  The Petitioner will pay the DM directly the amount of $__________ or ______ % to be applied toward the initial retainer on or before ___________________ (date).  The Co-Petitioner/Respondent will pay the DM directly the amount of $__________ or ______ % to be applied toward the retainer on or before ______________________ (date). 2. Thereafter, the DM shall bill his/her hourly rate of $__________ against the initial retainer, and fees and costs in excess shall remain apportioned as set forth above and shall be paid within 30 days of the date billed, unless otherwise ordered by the Court or agreed between the parties. 3. The parties agree to comply with the Order Appointing Decision-Maker issued by this Court.  By checking this box, I am acknowledging I am filling in the blanks and not changing anything else on the form.  By checking this box, I am acknowledging that I have made a change to the original content of this form. (Checking this box requires you to remove JDF number and copyright at the bottom of the form.) VERIFICATION AND ACKNOWLEDGEMENT I declare under penalty of perjury under the law of Colorado that the foregoing is true and correct. Executed on the ______ day of ______________, ______, __________________________________________, (date) (month) (year) (city or other location, and state OR country) ______________________________________ ______________________________________ (printed name of Petitioner) (printed name of Co-Petitioner/Respondent) ______________________________________ ______________________________________ Petitioner Signature Co-Petitioner/Respondent Signature ______________________________________ ______________________________________ Address Address ______________________________________ ______________________________________ City State Zip Code City State Zip Code ______________________________________ ______________________________________ Home Phone # Cell # Home Phone # Cell # ______________________________________ ______________________________________ Petitioner’s Attorney Signature, if any Co-Petitioner/Respondent’s Attorney Signature, if any JDF 1326 R8/17 STIPULATION REGARDING APPOINTING DECISION-MAKER © 2017 Colorado Judicial Department for use in the Courts of Colorado Page 2 of 2