CR 52; 26.10.040, .100 , .170
Mandatory Form (07/201 9)
FL Non -Parent 430
Findings and Conclusions on
Non -Parent Custody Petitio n
p. 1 of 9
Superior Court of Washington, County of
In re custody of :
Children :
Petitioner /s (person /s who started this case ):
Respondents (parent s and any guardian or custodian ):
No.
Findings and Conclusions on Non -Parent
Custody Petition
(FNFCL )
Fi ndings and Conclusions on
Non -P arent Custody Petition
Use this form together with either a Final Non -Parent Custody Order (form FL Non -Parent 431 ) or a Final Order
Denying Non -Parent Custody (form FL Non -Parent 432 ).
1. Basis for findings and conclusions (check all that apply):
[ ] Parties’ agreement .
[ ] Default Order (date): .
[ ] Trial for this case on (date): , with the following people present
(check all that apply):
[ ] Petitioner (name): [ ] This person’s lawyer
[ ] Other Petitioner (nam e): [ ] This person’s lawyer
[ ] Respondent (name): [ ] This person’s lawyer
[ ] Other Respondent (name): [ ] This person’s lawyer
[ ] Guardian ad Litem ( name):
[ ] Other (name and relationship to this case):
CR 52; 26.10.040, .100 , .170
Mandatory Form (07/201 9)
FL Non -Parent 430
Findings and Conclusions on
Non -Parent Custody Petitio n
p. 2 of 9
2. Indian children
(An Ind ian child is a child who is a member of an Indian tribe, or who is the biological child of an Indian tribe
member and eligible for membership .)
[ ] None of the children are Indian children . The state and federal Indian Child Welfare
Acts do not apply to this case. The court makes this conclusion because (check all
that apply) :
[ ] the Petitioner made a good faith effort to find out if any child in this case is an
Indian child . (RCW 13.38.050. ) The court has received no information showing
tha t any child is or may be an Indian child.
[ ] the Petitioner notified the tribal agent of every tribe the children may have been
eligible for membership in . List tribes notified :
.
Each tribe responded that the children were not tribal members and n ot eligible for
membership.
[ ] other (specify):
[ ] These children are Indian children :
Children Tribe
[ ] All children
[ ] (name/s):
[ ] All children
[ ] (name/s):
The federal and state Indian Child Welfare Acts apply to this case.
Notice to tribes – The Petitioner [ ] provided [ ] did not provide the required
Indian Child Welfare Act Notice (form FL Non -Parent 402 ) and a copy of th e Petition to
the agent for the tribe/s named above , the parents and any Indian custodian .
Evidence – The evidentiary requirements of the Acts [ ] have [ ] have not been
met as described below . (RCW 13.38.130)
Active efforts – The following active efforts were made to provide remedial services
and rehabilitative programs desig ned to p revent the breakup of the Indian family :
(Active efforts means: “ a documented, concerted, and good faith effort to facilitate
the parent's or Indian custodian's receipt of and engagement in ” those services
and programs. RCW 13.38.040 .)
Serious em otional or physical damage – The court considered testimony from a
qualified expert witness as defined in RCW 13.38.130. The court finds by clear
and convincing evidence that the children (check one): [ ] would [ ] would not
CR 52; 26.10.040, .100 , .170
Mandatory Form (07/201 9)
FL Non -Parent 430
Findings and Conclusions on
Non -Parent Custody Petitio n
p. 3 of 9
likely suffer serious e motional or physical damage if they lived with either parent or
an Indian custodian. The Court makes this conclusion because:
3. Jurisdiction over Indian child ren
[ ] Does not apply. None of the children are Indian children.
[ ] Th is court ca nnot decide this case for the se Indian children (names):
because th is court does not
have jurisdiction over the m. The Petition should be dismissed as to these children .
[ ] This court can decide this case for the Indian children because (check o ne) :
[ ] (Children’s names): are not
domiciled or living on a n Indian reservatio n, and are not wards of a tribal court.
(25 USC §1911)
[ ] (Children’s names): are
domiciled or living on an Indian reservatio n, or are wards of a tribal court, however
(check all that apply):
[ ] The child ren ’s tribe agrees to Washington State’s concurrent jurisdiction.
[ ] The child ren’s tribe decided not to use its exclusive jurisdiction (expressly
declined) . (RCW 13.38.060)
[ ] Washington State should claim emerg ency jurisdiction for children temporarily
located off the reservation to protect the children from immediate physical
damage or harm. (RCW 13.38.140)
[ ] Other (specify):
4. Dependency case
[ ] There is no open dependency case for these children .
[ ] There is an open dependency case for these children in county
under case number: . The court handling the dependency
has signed an order allowing this court to proceed with this non -parent custody case.
5. Jurisdiction over the children (RCW 26.27.201 – .221, .231, .261, .271)
[ ] Th is court cannot decide this case for the se children (names):
because th is court does not
have jurisdiction over the m. The Petition should be dismissed as to these children.
[ ] Th is court can decide t his case for the se children because (check all that apply; if a
box applies to all of the children, you may write “the children” instead of listing names ):
CR 52; 26.10.040, .100 , .170
Mandatory Form (07/201 9)
FL Non -Parent 430
Findings and Conclusions on
Non -Parent Custody Petitio n
p. 4 of 9
[ ] Exclusive, continuing jurisdiction – A Washington court has already made a
parenting plan, resi dential schedule or custody order for the child ren , and the court
still has authority to make other orders for (children’s names): .
[ ] Home state jurisdiction – Washington is the child ren ’s home state because
(check all that apply):
[ ] (Children’s names): lived in Washington with
a parent or someone acting as a parent for at least the 6 months just before
this case was filed, or if the child ren were less than 6 months old when the
case was filed , they ha d lived in Washington with a parent or some one acting
as a parent since birth.
[ ] There were times the child ren were not in Washington in the 6 months just
before this case was filed (or since birth if they were less than 6 months
old), but those were temporary absences.
[ ] (Children’s names): do not live in Washington
right now, but Washington was the child ren ’s home state some time in the 6
months just before this case was filed, and a p arent or someone acting as a
parent of the child ren still lives in Washington.
[ ] (Children’s names): do not have another
home state.
[ ] No home state or home state declined – No court of any other state (or tribe)
has the jurisdiction to make decisions for (children’s names): ,
or a court in the child ren ’s home state (or tribe) decided it is bette r to have this
case in Washington and:
The child ren and a parent or someone acting as a parent have ties to
Washington beyond just living here; and
There is a lot of information (substantial evidence) about the child ren ’s care,
protection, education and re lationships in this state.
[ ] Other state declined – The courts in other states (or tribes) that might be
(children’s names): ’s home state
have refused to take this case because it is better to have this case in Washington .
[ ] Temporary emergency ju risdiction – Washington had temporary emergency
jurisdiction over ( children’s names): when the case was
filed, and now has jurisdiction to make a final custody decision because:
When the case was filed, the children were abandoned in this state, or the
children were in this state and the children ( or children ’s parent, brother or
sister ) was abused or threatened with abuse;
The court signed a temporary order on (date) saying that
Washington’s jurisdiction will become final if no case is filed in the child ren ’s
home state (or tribe) by the time the child ren ha ve been in Washington for 6
months;
The children ha ve now lived in Washington for 6 months; and
No case concerning the child ren has been started in the children ’s home state
(or tribe) .
[ ] Other reason (specify):
CR 52; 26.10.040, .100 , .170
Mandatory Form (07/201 9)
FL Non -Parent 430
Findings and Conclusions on
Non -Parent Custody Petitio n
p. 5 of 9
6. Background Record s Check ed
The Court has (unless stated otherwise below) :
Checked the judicial information system for any information or proceedings
relevant to placement of the children;
Reviewed the records from the Depart ment of Social and Health Services provided
in response to the court’s Order to DSHS to Release CPS Information ; and
Reviewed the c riminal history record from the Washington State Patrol for
Petitioner and each adult living in Petitioner’s home.
[ ] The court did not check background records because the Petition is denied.
[ ] Other findings (specify):
7. Adequate Cause
The Court found there was adequate cause to make a final decision on the Petition in an
Order on Adequate Cause for Non -Parent Cu stody (form FL Non -Parent 417 ) signed by
the court on (date): .
8. Are there valid reasons why the children should not live with a parent?
[ ] No . The Petitioners did not prove that both parents were unfit or that the children
would suffer actual detr iment (harm) to their growth and development if they lived with
either parent. The Petition should be denied .
[ ] (Other findings ):
[ ] Yes. At the time this case was filed (check all that apply ):
[ ] the children we re not living with either parent. The children had been living with
(name/s): since (date): .
[ ] neither parent was a suitable custodian .
And ,
Both parents are currently unfit, or, even if they may be fit, the children will suffer
actual detriment (harm) to their growth and development i f they lived with either parent.
(Th ese conclusion s are based on the following facts .)
CR 52; 26.10.040, .100 , .170
Mandatory Form (07/201 9)
FL Non -Parent 430
Findings and Conclusions on
Non -Parent Custody Petitio n
p. 6 of 9
9. Should the children live with Petitioner /s?
[ ] Does not apply. The Court found no valid reasons why the children should not liv e
with a parent. The Petition should be denied .
[ ] No . The Petition should be denied. It is not in the child ren ’s best interests to live with
the Petitioner/s because (explain):
[ ] Yes. It is in the child ren ’s best interests to live with the Petitioner/s because (explain):
10 . Respondents ’ Visitation
[ ] Does not apply. The Petition should be denied .
[ ] The visitation ordered is reasonable. Findings about any reasons for limiting a
parent’s visitation are summarized either in the Residential Schedule or the Non -
Parent Custody Order . These findings are supported by the following facts (include
facts about both parents) :
11 . Limitation on Petitioner’s Authority (RCW 26.10.170)
[ ] Does not apply. The Petition sho uld be denied.
[ ] No limits should be put on the Petitioner’s authority over the children’s upbringing or
decision -making for the children.
[ ] Limits should be put on the Petitioner’s authority over the children’s upbringing or
decision -making for the children because (check all that apply ):
[ ] the parties have agreed as follows:
[ ] without a limit, the children’s physical, mental, or emotional health would be
endangered. (Explain):
CR 52; 26.10.040, .100 , .170
Mandatory Form (07/201 9)
FL Non -Parent 430
Findings and Conclusions on
Non -Parent Custody Petitio n
p. 7 of 9
[ ] The court finds that an agency should be appo inted to assure the Petitioner is
following the custodial or visitation terms of the order. The court finds that
(agency name): is an
appropriate agency that regularly deals with children .
[ ] Other findings:
12 . Support , insurance and taxes
The court has considered whether to order child support, health insurance, and allocation
of tax exemptions . The court finds:
[ ] Does not apply . The Petition should be denied.
[ ] Child Support – The child ren should be support ed according to state law .
[ ] The court signed the final Child Support Order and Worksheets filed separately
today or on (date ): .
[ ] There is no need for the court to make a child support order because the DSHS
Division of Child Support (DCS) has already established an admini strative child
support order for the children.
[ ] Heath Insurance or other expenses – The parents should pay for health insurance,
uninsured medical, day care, or other necessary expenses as listed in the (check one):
[ ] final Child Support Order or administrative order .
[ ] Final Non -Parent Custody Order (if no Child Support Order is being issued ).
Support is ordered based on the Worksheets and/ or the following findings:
[ ] Tax Issues – The parties should have the right to claim the children as their
dependents for purposes of personal tax exemptions and associated tax credits on
their t ax forms as listed on the final Child Support Order or Non -Parent Custody Order.
Important! Although the personal tax exemptions are currently suspended unde r federal law through tax
year 2025, other tax benefits may flow from claiming a child as dependent.
[ ] (Check here i f the court is not ordering child support, health insurance , other
expenses, and/ or allocating tax exemptions, and explain why .)
[ ] Other (specify):
13 . Protection Order
[ ] No one requested an Order for Protection in this case .
[ ] (Name): requested a n Order for Protection in this case.
CR 52; 26.10.040, .100 , .170
Mandatory Form (07/201 9)
FL Non -Parent 430
Findings and Conclusions on
Non -Parent Custody Petitio n
p. 8 of 9
Conclusion: The court should (check one):
[ ] not approve an Order for Protection order because:
[ ] approve an Order for Protection because:
14 . Restraining Order
[ ] No one requested a Restraining Order in this case .
[ ] (Name ): requested a Restraining Order .
Conclusion: The court should (check one):
[ ] not approv e a Restraining Order because:
[ ] approve a Restraining Order because:
15 . Fees and Court Costs
[ ] Each party should pay his /her own fees or costs.
[ ] (Name ): incurred fees and costs, and needs help to
pay those fees and costs. (Nam e): has the
ability to help pay fees and costs and should be ordered to pay the amount as listed in
the Final Non -Parent Custody Order or Final Order Denying Non -Parent Custody . The
court finds that the amount ordered is reasonable.
[ ] Fees for a gua rdian ad litem (GAL) or other court -appointed professional should be
paid as listed in the Final Non -Parent Custody Order or Final Order Denying Non -
Parent Custody . The court has considered relevant factors including each party’s
ability to pay, and finds the fees as ordered are reasonable.
[ ] Other findings:
16 . Ot her findings or conclusions (if any)
Date Judge or Commissioner
CR 52; 26.10.040, .100 , .170
Mandatory Form (07/201 9)
FL Non -Parent 430
Findings and Conclusions on
Non -Parent Custody Petitio n
p. 9 of 9
Petitioner /s and Respondent /s or their lawyers fill out below.
This document (check any that apply) : This document (check any that apply) :
[ ] is an agreement of the parties [ ] is an agreement of the parties
[ ] is presented by me [ ] is presented by me
[ ] may be signed by the court without notice to me [ ] may be signed by the court without notice to me
Petitioner signs here or lawyer signs here + WSBA # Respondent signs here or lawyer signs here + WSBA #
Print Name Date Print Name Date
This document (check any that apply) : This document (check any that apply) :
[ ] is an agreement of the pa rties [ ] is an agreement of the parties
[ ] is presented by me [ ] is presented by me
[ ] may be signed by the court without notice to me [ ] may be signed by the court without notice to me
Other Petitioner or lawyer signs here + WSBA # Other Respondent or lawyer signs here + WSBA #
Print Name Date Print Name Date
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