Fill and Sign the Form 349

Form 349Rev 2/18 Page 1 of 2 The Family Court of the State of Delaware In and For New Castle County Kent County Sussex County CONSENT ORDER – CUSTODY, VISITATION Petitioner v. Respondent Name Name D.O.B. D.O.B. File Number Street Address Street Address P.O. Box Number P.O. Box Number City/ State/Zip Code City/State/Zip CodePetition Number Attorney Name Attorney Name IN THE INTEREST OF the following child(ren):Name (Child #1)Date of BirthName (Child #2)Date of Birth Name (Child #3)Date of BirthName (Child #4)Date of Birth Name (Child #5)Date of BirthName (Child #6)Date of Birth The parties in the above-entitled cause hereby agree upon the following arrangement and do consent to the entry on an Order providing for the same:Type of Custody: Joint Custody Sole Custody Custody Awarded to: Physical Placement with: Relationship: Address: Visitation Awarded to: Relationship: Address: Form 349Rev 2/18 Page 2 of 2 Visitation shall be as follows: This agreement of the parties is subject to review of the parties’ criminal histories by a hearing officer before entry as an order of the court. Affidavit of Consent Be it remembered that on the above named petitioner and respondent personally came before me, the subscriber, a Notary Public for the State and County listed below, who being duly sworn to law did depose and say: I, the undersigned hereby agree upon the following custodial/visitation agreement for the above-named child(ren). I have signed this consent agreement voluntarily and of my own free will.If signed by a Commissioner, we hereby waive our right to a Review of a Commissioner’s Order because this Order is entered pursuant to this Voluntary Agreement. PetitionerRespondent State of State of County of County of Sworn to subscribed before me:Sworn to subscribed before me: Mediator/Notary PublicMediator/Notary Public So Ordered this Date: Judge/Commissioner