Prepared by U.S. Legal Forms, Inc.
Copyright 2016 - U.S. Legal Forms, Inc.
STATE OF IOWA
PATERNITY CASE PACKAGE
Control Number – IA-598A
This packet contains the following:
1. Instructions ;
2. Forms ; and
3. Access to Iowa Law Summary.
Paternity Instructions Page - 1 -
DISCLAIMER
These materials were developed by U.S. Legal Forms, Inc. based upon statutes and
forms for the State of Iowa. All Information and Forms are subject to this
Disclaimer: All forms in this package are provided without any warranty, express or
implied, as to their legal efect and completeness. Please use at your own risk. If
you have a serious legal problem we suggest that you consult an attorney. U.S.
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Forms (USLF) are not a substitute for the advice of an attorney.
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Paternity Instructions Page - 2 -
I. EXPLANATION OF AN ACTION TO ESTABLISH PARENTAGE
A. In Iowa, an action to determine Parentage begins with the
filing of a Petition in the District Court. The Petition must contain
certain information. The forms in this packet include the necessary
information for an action to determine Paternity/Parentage in the State
of Iowa.
B. You can use this packet if:
► You are an appropriate party to file the action as defined in
the Law Summary;
► If the child, the mother or the father reside in the State of
Iowa; and
► The action is brought in the county in which the child resides,
the mother resides, or the alleged father resides or is found
or, if the father is deceased, in which proceedings for probate
of his estate have been or could be commenced.
II. WHAT FORMS ARE INCLUDED
A. Iowa Civil Petitioner Cover Sheet
B. Complaint to Establish Parentage
C. Summons to Answer Complaint
D. Motion to Approve Compromise Agreement
E. Compromise Agreement
F. Order Approving Compromise Agreement
G. Motion for Genetic Testing
H. Affidavit in Support of Motion for Genetic Testing
I. Order for Genetic Testing
J. Agreement for Genetic Testing
K. Order for Genetic Testing by Agreement
Note: This package contains forms for use throughout your State. However,
some Counties, or Judges may require a diferent form, or modification to
these forms. If this happens, please consult with your local Court Clerk. If
you are required to use additional forms, please advise us by sending an e-
mail to orders@uslegalforms.com.
Paternity Instructions Page - 3 -
III. PROCEDURE FOR PATERNITY CASE IN THE STATE OF IOWA
A. Preliminary Note:
1. The attached forms may be completed by:
a. Printing the forms and completing by hand. Use
black ink and print neatly.
b. Printing the forms and completing using a
typewriter.
c. By completing the forms on your computer using a
word processing program and then printing the
forms.
2. Use complete names and not initials. Check your spelling
carefully, a misspelled word can delay your name change.
3. Print three (3) complete sets of forms.
4. All forms with a heading – the name of the court, the
Petitioner’s name, the case number, and the name of the
document – require that the heading be completed. You
will need to add the name of the court and the full name
of the Petitioner. The “Case No.” will be assigned by the
court clerk at the time of filing.
5. Forms that require your signature and include a notary
block MUST be signed in the presence of the notary or
court clerk who will complete the acknowledgement. Use
your complete name – first name, middle name, last
name.
6. When a form is filed with the court, request the clerk “file-
stamp” one copy of the form for your file.
7. A Law Summary is available and can be printed for your
State. To do so, go to where you located this package and
select the Law Summary link under the form title and
print. Review the Law Summary before beginning the
process of completing the forms.
B. Procedure
Step 1: Complete all the forms using complete names –
middle names instead of middle initials.
Step 2: File the Petition in the District Court in the county in
which the child resides, the mother resides, or the
Paternity Instructions Page - 4 -
alleged father resides or is found or, if the father is
deceased, in which proceedings for probate of his
estate have been or could be commenced.
Step 3: The Clerk of the Court will issue the Summons to be
served on the Defendant.
Step 4: If the Defendant is located within the geographical limits
of the District Court, you must arrange for personal
service of the Summons and Petition. Service can be
made by the sherif or the sheriffs deputy; by some other
person specially appointed by the court for that purpose;
or by any person who is not a party and is not less than
18 years of age; or other appropriate person.
Step 5: After the Defendant has been served, the next steps are
all in preparation for the Informal Hearing.
Step 6: At this point it is necessary to make a determination
whether the Respondent will agree to an admission of
paternity. If not, it will be necessary to have court
ordered blood tests in order to scientifically determine
parentage of the minor child(ren).
Step 7: If the Defendant will admit paternity, complete the
Compromise Agreement. The Agreement can then be
submitted to the Court at the Informal Hearing. The
parties should be prepared to present to the Court
financial information regarding their income, debts and
assets so that the court will have the information
necessary to determine whether the Agreement is
reasonable.
Step 8: If a compromise can’t be reached it will be necessary to
obtain an Order for Genetic Testing. The court may, and
upon request of a party, will, require the child and the
alleged parent to submit to genetic tests, including blood
tests. If the requesting party is the mother or the alleged
father, the court shall require that the request be made
pursuant to a sworn statement either setting forth facts
establishing a reasonable possibility of the requisite
sexual contact between the parties or denying paternity
setting forth facts establishing a reasonable possibility of
the non-existence of sexual contact between the parties.
If the Defendant will agree to the testing, prepare the
Agreement for Genetic Testing and the Order for Genetic
Testing by Agreement. If the Defendant will not agree to
the testing, prepare the Motion for Genetic Testing, Order
Paternity Instructions Page - 5 -
for Genetic Testing, and Affidavit in Support of Motion for
Genetic Testing for filing with the Court at the Hearing.
The results of the genetic testing will be furnished directly
to the Court. At that time, the parties will be informed by
the Court of the results. This will generally deal with all
the outstanding issues as to paternity and the matter will
be settled by the Court either dismissing the case or, if
the testing confirms paternity in the Respondent, entering
an Order establishing paternity and providing for support
to the child(ren).
Paternity Instructions Page - 6 -
NAME & ADDRESS of Attorney (or Petitioner / Plaintiff – if not represented by attorney):
Attorney P.I.N.: Telephone No: ( ) FOR COURT USE ONLY
CASE NUMBER:
COUNTY WHERE CASE FILED:
CASE NAME (Petitioner / Plaintiff vs. Respondent / Defendant):
NATURE OF THE CASE : CHECK the BOX to the LEFT of the ONE case category that most accurately describes your PRIMARY
CASE . If you are making more than one type of claim , check the one that involves the largest amount of damages or the one you
consider most important .
LAW: Contract/ Commercial
Claim
DOMESTIC RELATIONS
EQUITY
Debt collection (LA-C1) Dissolution -- children involved (CD-DC) Mortgage foreclosure (EQ-EM)
Employment-related claim (LA-C3) Dissolution -- no children (CD-DN) Other real property claim (EQ-ER)
Other contract or commercial claim (LA-C9) Modification -- children involved (CD-MC) Other equity (EQ-EO)
Modification -- no children (CD-MN)
LAW: Tort - Personal Injury
(P.I.) 236 - Domestic abuse (DA-DA)
OTHER CIVIL ACTION S
Motor vehicle accident (LA-T2) 234 - Foster care (DR-D1) Administrative appeal to dist. court (CV-V1)
Premises liability / slip & fall (LA-T3) 252A -- Support action (DR-D2) Change of name (CN-CN)
Malpractice: medical or dental (LA-T1) 252A.18 - Foreign support (DR-D3) Distress warrant (CV-V2)
Products liability (toxic chem. / subst.) (LA-T8) 252B.11 - Cost recovery (DR-D4) Foreign judgment entry (CV-V3 )
Products liability (not toxic substance) (LA-T4) 252C - Administrative Order (DR-D5 ) Lien (LN - IE, IH, IM or IO)
Wrongful death (LA-T7) 252D - Income withholding (DR-D6 ) Post conviction relief (PC-PC)
Other negligent / intentional P.I. (LA-T9) 252E - Medical support (DR-D7) Seized property / forfeiture (SP-SP)
252F/ 600B - Paternity (DR-D8) Transcript of judgment (TJ-TJ)
LAW: Tort - Other damages
(no P.I. ) 252K - UFISA (DR-R1) Other civil action (CV-V9)
Professional malpractice - no P.I. (LA-T5) 598B - Out of state custody (DR-R2) FOR COURT USE ONLY
Fraud / business tort (LA - C2) 600 - Adoption (AT-AT)
Other tort - property/financial damages (LA-T6) Other domestic relations action (DR-D9)
* NOTE TO PETITIONER /PLAINTIFF :
Pursuant to rule 48 of the Iowa Rules of Civil Procedure , a cover sheet MUST accompany each civil petition
EXCEPT: small claims, probate, or commitment actions.
DO NOT SERVE THIS COVER SHEET ON THE DEFENDANT(S) / RESPONDENT(S).
A cover sheet is not required when filing a counterclaim or crossclaim.
This cover sheet is for statistical purposes only . It shall have no legal effect in the case. Updated:
1-20-2000
IN THE IOWA DISTRICT COURT FOR __________________ COUNTY
)
)
NAME OF PLAINTIFF )
)
, Plaintiff )
) NO.
Vs. )
)
NAME OF DEFENDANT )
)
, Defendant )
COMES NOW Plaintiff, ______________________________ , Pro Se, as and for a
Complaint to Establish Paternity against Defendant, and alleges as follows:
A. BASIS
1. CHILD(REN) ON WHOSE BEHALF THE ACTION IS BROUGHT.
This action is brought on behalf of:
Name: ______________________________
Date of Birth: __________________
A resident of __________________ County, Iowa
Name: ______________________________
Date of Birth: __________________
A resident of __________________ County, Iowa
Name: ______________________________
Date of Birth: __________________
A resident of __________________ County, Iowa
Name: ______________________________
Date of Birth: __________________
A resident of __________________ County, Iowa
2. NATURAL MOTHER.
The natural mother of the child(ren) is ______________________________ [Name].
3. ALLEGED FATHER.
The alleged father of the child(ren) is:
____________________________________
____________________________________
5. JURISDICTION.
The following parties are presently residing in the state of Iowa:
mother ______________________________
alleged father ______________________________
other ______________________________
Other: ________________________________________________
6. JURISDICTION OVER THE CHILD.
This court has jurisdiction over the child for the reasons set forth below.
This state is the home state of the child because
the child lived in Iowa with a parent or a person acting as a parent for at
least six consecutive months immediately preceding the commencement of
this proceeding.
the child is less than six months old and has lived in Iowa with a parent or a
person acting as parent since birth.
any absences from Iowa have been only temporary.
Iowa was the home state of the child within six months before the
commencement of this proceeding and the child is absent from the state but
a parent or person acting as a parent continued to live in this state.
The child and the parent or the child and at least one parent or person acting as a
parent, have significant connection with the state other than mere physical
presence; and substantial evidence is available in this state concerning the child's
care, protection, training and personal relationships and
the child has no home state elsewhere.
the child's home state has declined to exercise jurisdiction on the ground
that this state is the more appropriate forum under the Iowa Code.
All courts in the child's home state have declined to exercise jurisdiction on the
ground that a court of this state is the more appropriate forum to determine the
custody of the child under the Iowa Code .
No other state has jurisdiction.
This court has temporary emergency jurisdiction over this proceeding because the
child is present in this state and the child has been abandoned or it is necessary in
an emergency to protect the child because the child, or a sibling or parent of the
child is subjected to or threatened with abuse.
7. CHILD SUPPORT AND RESIDENTIAL PLACEMENT.
The child is entitled to financial support pursuant to the Iowa Code and health insurance
coverage from any parent owing a duty of child support, and it is otherwise in the child’s best
interests to obtain a judicial determination of the parentage and residential placement of the
child.
Other:
8. CURRENT RESIDENCE OF THE CHILD.
The child currently resides with ____________________________________ [Name].
9. OTHER: ____________________________________________________________
I. RELIEF REQUESTED
The court is requested to enter an order and judgment that:
______________________________ [Name] be declared to be the natural father of
Name of child: ____________________________________
Name of child: ____________________________________
Name of child: ____________________________________
Name of child: ____________________________________
The birth certificate of the child(ren) be amended to identify the father.
Support be determined for the dependent child(ren) pursuant to the Iowa State Child
Support Schedule and either or both parents be ordered to maintain or provide health
insurance coverage for the child and pay extraordinary uninsured costs proportionate to
their income.
The natural father pay past support, medical, and other expenses incurred on behalf of the
child.
A residential plan or parenting plan for the child be adopted by the court as proposed by
the parents or as the court finds to be in the child’s best interest.
In the event no residential plan or parenting plan is proposed, the custodian and primary
residential parent be the parent with whom the child currently resides and the other
parent’s residential time be denied.
Court costs, blood test costs, guardian ad litem, attorney, and other reasonable fees be
awarded by the court.
Other: ________________________________________________
Dated: __________________ ____________________________________
Signature of Lawyer or Petitioner
____________________________________
Print or Type Name
I declare under penalty of perjury under the laws of the State of Iowa that the foregoing is true
and correct.
Signed at ____________________________________ [City and State] on
__________________ [Date].
____________________________________
Signature
Print or Type Name
JOINDER.
Does not apply.
The respondent joins in the petition. By joining in the petition, the respondent
agrees to the entry of a judgment and order in accordance with the petition,
without further notice.
Dated: __________________ ____________________________________
Signature of Respondent
Print or Type Name
IN THE CIRCUIT COURT OF ____________ COUNTY, IOWA
AT ________________________
FAMILY COURT DIVISION
In Re the Parentage of:
______________________________ )
)
______________________________ )
Petitioner )
)
Vs. ) CASE NO. __________________
)
)
______________________________ ) SUMMONS
Respondent )
TO: ____________________________________
YOU ARE HEREBY NOTIFIED that a Petition has been filed in this court in which it is
represented that Petitioner Respondent is the parent of the above named child(ren). In this
Petition, it is requested that the court enter judgment determining paternity, requiring the parents
to pay for the support of the child(ren), enter orders regarding parental responsibilities, and to
grant such further relief as the court deems proper, including requiring you to pay costs of this
action.
YOU ARE HEREBY SUMMONED to appear for a hearing in Courtroom ____________ of the
Circuit Court, at the above address, on the ______________________________ (date), at the
hour of __________________ (time), at which time an Order may be entered requiring you to
pay support and other costs asked in the Petition, a copy of which is attached hereto.
IF YOU FAIL TO APPEAR at the stated time and place, the court may enter judgment finding
you to be the parent of the child, enter child support orders, and address the other issues raised in
the Petition.
Dated __________________ , 20 ______ ____________________________________
Circuit Clerk
(Seal of Circuit Court)
By ____________________________________
Deputy Clerk
Directions to Clerk
The clerk should insert in the summons the names of only the defendant or defendants who are to be
personally served by the officer to whom the summons is delivered. The summons should be signed by
the clerk or deputy clerk under seal of the court and a copy of the summons and a copy of the petition for
each of such defendants should be delivered along with the original summons to the officer or other
person who is to make service. The copy of the summons may be a carbon or other copy and should be
signed and sealed in the same manner as the original but it is unnecessary to certify that the same is a true
copy. The copy of the petition may be a carbon or other copy and should be securely attached to the copy
of the summons but need not be certified a true copy. If plaintiff has no attorney, the address of plaintiff
should be stated in the summons, and the words "attorney __________________ for" eliminated. (See
Rules 54 and 55.25.)
Return on Service of Summons
I hereby certify that I have served the within summons:
(1) By delivering on the ______ day of _____________, 20___ a copy of the summons and a
copy of the petition to each of the within-named defendants
(2) By leaving on the _____ day of ____________, 20___ for each of the within-named
defendants. _______________________________________________________
________________________________________________________________
a copy of the summons and a copy of the petition at the respective dwelling place or usual place
of abode of said defendants with some person of his or her family over the age of 15 years;
(3)______________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
All done in _______________ County, Iowa
____________________________________
Sheriff of _____________ County, Iowa
By.
_________________________________
Deputy Sheriff
IN THE CIRCUIT COURT OF ____________ COUNTY, IOWA
AT ________________________
FAMILY COURT DIVISION
In Re the Parentage of:
______________________________ )
)
______________________________ )
Plaintiff )
)
Vs. ) CASE NO. __________________
)
) MOTION TO APPROVE
______________________________ ) COMPROMISE AGREEMENT
Defendant )
I, ______________________________ , Petitioner, hereby requests the Court approve the
Compromise Agreement attached hereto and incorporated herein as though set forth in full, and
further state as follows:
1. The Petitioner Respondent, admits that he is the father of the minor child(ren) of
this action.
2. The parties have reached a Compromise Agreement that addresses all the issues of child
support, visitation, and parenting.
3. The parties agree that the Compromise is fair and reasonable and request the Court
approve the Agreement.
Date: __________________
____________________________________
Petitioner Respondent
Address: ________________________
________________________
________________________
Telephone: ________________________
CERTIFICATE OF SERVICE
I certify that on __________________ (date) the original and one copy of this document
were filed with the Court; and, a true and accurate copy of the MOTION FOR APPROVAL OF
COMPROMISE AGREEMENT was served on the other party by Hand Delivery OR
by placing it in the United States mail, postage pre-paid, and addressed to the following:
TO: ______________________________
______________________________
______________________________
____________________________________
Signature
COMPROMISE AGREEMENT
STATE OF ____________
COUNTY OF __________________
WHEREAS , ____________________________________ (full legal name), hereinafter
referred to as "Petitioner", and ____________________________________ (full legal name),
hereinafter referred to as "Respondent", are the parents of certain minor child(ren); and
WHEREAS , the parties desire to make a mutually acceptable settlement of their rights,
liabilities, obligations regarding child custody, support and visitation; and
WHEREAS , the parties intend that this Agreement shall be binding and effective subject
to approval by the Court in that certain action pending in the __________________ Court for the
State of __________________ , Case Number ____________ , which is an action to determine
parentage involving Petitioner and Respondent; and
NOW THEREFORE, FOR AND IN CONSIDERATION of the mutual benefits and
advantages accruing to each party, the undersigned do hereby solemnly covenant, agree and
contract as set forth above and below and being sworn, certify that the all statements contained
herein are true and correct:
SECTION 1.
CHILD CUSTODY, PARENTAL RESPONSIBILITY, AND VISITATION
A. It is agreed that the Petitioner and the Respondent are the parents of the following
child(ren)
Name Birth date
______________________________ ________________________
______________________________ ________________________
______________________________ ________________________
______________________________ ________________________
B. Parental Responsibility Child Custody
Both Petitioner and Respondent are proper persons to have the permanent legal and
physical custody, parental responsibility, care and control of the minor children of the parties.
Petitioner and Respondent shall share the decision-making rights, the responsibilities and the
authority relating to the health, education and welfare of the children, and shall, therefore, make
joint decisions concerning the children’s health, education and welfare. Both Petitioner and
Respondent shall exchange information concerning the health, education and welfare of the
minor children, and shall confer with one another in the exercise of decision-making rights,
responsibilities and authority. Petitioner and Respondent shall have equal access to all medical,
dental and school records concerning the minor children.
However, the parties agree that the best interest of the child(ren) at this time is that
primary parental responsibility and physical custody of the minor child(ren) will be and agree as
follows:
Petitioner shall have primary parental responsibility and custody of the minor
child(ren) of the parties subject to the visitation rights of Respondent.
Respondent shall have primary parental responsibility and custody of the minor
child(ren) of the parties subject to the visitation rights of Petitioner.
Petitioner and Respondent shall have joint primary parental responsibility and
custody of the minor child(ren) of the parties, both legal and physical.
C. Secondary Parental Responsibility, Visitation, or Time Sharing - General
Provisions.
Visitation shall be conducted pursuant the following general provisions:
i) Visitation should be pleasant for the children and for the parent. Visitation should
help the children maintain a good relationship with the non-custodial parent.
ii) Visitation means the visiting parent has the children visit in his or her home
overnight. It may include trips and outings elsewhere.
iii) Visitation schedules shall be followed and the visiting parent shall inform the
other parent when he or she cannot comply with the schedule.
iv) Adjustment of the visitation schedule from time to time may be necessary
according to the children's ages, health and interests.
v) Visitation should provide meaningful personal contact for both the visiting parent
and the children.
vi) Visitation should not be used to check on the other parent and the children should
not be questioned for information about the other parent.
vii) Both parents should strive to agree on matters pertaining to the children, including
discipline, so that one parent is not undermining the other parent's efforts.
viii) It is in the child's best interest for each parent to have a frequent, meaningful and
continuing relationship with their children. For children to make an adequate adjustment
to the dissolution of their parents marriage, the children must be allowed to continue their
relationship with both parents, experience minimal changes in their lifestyle if at all
possible, and not experience post-divorce conflict between their parents.
D. Secondary Parental Responsibility, Visitation, or Time Sharing Schedule.
The non-custodial parent is entitled to reasonable visitation with the minor child (ren).
Petitioner and Respondent adopt the following visitation schedule for the non-custodial parent:
Birth to 1 Year of Age
i) Non-custodial parent shall have four (4) visits with the child per week, with such
contact lasting four (4) hours in length.
ii) If the child is taken from the home of the custodial parent, the child shall be
returned at least one (1) hour before evening bedtime.
iii) Holiday Access
Holiday access takes precedence over the regularly scheduled visitation plan.
The non-custodial parent shall be entitled to the following:
On each child's birthday from 5:00 p.m. until 8.00 p.m.;
Memorial Day Monday from 2:00 p.m. until 6:00 p.m.;
Labor Day Monday from 2:00 p.m. unti1 6:00 p.m.;
Thanksgiving Day from 2:00 p.m. until 6:00 p.m.;
Christmas Day from 2:00 p.m. until 6:00 p.m.;
Independence Day from 2:00 p.m. until 6:00 p.m.;
Mother's Day with Mother from 2:00 p.m. until 4:00 p.m. and Father's Day with
Father from 2:00 p.m. until 4:00 p.m.
1 Year of Age to 5 Years of Age
i) The non-custodial parent shall have access on alternate weekends from Friday at
6:00 p.m. until Sunday at 6:00 p.m.
ii) Additionally, the non-custodial parent shall be permitted one (1) week night each
and every week with the child from 5:30 p.m. until 7:30 p.m.
iii) Holiday Access
Holiday access takes precedence over the regularly scheduled access/visitation
plan.
The non-custodial parent shall be entitled to the following:
In years ending in an odd number:
The night before each child's birthday from 5:00 p.m. until 8:00 p.m.;
Memorial Day Monday from 9:00 a.m. until 6:00 p.m.;
Independence Day from 9:00 a.m. unti16:00 p.m.;
Thanksgiving Day from 9:00 a.m. until 6:00 p.m.;
Christmas Eve from 6:00 p.m. until Christmas Day at 10:00 a.m.;
In years ending in an even number:
Each child's birthday from 5:30 p.m. until 7:30 p.m.;
Easter from 8:00 a.m. unti1 6:00 p.m.;
Labor Day Monday from 9:00 a.m. until 6:00 p.m.;
Halloween evening from 5:30 p.m. until 8:00 p.m.;
Christmas Day from 10:00 a.m. until 7:00 p.m.
iv) Summer Visitation
The non-custodial parent shall have one (1) week of vacation with the children each June,
July and August of each year. The non-custodial parent shall notify the custodial parent in
writing no later than May 1 of each year as to the specific weeks of such summer visitation.
5 Years of Age and Beyond
i) Non-custodial parent shall have access with the child on alternate weekends from
Friday at 6:00 p.m. until Sunday at 6:00 p.m. and on the Wednesday preceding the
weekend access from 5:30 p.m. to 7:30 p.m.
ii) In addition, the non-custodial parent shall have access with the child during the
week immediately following the weekend visitation on Tuesday and Thursday evening
from 5:30 p.m. until 7:30 p.m.
iii) Holiday Access:
Holiday access takes precedence over the regularly scheduled access/visitation
plan.
The non-custodial parent shall be entitled to the following:
In years ending in an odd number:
The night before each child's birthday from 5:00 p.m. to 8:00 p.m.;
Spring Break from Friday at 6:00 p.m. to the Sunday prior to the start of school at
6:00 p.m.;
Memorial Day weekend from 6:00 p.m. on Friday until 6:00 p.m. on Monday;
Independence Day from 6:00 p.m. on July 3rd until 6:00 p.m. on July 5th;
Thanksgiving holiday from 6:00 p.m. on Wednesday until 6:00 p.m. on Sunday;
From 6:00 p.m. on December 26th until
6:00 p.m. on January 1st.
In years ending in an even number:
Each child's birthday from 5:30 p.m. until 7:30 p.m.;
Easter weekend from 6:00 p.m. on Good Friday until 6:00 p.m. on Easter Sunday;
Labor Day weekend from 6:00 p.m. on Friday until 6:00 p.m. on Monday;
Halloween evening from 5:30 p.m. until 9:00 p.m. Christmas holiday from 6:00
p.m. on December 20th until 6:00 p.m. on December 26th.
iv) Mother's Day/Father's Day
The mother shall have access every Mother's Day weekend from Friday at 6:00 p.m. until
Sunday at 6:00 p.m.; the father shall have access every Father's Day weekend from Friday at
6:00 p.m. until Sunday at 6:00 p.m.
v) Summer Visitation:
The non-custodial parent shall have five (5) weeks of summer visitation with the child to
be taken in no more than two (2) week intervals and with such weekly or two (2) week visits to
be nonconsecutive. The non-custodial parent shall notify the custodial parent in writing no later
than May 1st of each year as to the specific weeks of such summer visitation.
E. Secondary Parental Responsibility, Visitation, or Time Sharing Additional
Provisions.
In exercising visitation rights the following additional provisions apply:
1. Conflicts Between Regular Weekend, Holiday, and Extended Summer
Visitation. Where there is a conflict between a holiday weekend and the regular weekend
visitation, the holiday takes precedence. Thus, if the non-custodial parent misses a regular
weekend because it is the custodial parent's holiday, the regular alternating visitation schedule
will resume following the holiday. If the non-custodial parent received two consecutive
weekends because of a holiday, the child will spend the following weekend with the custodial
parent. When there is a conflict between holiday visitation and extended summer visitation, the
holiday visitation takes precedence. When there is a conflict between regular weekend visitation
and extended summer visitation, extended summer visitation takes precedence.
2. Appropriate Conduct By Parents . Parents shall, at all times, avoid speaking
negatively about each other and should firmly discourage such conduct by relatives or friends.
Each parent should encourage the children to support the other parent. The basic rules of
conduct and discipline established by the custodial parent should be the baseline standard for
both parents, and consistently enforced by both, so that the children do not receive mixed signals.
3. Parental Communication. Parents shall at all times keep each other advised of
their home and work addresses and telephone numbers. So far as possible, all communication
concerning the children shall be conducted between the parents in person, or telephonically at
their residences (and not at their places of employment).
4. Grade Reports and Medical Information. The custodial parent shall provide
the non-custodial parent with grade reports and notices from school as they are received and
shall, consistent with Alaska law, permit the non-custodial parent to communicate concerning the
children directly with the school and with the children's doctors and other professionals, outside
the presence of the custodial parent. Each parent shall immediately notify the other of any
medical emergencies or serious illnesses of the children. The custodial parent shall notify the
non-custodial parent of all school or other events (like Church or Scouts) involving parental
participation. If the children are taking medications, the custodial parent shall provide a
sufficient amount and appropriate instructions.
5. Visitation Clothing. The custodial parent shall send an appropriate supply of the
children's clothing with them, which shall be returned clean (when reasonably possible), with the
children, by the non-custodial parent. The non-custodial parent shall advise, as far in advance as
possible, of any special activities so that the appropriate clothing may be sent.
6. Visitation or Support Disputes. Neither visitation nor child support is to be
withheld because of either parent's failure to comply with a court order. The children have aright
to both support and visitation, neither of which is dependent upon the other. In other words,
failure to pay support does not mean no visitation and no visitation does not mean no support. If
there is a violation of either a visitation or a support order, the exclusive remedy is to apply to the
court for appropriate sanctions.
7. Adjustments to This Visitation Schedule. Although this is a rather specific
schedule, the parties are expected to fairly modify visitation when family necessities, illnesses or
commitments reasonably so require. The requesting party shall give as much notice as
circumstances permit.
8. Pickup and Drop-off. Unless other arrangements are made, the non-custodial
parent shall pick up the children at the times specified and return them at the times specified.
The custodial parent shall have the children ready for visitation at the time they are to be picked
up and shall be present at the home to receive the children at the time they are returned.
Unjustified violations of this provision may result in the offender being subject to contempt of
court. (Commentary: While it is most desirable for the parents to pick up and return the children,
this provision does not prohibit grandparents, current spouses or other appropriate adults known
to the children.)
9. Extracurricular Activities. Children are often involved in sports, lessons, and
other extracurricular activities, which are generally to their benefit and enjoyment. Each parent
shall recognize that a reasonable amount of extracurricular activities are generally assumed to be
in the children's best interests. Each parent should attempt to be flexible in order to
accommodate the children's extracurricular activity schedules as must as reasonably possible,
although extracurricular activities should not supersede summer visitation with non-custodial
parents, nor should they be used as a method by which to deny access to the non-custodial
parent. In recognition of the scheduling difficulties that can be caused by children' s
extracurricular activities, custodial parents should act in good faith in attempting to schedule
such extracurricular activities as not to unreasonably infringe upon the non-custodial parent's
access to the children. Likewise, the non-custodial parent should act in good faith in attempting
to assist in transportation needs and in accommodating the children's extracurricular schedules as
much as reasonably possible. Good faith communication by the parents is essential with regard
to the difficult issue of the scheduling of children's extracurricular activities.
10. Notice of Canceled Visitation. Whenever possible, the non-custodial parent
shall give a minimum of three (3) days notice of intent not to exercise all or part of the scheduled
visitation. When such notice is not reasonably possible, the maximum notice permitted by the
circumstances, and the reason therefore, shall be given. The custodial parent shall give the same
type of notice when good cause exists making the cancellation or modification of scheduled
visitation necessary.
11. Missed Visitation. In the event the non-custodial parent misses visitation as the
result of illness of the child or parent, an emergency, or other such reasonable excuse, the parties
shall make a good faith effort to make up a portion of that visitation within a reasonable period
of time, understanding the importance of the non-custodial parent's continuing and frequent
contact with the children. (Commentary: It is important to remember that illness should not
necessarily deprive the non-custodial parent of visitation with the children. Clearly, a non-
custodial parent can take care of a sick child as well as the custodial parent in many
circumstances.)
12. Custodial Parent's Vacation. Unless otherwise specified, the custodial parent
shall be entitled to a period of vacation with the children no less than that accorded the non-
custodial parent, whose visitation shall abate during the first fourteen days thereof, and thereafter
only so long as distance makes visitation impracticable.
13. Caretaker Provision. As a general rule, each parent shall have the right of first
refusal for childcare or baby sitting needs of the other parent for durations of four hours or more.
Whenever either parent has a need for child care or baby sitting for a duration of four hours or
more, that parent should always make a good faith attempt first to inquire of the other parent,
with as much advance notice as reasonably possible, whether the other parent desires to provide
child care or baby sitting. The other parent is under no obligation to provide the childcare or
baby sitting. If the other parent elects to provide such childcare or baby sitting, it shall be done
at no cost. This provision is intended to provide each parent additional access to the children
whenever reasonably possible.
14. Telephone and Mail Privileges. Each parent shall allow liberal and reasonable
telephone and mail privileges with the children.
15. Medical Reports and Bills. The Custodial parent shall provide copies of all
medical information, and documentation, including bins, within seven (7) days of their receipt
and shall immediately notify the other parent in the event of a medical emergency. Every effort
shall be made for the custodial parent to provide the non-custodial parent with the necessary
information of a medical expense in order to get the bill satisfied. The parent with the medical
insurance shall provide the other parent with a copy of the explanation of benefits within seven
(7) days from the date of receipt of same so that the uninsured portion of the bill can be quickly
calculated and paid within a reasonable period of time.
16. Abatement of Support During Extended Visitation. If the non-custodial
parent's support obligation is current, support shall abate by 50 percent during any visitation of
seven (7) consecutive days or more. If support is not current, the 50 percent that would have
been abated shall be paid and shall apply to the existing arrearage. (Commentary: If the
custodial parent actually receives the full amount of child support during this period and if
support is current, it is the custodial parent's obligation to refund the money immediately to the
non-custodial parent. This alleviates many of the problems that arise when wage-withholding
orders have been issued.)
17. Modification. If the parties mutually agree permanently to change the provisions
of their decree of divorce, they must petition the Court to approve and order that change. In the
event that the parties do not obtain a court order, the Court will not be bound by any alleged
agreement of the parties.
18. Neither parent shall take the child(ren) from the custody of the other parent or any
child care provider or other person entrusted by the other parent with the care of the child(ren)
without the agreement of the other party during the other party’s time of parental responsibility
or visitation.
F. Other Provisions. {explain any other agreed-upon arrangements}
____________________________________________________________
SECTION 2.
CHILD SUPPORT, HEALTH INSURANCE, DENTAL INSURANCE
A. Amount and Person to Pay. Petitioner Respondent will pay child support
to Respondent Petitioner for the benefit of the minor children of the parties in the amount
of $____________ , per child, every week other week month, beginning
________________________ {date} and continuing until modified by court order, or the minor
child(ren) becomes an adult, emancipated, marries, dies, otherwise becomes self-supporting.
(Note: Child support is stated in terms of amount per child.)
B. Child Support Arrearage. There currently is a child support arrearage of
$ __________________ for retroactive child support and/or $ __________________ for
previously ordered unpaid child support. The total of $ __________________ in child support
arrearage shall be repaid at the rate of $ __________________ every week other week
month, beginning ________________________ , until paid in full including statutory interest.
C. Health Insurance. Petitioner Respondent will maintain health insurance
coverage for the parties’ minor child(ren). The party providing coverage will provide insurance
cards to the other party showing coverage. OR Health insurance is not reasonably available
at this time. Any uninsured/ unreimbursed medical costs for the minor child(ren) shall be
assessed as follows:
a. Shared equally by both parents.
b. Prorated according to the child support guideline percentages.
c. Other {explain} :
____________________________________________________________
As to these uninsured/unreimbursed medical expenses, the party who incurs the expense
shall submit a request for reimbursement to the other party within 30 days, and the other party,
within 30 days of receipt, shall submit the applicable reimbursement for that expense, according
to the schedule of reimbursement set out in this paragraph.
D. Dental Insurance. Petitioner Respondent will maintain dental insurance
coverage for the parties’ minor child(ren). The party providing coverage will provide insurance
cards to the other party showing coverage. OR dental insurance is not reasonably
available at this time. Any uninsured/ unreimbursed dental costs for the minor child(ren) shall be
assessed as follows:
a. Shared equally by both parents.
b. Prorated according to the child support guideline percentages.
c. Other {explain} :
____________________________________________________________
As to these uninsured/unreimbursed dental expenses, the party who incurs the expense
shall submit a request for reimbursement to the other party within 30 days, and the other party,
within 30 days of receipt, shall submit the applicable reimbursement for that expense, according
to the schedule of reimbursement set out in this paragraph.
E. Life Insurance. Petitioner Respondent shall be required to maintain life
insurance coverage for the benefit of the parties’ minor child(ren) in the amount of
$ ____________ until the youngest child becomes an adult, becomes emancipated,
marries, dies, or otherwise becomes self-supporting.
IRS Income Tax Deduction(s). The parent granted primary residential responsibility or
sole parental responsibility of the parties’ minor child(ren) shall have the benefit of any tax
deductions for the child(ren) or as follows {explain} :
________________________________________________________________________
The other parent will convey any applicable IRS form regarding the income tax
deduction.
F. Other provisions relating to child support (e.g., uninsured medical/dental
expenses, insurance coverage, life insurance to secure child support, orthodontic payments,
college fund, etc.): ____________________________________________________________
SECTION 3.
ABSENCE OF DURESS OR UNDUE INFLUENCE
The parties agree and state that each has freely and voluntarily entered into this
agreement. This agreement was executed free of any duress, coercion, collusion, or undue
influence. In some instances, it represents a compromise of disputed issues; however, the
parties believe that the terms and conditions of the Agreement are fair and reasonable.
SECTION 4.
ENFORCEMENT
This Agreement may be enforced by actions and proceedings for Contempt of Court, or
attachment and garnishment, for specific performance, or any other remedy legally available to
either Husband or Wife, for the enforcement of the provisions and covenants of this Agreement.
SECTION 5.
BANKRUPTCY
To the extent of any obligation contained herein is discharged in bankruptcy and the non-
bankrupt party is held liable for said debt, the non-bankrupt party shall have the right to petition
a court of competent jurisdiction for spousal support in an amount sufficient to cover any
amounts so discharged.
SECTION 6.
ENTIRE AGREEMENT
This Agreement constitutes the entire agreement between the parties and each party
acknowledges that there are no further agreements not expressly included herein and that this
Agreement may be modified, altered, or amended only in writing, duly signed and notarized by
each in the form of this original.
SECTION 7.
FULLY READ AND UNDERSTAND; INFORMED CONSENT
Each party represents and acknowledges that he or she has fully read this Agreement,
consulted with each other, carefully considered same, and have signed and executed same after
such consultation, that the signing of this Agreement is free and voluntary without force or
collusion by either party or any third party, and that each party signed same with the full
knowledge of said party's rights, obligations, and responsibilities. Each party agrees that they
have had a reasonable opportunity to consult with an attorney of their choice in the negotiation
and preparation of this document, and regarding any divorce proceeding.
SECTION 8.
SEVERABILITY
If any portion of the agreement shall be held to be void, voidable or unenforceable for
any reason, then all the remaining parts or portions shall be construed, implemented and
administered as if such void, voidable or unenforceable portion did not appear herein.
SECTION 9.
CONTROLLING LAW
This Agreement shall be governed, enforced and interpreted according to the laws of the State of
Iowa.
SECTION 10.
EFFECTIVE DATE; HEIRS AND ASSIGNS
This agreement shall be binding upon the parties and their legal representatives,
successor, heirs and assigns, subject to approval by the Court in which paternity proceedings are
instituted or pending.
EXECUTED AND AGREED ON THE DATES SET FORTH BELOW. I certify that I
have been open and honest in entering into this settlement agreement. I am satisfied with this
agreement and intend to be bound by it.
Dated: __________________ _________________________________________
Signature of Petitioner
Print or Type Name
Address:
City, State, Zip:
Telephone Number:
Fax Number:
Dated: __________________ __________________________________________
Signature of Petitioner
Print or Type Name
Address:
City, State, Zip:
Telephone Number:
Fax Number:
STATE OF __________________
COUNTY OF __________________
On this ______ day of ____________ in the year ______ , before me, the undersigned notary
public, personally appeared ______________________________ , known to me to be the
person(s) whose name(s) is/are subscribed to the within instrument and acknowledged that
he/she/they executed the same for the purposes therein contained.
In witness whereof, I hereunto set my hand and official seal.
____________________________________
Notary Public
Print or Type Name
My commission expires: __________________
STATE OF __________________
COUNTY OF __________________
On this ______ day of ____________ in the year ______ , before me, the undersigned notary
public, personally appeared ______________________________ , known to me to be the
person(s) whose name(s) is/are subscribed to the within instrument and acknowledged that
he/she/they executed the same for the purposes therein contained.
In witness whereof, I hereunto set my hand and official seal.
____________________________________
Notary Public
Print or Type Name
My commission expires: __________________
IN THE CIRCUIT COURT OF ____________ COUNTY, IOWA
AT ________________________
FAMILY COURT DIVISION
In Re the Parentage of:
______________________________ )
)
______________________________ )
Plaintiff )
)
Vs. ) CASE NO. __________________
)
) ORDER APPROVING
______________________________ ) COMPROMISE AGREEMENT
Defendant )
THE COURT, having read and considered the Motion for Approval of Compromise Agreement,
having reviewed the case file and being fully advised in the premises therein, rules as follows:
1. This Court has jurisdiction over the parties under the law.
2. Petitioner and Respondent are the natural parents of the child(ren).
CHILD’S NAME DATE OF BIRTH
______________________________ ______________________________
______________________________ ______________________________
______________________________ ______________________________
______________________________ ______________________________
3. The terms and conditions contained in the Compromise Agreement filed by the Parties is
approved and incorporated herein though set forth in full.
4. That the birth certificate of the child(ren) is at variance with this Decree and new birth
certificate shall be issued and the child’s last name changed to that of the
Petitioner Respondent.
5. OTHER ORDERS: This Court makes further Orders relating to this matter as follows:
________________________________________________________________________
Date: __________________
____________________________________
JUDGE
IN THE CIRCUIT COURT OF ____________ COUNTY, IOWA
AT ________________________
FAMILY COURT DIVISION
In Re the Parentage of:
______________________________ )
)
______________________________ )
Plaintiff )
)
Vs. ) CASE NO. __________________
)
) MOTION FOR GENETIC
______________________________ ) TESTING
Defendant )
I, ______________________________ , ask that the Court Order all parties to submit to genetic
testing, and state as follows:
1. The Petitioner Respondent, denies that he is the father of the minor child(ren) of
this action.
2. The Court has authority to order genetic testing.
3. I have contacted ________________________________________________ (name of
lab), and have obtained an appointment for __________________ (date) at
____________ so that all parties may appear for purpose of obtaining genetic specimens.
4. I have been advised that the cost of this testing will be $ ____________ (total amount for
genetic testing).
5. I request that the Court order that the tests be paid as follows:
____________ % Petitioner ____________ % Respondent
6. I also ask that the Court order all parties to cooperate with the testing, and to notify the
Petitioner Respondent that if he fails to do so, the Court may enter orders against
him including finding him to be the father of:
Names of Children:
________________________________________________
________________________________________________
________________________________________________
________________________________________________
Date: __________________
____________________________________
Petitioner Respondent
Address: ________________________
________________________
________________________
Telephone: ________________________
CERTIFICATE OF SERVICE
I certify that on __________________ (date) the original and one copy of this document
were filed with the Court; and, a true and accurate copy of the MOTION FOR GENETIC
TESTING was served on the other party by
Hand Delivery OR by placing it in the United States mail, postage pre-paid, and
addressed to the following:
TO: ______________________________
______________________________
______________________________
____________________________________
(Your Signature)
IN THE CIRCUIT COURT OF ____________ COUNTY, IOWA
AT ________________________
FAMILY COURT DIVISION
In Re the Parentage of:
______________________________ )
)
______________________________ )
Plaintiff )
)
Vs. ) CASE NO. __________________
)
) AFFIDAVIT IN SUPPORT
______________________________ ) OF GENETIC TESTING
Defendant )
STATE OF __________________
COUNTY OF __________________
____________________________________ , being duly sworn, deposes and says:
1. I am the petitioner in the within action and submit this affidavit in support of my Motion
for Genetic Testing.
2. That the following facts establish a reasonable possibility of the requisite sexual contact
between the parties:
________________________________________________________________________
WHEREFORE, I respectfully request that the Court enter an Order requiring the Respondent
submit to genetic testing.
____________________________________
Signature
Print or Type Name
Sworn to before me this day of ________________________
____________________________________
Notary Public
IN THE CIRCUIT COURT OF ____________ COUNTY, IOWA
AT ________________________
FAMILY COURT DIVISION
In Re the Parentage of:
______________________________ )
)
______________________________ )
Plaintiff )
)
Vs. ) CASE NO. __________________
)
) ORDER FOR GENETIC TESTING
______________________________ )
Defendant )
THE COURT , having read and considered the Motion For Genetic Testing, having reviewed the
case file and being fully advised in the premises therein, rules as follows:
THE COURT FINDS that it appropriate to grant the motion.
IT IS THEREFORE ORDERED:
1. The parties are ordered to submit to genetic testing and samples to be drawn at
Name of Lab ____________________________________
Date ____________________________________
Time ____________________________________ .
2. The parties shall cooperate with the genetic testing.
3. Costs of genetic testing shall be paid by ____________ % Petitioner ____________ %
Respondent.
4. Should the Petitioner Respondent fail to comply with said testing, a default order
may enter against that party.
5. The matter shall be set for hearing by Petitioner Respondent before this Court, for
receipt of testing results once the results are received.
6. Both parties are ordered to notify the Court, in writing, of any change of address for
notice purposes.
DATE: __________________
BY THE COURT:
____________________________________
Judge
IN THE CIRCUIT COURT OF ____________ COUNTY, IOWA
AT ________________________
FAMILY COURT DIVISION
In Re the Parentage of:
______________________________ )
)
______________________________ )
Plaintiff )
)
Vs. ) CASE NO. __________________
)
) AGREEMENT FOR GENETIC
______________________________ ) TESTING
Defendant )
Petitioner and Respondent agree to the following:
1. The Respondent requests genetic testing and denies that he is the father of the minor
child(ren):
Name of Child(ren) Date of Birth
____________________________________ ______________________________
____________________________________ ______________________________
____________________________________ ______________________________
____________________________________ ______________________________
2. It is agreed that the Child, Petitioner, and Respondent will submit to genetic testing.
3. Costs of genetic testing shall initially be paid by: Petitioner Respondent
4. If the ________________________ fails to appear for the testing, the Court may find him
to be the father.
5. The matter will be set for hearing once the test results are received.
6. The parties agree to notify the Court, in writing, of any change of address or employment
within ten days of the change.
I have read this agreement, understand the terms and agree to be bound by those terms.
____________________________________ ____________________________________
Petitioner Respondent
STATE OF __________________
COUNTY OF __________________
On this ______ day of ____________ in the year ______ , before me, the undersigned notary
public, personally appeared ______________________________ , known to me to be the
person(s) whose name(s) is/are subscribed to the within instrument and acknowledged that
he/she/they executed the same for the purposes therein contained.
In witness whereof, I hereunto set my hand and official seal.
____________________________________
Notary Public
Print or Type Name
My commission expires:
__________________
STATE OF __________________
COUNTY OF __________________
On this ______ day of ____________ in the year ______ , before me, the undersigned notary
public, personally appeared ______________________________ , known to me to be the
person(s) whose name(s) is/are subscribed to the within instrument and acknowledged that
he/she/they executed the same for the purposes therein contained.
In witness whereof, I hereunto set my hand and official seal.
____________________________________
Notary Public
Print or Type Name
My commission expires:
__________________
IN THE CIRCUIT COURT OF ____________ COUNTY, IOWA
AT ________________________
FAMILY COURT DIVISION
In Re the Parentage of:
______________________________ )
)
______________________________ )
Plaintiff )
)
Vs. ) CASE NO. __________________
)
) ORDER FOR GENETIC
______________________________ ) TESTING BY AGREEMENT
Defendant )
THE COURT, having read the foregoing agreement between the parties regarding genetic
testing,
FINDS THAT, the same is fair and not unconscionable, and therefore makes the same an order
of the Court.
The parties shall appear for genetic testing as stated in the agreement.
Costs of testing shall be paid by Petitioner Respondent
Date: __________________
BY THE COURT:
____________________________________
