Fill and Sign the Order Custody Visitation Form

Form 349 Rev 2/18 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 File Number                   D.O.B. D.O.B.             Street Address Street Address Petition Number                               P.O. Box Number P.O. Box Number             City/ State/Zip Code City/State/Zip Code             Attorney Name Attorney Name             IN THE INTEREST OF the following child(ren): Name (Child #1) Date of Birth Name (Child #2) Date of Birth                         Name (Child #3) Date of Birth Name (Child #4) Date of Birth                         Name (Child #5) Date of Birth Name (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:             Page 1 of 2 Form 349 Rev 2/18 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. Petitioner Respondent State of       State of       County of       County of       Sworn to subscribed before me: Sworn to subscribed before me: Mediator/Notary Public Mediator/Notary Public So Ordered this Date:             Judge/Commissioner Page 2 of 2