Fill and Sign the Parenting Plan 497430916 Form

PRINT in INK Enter the name of the county in which this case is filed. STATE OF WISCONSIN, CIRCUIT COURT,       COUNTY For Official Use Check marriage or paternity. If paternity, enter the initials of the child. In RE: The marriage paternity of       Petitioner/Joint Petitioner-Wife:       First name Middle name Last name andEnter the name of the petitioner. If joint petitioners, enter the name of the wife. Proposed Parenting Plan Case No.       Enter the name of the respondent. If joint petitioners, enter the name of the husband. Respondent/Joint Petitioner-Husband:       First name Middle name Last name Enter the case number. I understand that Wisconsin law states that in an action in which legal custody or physical placement is contested:  I am required to file a proposed parenting plan within 60 days after the court waives mediation or within 60 days after the mediator notifies the court that no agreement has been reached.  If I fail to file such a plan, I may lose my right to contest the plan submitted by the other parent unless I can show good cause for my delay. I am the mother father of the minor children of this case. I AM PROPOSING THE FOLLOWING PARENTING PLAN: A. Legal Custody 1. L egal custody of the minor children shall be as follows: FA-4147V, 01/09 Proposed Parenting Plan §767.41(1m), Wisconsin Statutes This form shall not be modified. It may be supplemented with additional material. Page 1 of 5Name of Child Date of Birth Joint Legal Custody Sole Legal Custody to Mother Sole Legal Custody to Father                                                                                                             Check mother or father. Note: Legal custody is the right and responsibility to make major decisions about a child, except for those specific decisions described in 2, if any. Enter the name of each child and check who you believe should have legal custody. Proposed Parenting Plan Page 2 of 6 Case No. Error: Reference source not found _____________ 2. Specific Decision Making Authority Decisions in the following listed areas will be made as follows: B. Physical Placement In allocating the time the minor children spend between the parents, the court should award the placement on a day-to-day basis as follows: AND the physical placement schedule shall be: a. as listed in the attached document. b. as proposed below (on a biweekly basis): Mon. Tues. Wed. Thurs. Fri. Sat. Sun. Week 1                                           Week 2                                           C. Summer and Holiday Placement Schedule The summer and holiday placement schedule should be as follows: 1. as proposed here: HOLIDAYS With Mother the following years With Father the following years Every year Even years Odd years Every year Even years Odd years a. Mother’s Day b. Memorial Day c. Father’s Day d. July 4th e. Labor Day f. Halloween FA-4147V, 01/09 Proposed Parenting Plan §767.41(1m), Wisconsin Statutes This form shall not be modified. It may be supplemented with additional material. Page 2 of 5Decision Jointly By Mother By Father a. Non-Emergency Health Care b. Education/School Activities c. Child Care Providers d. Non-School Activities e. Other:       Name of Child Equal Shared Placement Primary Physical Placement to Mother Primary Physical Placement to Father                                     Enter the name of each child and check which parent you believe should have physical placement of that child. And check a or b. If a, attach a schedule. If b, describe how placement will be shared in the chart provided. Check who will be making the specific decisions for each subject area in a-d. If other, please specify. Note: Physical Placement is the right to have a child physically placed with a party. Check 1, 2 or 3. If 1, enter the year [every/odd/even] in which the schedule will begin. Check which parent you believe should have the children for each holiday break. Proposed Parenting Plan Page 3 of 6 Case No. Error: Reference source not found _____________ g. Thanksgiving h. Christmas Eve i. Christmas Day j. New Year’s Eve k. New Year’s Day l. Religious Holiday       m. Religious Holiday       n. Father’s Birthday o. Mother’s Birthday p. Children’s Birthday(s) q. Other:       r. Other:       s. School Spring Break t. School Teacher Conventions u. Summer Break to be shared as follows:       2. According to the attached       County standard placement schedule. 3. Other:       See attached D. Child Care 1. The children do not require child care. 2. The child care will be provided by       And t he cost of child care will be paid as follows: a. The mother to pay       %. b. The father to pay       %. E. Transportation Issues 1. The physical transfer of the children for placement should be as follows: a. All transportation to and from placements will be provided by the mother. b. All transportation to and from placements will be provided by the father. c. Transportation will be shared with: 1. parent with children shall deliver. 2. parent without children shall pick up. d. Other:       2. Transfers of children shall take place at: a. parent’s home. b. halfway point:       c. other location:       d. Inter-spousal battery/domestic violence is an issue in this relationship and in order to ensure the safety of the children and/or parent, transfers of the children between the parents shall be: 1. supervised by       2. at a neutral public site       3. at a home of the following person       4. Other:       3. Transportation Costs shall be: a. paid by party who incurs the costs. FA-4147V, 01/09 Proposed Parenting Plan §767.41(1m), Wisconsin Statutes This form shall not be modified. It may be supplemented with additional material. Page 3 of 5Check 1 or 2. If 2, enter the name of the childcare provider and indicate in a and b the percent you propose each parent should pay toward the cost. The total amount must equal 100%. For 3, check a or b. If b, enter how you propose the transportation costs should be paid.Check a, b, c, or d. If c, check 1 or 2 If d, enter the other proposal. For 2, check a, b, or c. If b or c, enter the location for the drop-off. If d, check 1,2,3 or 4. For each enter the requested information. If 2, write the name of the county whose schedule you are using. If 3, enter the other schedule. Proposed Parenting Plan Page 4 of 6 Case No. Error: Reference source not found _____________ b. paid as follows:       F. Child Support The noncustodial parent shall be responsible for child support as follows: 1. as required by the state support guidelines (see divorce/paternity summons). 2. according to the attached proposal. Note: If the proposal is different from the state guidelines, the reason why it is different must be given. G. School 1. The children will attend school at: Name of Child School/ School District                                                                                                 2. Education costs will be paid as follows: a. The mother to pay       %. b. The father to pay       %. H. Residence 1. Current a. I currently reside at: Address       City       State       Zip       b. This is an inter-spousal battery/domestic violence case; I decline to give a specific address, but my general location is currently       . 2. Future a. For the next two years it is my intention to reside at: Address       City       State       Zip       b. This is an inter-spousal battery/domestic violence case; I decline to give a specific future address, but it is my intention to generally reside for the next two years at:       . I. Current Employer 1. I am currently employed at: Employer       City       State       Days/Hrs.       2. This is an inter-spousal battery/domestic violence case; I decline to give my specific employment, but where I generally work is       . J. Health Care 1. Providers: Healthcare services will be provided to the children by the following: Doctors/Pediatrician/Clinic       Eye/Optometrist       Dentist/Orthodontist       Insurance/Health Plan (if any)       Other:       2. Expenses a. Healthcare Insurance for the minor children shall be: 1. paid by me. FA-4147V, 01/09 Proposed Parenting Plan §767.41(1m), Wisconsin Statutes This form shall not be modified. It may be supplemented with additional material. Page 4 of 5Check 1, or 2. Enter the name of each child and indicate which school you propose he/she attend. Enter the name of each provider. If other, enter the description along with the provider name. Check 1, 2, 3, 4 or 5. If 4, describe your payment suggestion. If 5, attach the plan.Check a or b. If a, enter the address. If b, enter your general location. Check a or b. If a, enter the address at which you intend to live for the next two years. If b, enter the general location of where you intend to live for the next two years. Check 1 or 2. If 1, enter your current employer and your general work schedule. If 2, enter your general employment.Enter the percentage each parent should pay. The total amount must equal 100%. Proposed Parenting Plan Page 5 of 6 Case No. Error: Reference source not found _____________ 2. paid by the other parent. 3. shared equally by both of us. 4. paid as follows:       5. See attached plan . b. Uninsured healthcare expenses shall be: 1. paid by me. 2. paid by the other parent. 3. shared equally by both of us. 4. paid as follows:       5. See attached plan . K. Religious Upbringing 1 . The minor children will be raised in the following religion:       2 . No religious affiliation is planned. L. Maintaining Contact with Other Parent I shall assist the children in maintaining contact with the other parent by: 1 . direct contact through periods of placement. 2 . telephone contact. 3 . cards/letters. 4 . e-mail. 5 . providing copies of children’s school projects. 6 . providing photographs of children participating in activities. 7 . assisting children with gift purchasing for other parent for birthdays and holidays. 8 . assisting children with letter writing to other parent. 9 . creating personal web-site for posting pictures, letters, information, comments. 10 . Other:       (Note: Each parent is expected to take personal responsibility for contacting the schools to obtain school calendars and report cards and attending parent-teacher meetings.) M. Resolving Disagreements If there are disagreements between myself and the other parent on issues that are to be joint decisions, the way to resolve the disagreements will be : 1 . the parent who has primary physical placement will decide. 2 . the parent who has physical placement at the time of the disagreement will decide. 3 . to allow the parent who generally made this type of decision before these court proceedings were started to make the same type of decision in the future. 4 . to review the issues from the other parent’s or children’s standpoint and reconsider my position. 5 . to determine whether my opposition is in good faith and in the best interests of the children or whether it is an attempt to spite the other parent, if it is not in good faith or the best interests, reconsider my position. 6. to determine whether this is a situation in which the children is/are attempting to manipulate one parent against the other; if it appears to be manipulative, attempt to consult with the other parent to prevent the children from trapping us in this position. 7 . to ask for assistance from friends, relatives, clergy, or others who can be neutral and fair. 8 . I would suggest the following person(s) to serve as a third-party neutral(s): 9 . to contact the family court mediation program. 10 . Other:       FA-4147V, 01/09 Proposed Parenting Plan §767.41(1m), Wisconsin Statutes This form shall not be modified. It may be supplemented with additional material. Page 5 of 5Check 1 or 2. If 1, enter the name of the religion. Check 1, 2, 3, 4, 5, 6, 7, 8, 9, or 10. If 8, enter the name(s) of the individuals. If 10, enter your suggested method.Check 1, 2, 3, 4 or 5. If 4, describe your payment suggestion. If 5, attach the plan. Check all that apply in 1- 10. If other, enter a description. Proposed Parenting Plan Page 6 of 6 Case No. Error: Reference source not found _____________ Only one party needs to sign. However, if both parties agree, both should sign and print their names. Enter the date on which you signed your name. Note: This signature does not need to be notarized. u Signature       Print or Type Name       Date u Signature       Print or Type Name       Date FA-4147V, 01/09 Proposed Parenting Plan §767.41(1m), Wisconsin Statutes This form shall not be modified. It may be supplemented with additional material. Page 6 of 5