Fill and Sign the Stipulation Order and Form

––––– ––––– ––––– ––––– ––––– ––––– ––––– ––––– ––––– ––––– ––––– ––––– ––––– –– ––––– ––––– ––––– ––––– ––––– ––––– ––––– ––––– ––––– –– –– –– –– –– –– ––––– ––––– ––––– ––––– ––––– ––––– –– –– –– –– –– –– –– –– ––––– –––– – ––––– FL- 355ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address): TELEPHONE NO. FOR COURT USE ONLY TELEPHONE NO: FAX NO. (Optional): E-MAIL ADDRESS (Optional): ATTORNEY FOR (Name): SUPERIOR COURT OF CALIFORNIA, COUNTY OF STREET ADDRESS MAILING ADDRESS CITY AND ZIP CODE BRANCH NAME PETITIONE R: RESPONDEN T: OTHER: : STIPULATION AND ORDER FOR CUSTODY AND/OR VISITATION OF CHILDREN CASE NUMBER MODIFICATION The parties signing this stipulation agree that: 1. This court has jurisdiction over the minor children because California is the children's home state. 2. The habitual residence of the children is the United States of America. and consisting of (number): custody and visitation agreement and request that it be made an order of the court, or pages is their3. The parties acknowledge they were advised that any violation of this order may result in civil or criminal penalties, or both. 4. a. The parties stipulate that the attached document, dated (specify): b. The parties stipulate that the attached forms FL- 341 FL-341 (A) FL-341 (B) FL-341 (C) FL-341 (D) FL-341 (E) are their agreement regarding custody and/or visitation of their children and request that they be made an order of the court. Each party declares under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Dat e: Dat e: (TYPE OR PRINT NAME) (SIGNATURE OF PETITIONER) (TYPE OR PRINT NAME) Dat e: (SIGNATURE OF RESPONDENT) Dat e: (TYPE OR PRINT NAME) (SIGNATURE OF ATTORNEY FOR PETITIONER) Dat e: (TYPE OR PRINT NAME) (SIGNATURE OF ATTORNEY FOR RESPONDENT) Dat e: (TYPE OR PRINT NAME) (SIGNATURE OF OTHER) (TYPE OR PRINT NAME) (SIGNATURE OF ATTORNEY FOR OTHER) FINDINGS AND ORDERTHE COURT FINDS: 1. This court has jurisdiction over the minor children because California is the children's home state. 2. The habitual residence of the children is the United States of America. 3. Both parties have been advised that any violation of this order may result in civil or criminal penalties, or both. THE COURT ORDERS: 1. The agreement of the parties regarding custody and visitation as set forth in the attached document dated (specify): and consisting of (number): pages or set forth in the attached forms: FL- 341 FL-341 (A) FL-341 (B) FL-341 (C) FL-341 (D) FL-341 (E) is adopted as the order of the court and fully incorporated by reference herein. Dat e: JUDICIAL OFFICER Page 1 of 1 Form Approved for Optional Use Judicial Council of California FL-355 [New January 1, 2004] STIPULATION AND ORDER FOR CUSTODY AND/OR VISITATION OF CHILDREN elec troni c form ã 2004 WWW.LawCA.co m L a w P u b l i s h e r s