Form JD-FM-199 "Proposed Parental Responsibility Plan" - Connecticut

What Is Form JD-FM-199?

This is a legal form that was released by the Connecticut Superior Court - a government authority operating within Connecticut. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on March 1, 2014;
  • The latest edition provided by the Connecticut Superior Court;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form JD-FM-199 by clicking the link below or browse more documents and templates provided by the Connecticut Superior Court.

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Download Form JD-FM-199 "Proposed Parental Responsibility Plan" - Connecticut

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PROPOSED PARENTAL
STATE OF CONNECTICUT
RESPONSIBILITY PLAN
SUPERIOR COURT
www.jud.ct.gov
JD-FM-199 Rev. 3-14
C.G.S. Sec. 46b-56a
ADA NOTICE
Instructions
The Judicial Branch of the State of Connecticut complies with the
If there is a dispute in Superior Court between the parents about the child
Americans with Disabilities Act (ADA). If you need a reasonable
(ren)'s custody, care, education and upbringing, this form must be completed
accommodation in accordance with the ADA, contact a court clerk
and filed with the court on or before the case management date, if applicable,
or an ADA contact person listed at www.jud.ct.gov/ADA.
or, as otherwise ordered by the court. Attach additional sheets if necessary.
Judicial District of
At (Town)
Docket number
Plaintiff's name (Last, First, Middle Initial)
Defendant's name (Last, First, Middle Initial)
It is proposed that:
1) The physical residence of the child(ren) will be according to the following schedule:
2) Decision-making about the child(ren)'s health, education and religious upbringing will be allocated to the parent(s) as
follows:
3) Future disputes between the parents will be resolved in the following manner (include, where appropriate, the
involvement of a mental health professional or other parties to help reach a developmentally appropriate resolution to
such disputes):
4) Failure of either parent to honor his or her responsibilities under the plan will be dealt with in the following manner:
5) The changing needs of the child(ren) as the child(ren) grow and mature will be dealt with in the following manner:
6) Other:
The child(ren)'s exposure to harmful parental conflict will be minimized; the parents will, in appropriate circumstances,
meet their responsibilities through agreements; and both parents will protect the best interests of the child(ren).
Signature of party
Date signed
Signature of attorney (if applicable)
Date signed
u
u
Certification
I certify that a copy of this document was mailed or delivered electronically or non-electronically on (date)
to all attorneys
and self-represented parties of record and that written consent for electronic delivery was received from all attorneys and self-represented
parties receiving electronic delivery.
Name and address of each party and attorney that copy was mailed or delivered to*
*If necessary, attach additional sheet or sheets with name and address which the copy was mailed or delivered to.
Print or type name of person signing
Date signed
Signed (Signature of filer)
u
Telephone number
Mailing address (Number, street, town, state and zip code)
Print Form
Reset Form
PROPOSED PARENTAL
STATE OF CONNECTICUT
RESPONSIBILITY PLAN
SUPERIOR COURT
www.jud.ct.gov
JD-FM-199 Rev. 3-14
C.G.S. Sec. 46b-56a
ADA NOTICE
Instructions
The Judicial Branch of the State of Connecticut complies with the
If there is a dispute in Superior Court between the parents about the child
Americans with Disabilities Act (ADA). If you need a reasonable
(ren)'s custody, care, education and upbringing, this form must be completed
accommodation in accordance with the ADA, contact a court clerk
and filed with the court on or before the case management date, if applicable,
or an ADA contact person listed at www.jud.ct.gov/ADA.
or, as otherwise ordered by the court. Attach additional sheets if necessary.
Judicial District of
At (Town)
Docket number
Plaintiff's name (Last, First, Middle Initial)
Defendant's name (Last, First, Middle Initial)
It is proposed that:
1) The physical residence of the child(ren) will be according to the following schedule:
2) Decision-making about the child(ren)'s health, education and religious upbringing will be allocated to the parent(s) as
follows:
3) Future disputes between the parents will be resolved in the following manner (include, where appropriate, the
involvement of a mental health professional or other parties to help reach a developmentally appropriate resolution to
such disputes):
4) Failure of either parent to honor his or her responsibilities under the plan will be dealt with in the following manner:
5) The changing needs of the child(ren) as the child(ren) grow and mature will be dealt with in the following manner:
6) Other:
The child(ren)'s exposure to harmful parental conflict will be minimized; the parents will, in appropriate circumstances,
meet their responsibilities through agreements; and both parents will protect the best interests of the child(ren).
Signature of party
Date signed
Signature of attorney (if applicable)
Date signed
u
u
Certification
I certify that a copy of this document was mailed or delivered electronically or non-electronically on (date)
to all attorneys
and self-represented parties of record and that written consent for electronic delivery was received from all attorneys and self-represented
parties receiving electronic delivery.
Name and address of each party and attorney that copy was mailed or delivered to*
*If necessary, attach additional sheet or sheets with name and address which the copy was mailed or delivered to.
Print or type name of person signing
Date signed
Signed (Signature of filer)
u
Telephone number
Mailing address (Number, street, town, state and zip code)
Print Form
Reset Form