"Agreed Order for Custody of a Minor Child"

Agreed Order for Custody of a Minor Child is a 2-page legal document that was released by the United States District Court and used nation-wide.

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NO. _________________________
PETITIONER
IN THE DISTRICT COURT
JUDICIAL DISTRICT
RESPONDENT
{COUNTY, STATE}
AGREED ORDER FOR CUSTODY OF A MINOR CHILD
Petitioner’s Name:
Address:
Phone Number:
Occupation:
SSN:
Marriage Status:
DOB:
Birthplace:
Relationship to Child:
q Mother q Father q Legal Guardian
Respondent’s Name:
Address:
Phone Number:
Occupation:
SSN:
Marriage Status:
DOB:
Birthplace:
q Mother q Father q Legal Guardian
Relationship to Child:
Child 1:
DOB:
Child 2:
DOB:
Child 3:
DOB:
Child 4:
DOB:
Child 5:
DOB:
The two parties have the aforementioned child(ren) together and are seeking separation and divorce.
Therefore they agree to the following custody terms:
q The two parties will share joint custody.
Petitioner will have custody on the following dates and times:
Day of Week:
Times:
Day of Week:
Times:
Day of Week:
Times:
Day of Week:
Times:
Day of Week:
Times:
Day of Week:
Times:
Day of Week:
Times:
Respondent will have custody on the following dates and times:
Day of Week:
Times:
Day of Week:
Times:
Day of Week:
Times:
Day of Week:
Times:
Day of Week:
Times:
Day of Week:
Times:
NO. _________________________
PETITIONER
IN THE DISTRICT COURT
JUDICIAL DISTRICT
RESPONDENT
{COUNTY, STATE}
AGREED ORDER FOR CUSTODY OF A MINOR CHILD
Petitioner’s Name:
Address:
Phone Number:
Occupation:
SSN:
Marriage Status:
DOB:
Birthplace:
Relationship to Child:
q Mother q Father q Legal Guardian
Respondent’s Name:
Address:
Phone Number:
Occupation:
SSN:
Marriage Status:
DOB:
Birthplace:
q Mother q Father q Legal Guardian
Relationship to Child:
Child 1:
DOB:
Child 2:
DOB:
Child 3:
DOB:
Child 4:
DOB:
Child 5:
DOB:
The two parties have the aforementioned child(ren) together and are seeking separation and divorce.
Therefore they agree to the following custody terms:
q The two parties will share joint custody.
Petitioner will have custody on the following dates and times:
Day of Week:
Times:
Day of Week:
Times:
Day of Week:
Times:
Day of Week:
Times:
Day of Week:
Times:
Day of Week:
Times:
Day of Week:
Times:
Respondent will have custody on the following dates and times:
Day of Week:
Times:
Day of Week:
Times:
Day of Week:
Times:
Day of Week:
Times:
Day of Week:
Times:
Day of Week:
Times:
Day of Week:
Times:
q
will have custody of child(ren).
will have visitation rights on the following dates and times:
Day of Week:
Times:
Day of Week:
Times:
Day of Week:
Times:
Day of Week:
Times:
Day of Week:
Times:
Day of Week:
Times:
Day of Week:
Times:
q
will have full custody of child(ren).
will have no visitation rights.
Further, both parties agree to the following child support terms:
q
Neither party will pay child support.
q
will pay the amount of
per week.
Both parties swear and attest that the above is true to the best of their knowledge.
Petitioner Signature
Date
Respondent Signature
Date
Subscribed and sworn to before me this
day of
20
(Notary Public),
County.
My commission expires
20
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