Parenting Plan Form - West Virginia

SCA-FC-121: Parenting Plan
Review Date: 05/2014; Revision Date: 05/2014; WVSCA Approved: 06/17/2014
Page 1 of 15
IN THE FAMILY COURT OF
COUNTY, WEST VIRGINIA
IN RE:
The Marriage / Children Of:
Civil Action No.
Petitioner (First/Middle/Last)
, and
Respondent (First/Middle/Last)
.
PARENTING PLAN
This Parenting Plan is proposed
individually by , the Petitioner / Respondent.
*Every Individual Plan must be accompanied by a completed Worksheet.
jointly by , and
This plan is proposed for use temporarily / permanently / both temporarily and permanently.
CHILDREN
List the name and date of birth of all children subject to this Parenting Plan.
Name Date of Birth
/
/
/ /
/ /
/ /
Name Date of Birth
/
/
/ /
/ /
/ /
The other parent should not have parenting time with the children due to the following:
.
RESTRICTIONS
The Family Court can restrict a parent's contact with the children if the parent has engaged in certain
kinds of conduct harmful to the children. To begin, you must read the following list of types of conduct that
can require restrictions, and then you must read the rest of the Restrictions section and complete the items that
apply to your situation.
CONDUCT THAT CAN REQUIRE PARENTAL RESTRICTIONS.
The parent has abused, neglected, or abandoned a child.
The parent has sexually assaulted or abused a child.
The parent has committed acts of domestic violence.
.
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