Proposed Parenting Plan Form - Wisconsin

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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 5
Enter the name of the
county in which this case
is filed.
STATE OF WISCONSIN, CIRCUIT COURT,
COUNTY
Check marriage or
paternity. If paternity,
enter the initials of the
child.
For Official Use
Enter the name of the
petitioner. If joint
petitioners, enter the name
of the wife.
In RE: The marriage paternity of
Petitioner/Joint Petitioner-Wife:
First name Middle name Last name
and
Enter the name of the
respondent. If joint
petitioners, enter the name
of the husband.
Enter the case number.
Respondent/Joint Petitioner-Husband:
First name Middle name Last name
Proposed Parenting Plan
Case No.
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. Legal custody of the minor children shall be as follows:
2. Specific Decision Making Authority
Decisions in the following listed areas will be made as follows:
Name of Child
Date of
Birth
Joint
Legal
Custody
Sole
Legal Custody
to Mother
Sole Legal
Custody to
Father
Decision Jointly By Mother By Father
a.
Non-Emergency Health Care
b.
Education/School Activities
c. Child Care Providers
d.
Non-School Activities
e.
Other:
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.
Check who will be
making the specific
decisions for each
subject area in a-d. If
other, please specify.
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