Sample Blank Parenting Plan - Florida

Florida Supreme Court Approved Family Law Form 12.995(a), Parenting Plan (03/09)
IN THE CIRCUIT COURT OF THE JUDICIAL CIRCUIT,
IN AND FOR COUNTY, FLORIDA
Case No.:
Division:
Petitioner,
and
Respondent.
/
PARENTING PLAN
This parenting plan is: (Choose only one)
[ ] A Parenting Plan submitted to the court with the agreement of the parties.
[ ] A proposed Parenting Plan submitted by or on behalf of:
{Parent’s Name}_______________________________________________.
[ ] A Parenting Plan established by the court.
This parenting plan is: (Choose only one)
[ ] A final Parenting Plan established by the court.
[ ] A temporary Parenting Plan established by the court.
[ ] A modification of a prior final Parenting Plan or prior final order.
I. PARENTS
Mother
Name:__________________________________________________________________
Address: ________________________________________________________________
Telephone Number: ______________________________________________________
E-Mail: _________________________________________________________________
Father
Name:__________________________________________________________________
Address: ________________________________________________________________
Telephone Number: ______________________________________________________
E-Mail: _________________________________________________________________
II. CHILDREN: This parenting plan is for the following child(ren) born to, or adopted by the parties:
(add additional lines as needed)
Name Date of Birth Sex
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
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