Agreed Order For Custody Agreement
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2NO. _________________________
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:
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