Form Pkt-008 - Domestic Violence - Restraining Order With Children Packet Page 16

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CONFIDENTIAL
CASE NAME
CASE NUMBER
FAMILY COURT SERVICES (FCS) DATA SHEET
Complete the following questions.
1. Which parent filed the current court action?
2. What is the action regarding?
3. Is there a court order regarding custody and visitation now?
Yes
No
a. If yes, briefly summarize:
b. When was it issued?
4. If there is no court order or a different schedule is being practiced, summarize your current parenting
schedule:
5. What parenting schedule would you like to have?
Date:
Signature of Party Filling Out This Form
NO ATTACHMENTS
FAMILY COURT SERVICES (FCS) DATA SHEET
SDSC FCS-002 (Rev. 5/16)
Page 3 of 3
(CONFIDENTIAL)
Mandatory Form

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