Proposed Paternity Resolution
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FOR CLERK’S USE ONLY
Name of Person Filing:
___________________________________
Mailing Address:
___________________________________
City, State, Zip Code:
___________________________________
Daytime Phone Number: ___________________________________
Evening Phone Number: ___________________________________
ATLAS Number (if Applicable):_______________________________
State Bar Number (If Applicable):_____________________________
Representing:
Self
Petitioner
Respondent
SUPERIOR COURT OF ARIZONA
MOHAVE COUNTY
______
__________
_____________________
Case Number __________________________
Petitioner
_____________________________________
PROPOSED PATERNITY RESOLUTION
Respondent
STATEMENT OF:
FATHER
MOTHER
The undersigned party provides the following positions on each of the issues in this case (BE SPECIFIC):
1.
IV-D Case:
I receive or have received public assistance that may include AFDC, TANF, or AHCCCS for my
children or me.
I have a case with the Division of Child Support Enforcement.
2.
Custody: The other parent and I have the following natural or adopted children in common:
Child(ren)’s Name(s)
Date(s) of Birth
Age(s)
_________________________________________________
________________
__________
_________________________________________________
________________
__________
_________________________________________________
________________
__________
_________________________________________________
________________
__________
The children should live primarily with
Mother
Father and have parenting time with
Mother
Father as follows (check all that apply):
In accordance with Mohave County Guidelines for reasonable parenting time.
Model Parenting Time Plans (describe plan)____________________________________________.
Every other weekend from:
__________________ at _________
a.m.
p.m. to
__________________ at _________
a.m.
p.m.
One-half of the holidays on an alternating basis.
For ________ weeks in the summer from ________________ to _______________(inclusive).
Spring Break from school.
Other: ______________________________________________________________________
____________________________________________________________________________
Mother or
Father should have sole legal custody.
OR
Mother and Father should have joint legal custody.
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3/29/10
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