SDSC FLF-011 (New 6/10) ATTACHED DECLARATION IN SUPPORT OF REQUEST Page 1 of 2

Cal. Form FLF-011

California Superior Local Rules

SDSC FLF-011 (New 6/10) ATTACHED DECLARATION IN SUPPORT OF REQUEST FOR CHILD CUSTODY / VISITATION ORDERS

SHORT TITLE CASE NUMBER ATTACHED DECLARATION IN SUPPORT OF REQUEST FOR CHILD CUSTODY / VISITATION ORDERS The following information is submitted in support of my request for child custody and/or visitation orders: 1. Primary caretaker information a. The primary caretaker of the child(ren) is: . b. The person who takes the child(ren) to the doctor and dentist is: . c. The person who transports and attends the extr acurricular activities of the child(ren) is: . d. The person who helps/supervises the child(ren) with daily homework is: . e.

The person who attends school events with t he child(ren) and meets with teachers is: . 2. Distance between homes and availability of transportation a. The distance between the homes of the parties is: 0 to 10 miles to 30 miles to 60 miles over 60 miles unknown. b. I have the following transportation available: private vehicle public transportation unknown. c. The other party has the followi ng transportation available: private vehicle public transportation unknown. 3. Work

schedule of parties NAME MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY SATURDAY SUNDAY Work

Schedule Each Day NAME MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY SATURDAY SUNDAY Work

Schedule Each Day 4. Current or planned childcare arrangements Before school: After school: During work hours: 5. Schools and/or school issues Attendance issues. Homework issues. Special needs. IEP (Individualized education plan). Explanation: SDSC FLF-011 (New 6/10) ATTACHED DECLARATION IN SUPPORT OF REQUEST FOR CHILD CUSTODY / VISITATION ORDERS

SHORT TITLE CASE NUMBER 6. Special medical needs or conditions of the child(ren) 7. Other issues The other parent has a history of substance abuse, domestic violence, or poor parenting skills. The other parent has no relationship with our child(ren) and does not visit or call our child(ren). The other parent has not followed the current custody/visitation order. Other: . 8. Material change of circumstance (for modification of orders only) A material change of circumstance affecting the best interest s of the child(ren) has occurred since the last order was made. Describe the change(s): 9.

Proposed parenting plan My proposed parenting plan is: This plan is in the best interest of the child(ren) because: Additional facts contained on attached JC form #MC-031. I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Date: Type or Print Name Signature of Declarant

Document details

Collection	California Superior Local Rules
Citation	Cal. Form FLF-011
Type	court_rule
Language	en
Format	pdf
Source	CA_LOCAL
Identifier	2ceba458c00111c4afd6dea611b6346691d69f87

Source file is stored in the law ingest library (pdf).