-1- 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 SUPERIOR COURT OF THE STATE OF CALIFORNIA COUNTY OF ORANGE - LAMOREAUX JUSTICE CENTER Pursuant to the Court’s order of and after meeting and conferring, the parties submit the following Joint Statement in relation to the issues for the hearing in this matter. On behalf of Petitioner Dated: By: _____________________________ Print: On behalf of Respondent Dated: By: _____________________________ Print: Petitioner: and Respondent: Case No: JOINT STATEMENT OF PARTIES ON ISSUE OF CHILD CUSTODY AND RELATED ISSUES Hon.

Time: Dept: Date: -2- 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 JOINT STATEMENT OF PARTIES ON ISSUE OF CHILD CUSTODY AND RELATED ISSUES ISSUES MOTHER’S CONTENTIONS FATHER’S CONTENTIONS Legal Custody - Current Orders Requested Orders Reason for change Physical Custody - Current Orders Requested Orders Reason for change

Schedule of Contact Current

schedule Requested

schedule Reason for change Best Interests of the Child considerations: Health, safety & welfare Domestic violence Substance abuse Criminal history Child abuse/neglect Parental incapacity Parental conflict -3- 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 Other Issues: Developmental Emotional Psychological Medical Special Needs Extended family New relationships Sibling issues Conflict with a parent Requested Orders and reason: CCI Evidence Code Minor’s Counsel Emergency Investigation Minor Interview Judge Interview Talking Parents/OFW Parenting Classes Counseling Supervised Visitation Substance Abuse Testing Mediation JOINT STATEMENT OF PARTIES ON ISSUE OF CHILD CUSTODY AND RELATED ISSUES