Parenting Plan — Basic · Step 4 of 5
Signature & Certification
Dated:
Write the date you are signing this form.
Signature of Petitioner/Parent
Sign your name here to show you agree with this plan. Only sign in front of a notary or clerk if required.
Printed Name:
Print your full legal name so it is easy to read.
Address:
Enter your current street address where you live or get mail.
City, State, Zip:
Enter the city, state, and ZIP code for your address.
Telephone Number:
Enter a phone number where you can be reached.
Fax Number:
Enter your fax number if you have one. Leave blank if you don't.
Designated E-mail Address(es):
Enter the email address where you want to receive legal documents.
Dated:
Write the date you are signing this form.
Signature of Respondent/Parent
Sign your name here as the respondent or parent. Do not sign until you are in front of a notary or clerk.
Printed Name:
Print your full name clearly so it can be read easily.
Address:
Write your home street address.
City, State, Zip:
Write the city, state, and ZIP code that go with your address.
Telephone Number:
Write a phone number where you can be reached.
Fax Number:
Write your fax number if you have one. Leave blank if you do not.
Designated E-mail Address(es):
Write the email address where you want to receive court papers.
This form was prepared for the: {choose only one} Petitioner / Respondent
If a non-lawyer helped fill out this form, check whether it was prepared for the Petitioner or the Respondent.
{name of individual}
Write the name of the person who helped you fill out this form, if anyone did.
{name of business}
Write the name of the business where the helper works, if there is one.
{address}
Write the street address of the person or business that helped you.
{city}
Write the city of the helper's address.
{state}
Write the state of the helper's address.
{zip code}
Write the ZIP code of the helper's address.
{telephone number}
Write the phone number of the person or business that helped you.
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