Children

a. General Information

That Plaintiff and Defendant have (number) ______ minor children in common Write how many children under 18 you and your spouse share, either by birth or adoption.

b. Children's Basic Information

Child's Name: Write the full name of your first child. Date of Birth Enter the birth date of your first child. Child's Name: Write the full name of your second child, if you have one. Date of Birth Enter the birth date of your second child, if you have one. Child's Name: Write the full name of your third child, if you have one. Date of Birth Enter the birth date of your third child, if you have one. Child's Name: Write the full name of your fourth child, if you have one. Date of Birth Enter the birth date of your fourth child, if you have one. Child's Name: Write the full name of your fifth child, if you have one. Date of Birth Enter the birth date of your fifth child, if you have one. The children are residents of Nevada and have lived here for at least the past 6 months. Check this if your children have lived in Nevada for at least the last 6 months. This lets the court decide custody. The children are not residents of Nevada or have not lived here for at least the past 6 months. Check this if your children have not lived in Nevada for the last 6 months. You must name the state where they live below. The children live in (state) Write the name of the state where your children mainly live. The parties are granted joint legal custody of the minor child(ren). Check this if both parents will share the right to make big decisions for the children, like school, health, and religion. The Plaintiff is granted sole legal custody of the minor child(ren). Check this if only the person who started the case will make the big decisions for the children. The Defendant is granted sole legal custody of the minor child(ren). Check this if only the other spouse (the one who was sued) will make the big decisions for the children. Nevada is not the home state of the child(ren) and does not have jurisdiction. Check this if the children have not lived in Nevada long enough for this court to decide custody. The parties shall share joint physical custody of the minor child(ren). The parties shall exercise a regular and/or holiday timeshare as outlined in Exhibit 1 which is incorporated herein. Check this if the children will live with both parents on a shared schedule. The schedule details go in Exhibit 1. Primary physical custody of the minor child(ren) shall be awarded to Check this if the children will live mostly with one parent, and the other parent gets visits. Plaintiff Check this if the person who started the case will be the main parent the children live with. Defendant Check this if the other spouse will be the main parent the children live with. Sole physical custody of the minor child(ren) shall be awarded to Check this if the children will live with only one parent, with little or no time with the other. Plaintiff Check this if the person who started the case will be the only parent the children live with. Defendant Check this if the other spouse will be the only parent the children live with. Nevada is not the home state of the child(ren) and does not have jurisdiction. Check this if the children have not lived in Nevada long enough for this court to decide where they live.

c. Child Support

child support would be paid by (parent name) Write the full name of the parent who would pay child support under the state guidelines. in the amount of $________ per month. Write the monthly child support amount the guidelines say should be paid. Child support should be set at the above amount that complies with the guidelines established by the Administrator of the Division of Welfare and Supportive Services. Check this box if child support should be the same amount the guidelines say. Court finds that child support should be set at $__________ based on the following adjustments from the guidelines: Check this box if child support should be a different amount because of special reasons. Court finds that child support should be set at $ Write the changed child support amount the court should set instead of the guideline amount. based on the following adjustments from the guidelines: Explain the reasons the child support amount is different from the guidelines. $0 per month Check this box if no child support will be paid each month. $ _________ per month paid by Check this box if a set dollar amount of child support will be paid each month. $ _________ per month paid by (parent who will pay) Write the monthly dollar amount of child support that will be paid. per month paid by (parent who will pay) Write the full name of the parent who will pay the child support. The worksheet calculation and/or the guidelines established by the Administrator of the Division of Welfare and Supportive Services. Check this box if the support amount comes from the standard state worksheet or guidelines. The amount already established by the District Attorney, Family Support Division, case (insert case number) R Check this box if the support amount was already set in a District Attorney case. Division, case (insert case number) R__________________. Write the case number from the District Attorney, Family Support Division case. The amount determined by the court. Check this box if the judge decided the support amount. There are no child support arrearages or the entitled custodial parent waived his/her right to child support arrearages. Check this if there is no past-due child support owed, or if the parent who could collect it has given up that right. The parties are currently receiving or have received welfare benefits in the past. The parties cannot waive child support arrears. Check this if either parent gets or got public assistance. In that case, back support cannot be given up. Child support arrears are being handled by the District Attorney, Family Support Division, case (insert case number) R____ and shall continue as ordered in that case. Check this if a government office is already managing the past-due child support in a separate case. case (insert case number) R Enter the case number from the District Attorney's office that handles the back support. Back child support shall be paid by (name of parent who will pay back child support) ____ in the total amount of $____, which amount is reduced to judgment. Check this if one parent must pay a set amount of past-due child support. Back child support shall be paid by (name of parent who will pay back child support) Write the full name of the parent who has to pay the past-due child support. in the total amount of $ Enter the total dollar amount of past-due child support owed. There are no child care costs for either parent. Check this if neither parent pays for child care, like daycare or a babysitter. The monthly child care costs for the child(ren) are: $____. The monthly amount should be paid by Check this if there are monthly child care costs that need to be split between the parents. The monthly child care costs for the child(ren) are: $ Enter the total monthly cost for child care, such as daycare. Plaintiff Check this if the person who started the case pays the child care costs. Defendant Check this if the other spouse pays the child care costs. both parents equally Check this if both parents split the child care costs evenly.

d. Health & Medical Support

Medicaid. Check this if the children's health coverage comes through Medicaid. Private / Employer insurance. The monthly premium should be paid by Check this if the children are covered by health insurance from a job or a private plan. Plaintiff Check this if the person who started the case pays the insurance premium. Defendant Check this if the other spouse pays the insurance premium. both parents equally Check this if both parents split the insurance premium evenly. Other: Check this if the children's health coverage comes from another source not listed above. Other: Describe the other type of health coverage for the children. Any medical expenses not covered by insurance shall be paid equally by both parties. Check this if both parents split medical bills that insurance does not pay evenly. Any medical expenses not covered by insurance shall be paid by (name of parent) Check this if only one parent pays medical bills that insurance does not cover. Any medical expenses not covered by insurance shall be paid by (name of parent) Write the full name of the parent who pays the medical bills insurance does not cover. The 30/30 Rule shall apply to all unreimbursed medical and dental expenses. Check this box if both parents must follow the 30/30 Rule for splitting medical and dental costs not covered by insurance. See the footnote for how it works. The 30/30 Rule shall NOT apply to unreimbursed medical and dental expenses. Check this box if you do not want the 30/30 Rule to apply to medical and dental costs. Only check one of these two boxes. The Plaintiff shall claim the following children as dependents for tax purposes every year: Check this box if the Plaintiff will claim the children on taxes every year. This decides who gets the tax benefit. year: (insert child(ren)'s names): Write the full names of the children the Plaintiff will claim on taxes. The Defendant shall claim the following children as dependents for tax purposes every year: Check this box if the Defendant will claim the children on taxes every year. This decides who gets the tax benefit. every year: (insert child(ren)'s names): Write the full names of the children the Defendant will claim on taxes. The tax deduction shall alternate, with Plaintiff claiming the child(ren) in Check this box if the parents will take turns claiming the children on taxes from year to year. even Check this if the Plaintiff claims the children in even-numbered years (like 2024, 2026). odd years, and Defendant claiming the child(ren) the other years. Check this if the Plaintiff claims the children in odd-numbered years (like 2025, 2027). The tax deduction shall be allocated per federal law. Check this box if you want the IRS rules to decide who claims the children, instead of setting it here.

e. Possession & Access

No Visitation Requested Because: (explain) Check this box only if you are not asking for any visitation time with the child. No Visitation Requested Because: (explain) Explain why you are not asking for visitation, such as safety concerns or distance. Regular Schedule: Write out the everyday parenting plan. List the exact days and times each parent has the child, like 'Mom: Saturday 7pm to Wednesday 3pm.' Same as the regular schedule. Check this if the summer plan stays exactly the same as the everyday schedule. Other: Check this if summer follows a different plan than the regular schedule. Other: Describe the special summer plan, including dates and times for each parent. Mother every year from 9am – 7pm. Check this if the mother has the child every Mother's Day and her birthday from 9am to 7pm. Other: Check this if you want a different plan for Mother's Day and the mother's birthday. Other: Describe your own plan for Mother's Day and the mother's birthday, with times. Father every year from 9am – 7pm. Check this if the father has the child every Father's Day and his birthday from 9am to 7pm. Other: Check this if you want a different plan for Father's Day and the father's birthday. Other: Describe your own plan for Father's Day and the father's birthday, with times. Even years with (parent) ___; Odd years with (parent) ___ Check this to split the child's birthday by year, with one parent in even years and the other in odd years. Even years with (parent) Name the parent who has the child on their birthday during even-numbered years (like 2024, 2026). Odd years with (parent) Name the parent who has the child on their birthday during odd-numbered years (like 2025, 2027). Other: Check this if you want a different plan for the child's birthday. Other: Describe your own plan for the child's birthday, including times. Even Years: MLK Jr. Day, Memorial Day, Labor Day with (parent) ___; Odd Years ... Check this to split the three-day holiday weekends by year between the parents. Even Years: MLK Jr. Day, Memorial Day, Labor Day with (parent) Name the parent who gets MLK Jr. Day, Memorial Day, and Labor Day in even-numbered years. Odd Years: MLK Jr. Day, Memorial Day, Labor Day with (parent) Name the parent who gets MLK Jr. Day, Memorial Day, and Labor Day in odd-numbered years. Other: Check this if you want a different plan for three-day holiday weekends. Other: Describe your own plan for splitting three-day holiday weekends, with dates and times. Even years with (parent) _____________________________. Write the name of the parent who gets the children for spring break during even-numbered years (like 2024, 2026). Other: _________________________________________ If you have a different spring break plan, describe it here instead of using the even/odd year setup. Even years with (parent) Check this box if you want to split spring break by even and odd years. Other: Check this box if you have a different spring break plan to describe. Odd years with (parent) _____________________________. Write the name of the parent who gets the children for Thanksgiving during odd-numbered years (like 2025, 2027). Other: _________________________________________ If you have a different Thanksgiving plan, describe it here instead of using the even/odd year setup. Odd years with (parent) Check this box if you want to split Thanksgiving by even and odd years. Other: Check this box if you have a different Thanksgiving plan to describe. Even years: segment 1 with (parent) ____________________, Write the name of the parent who gets the children for the first part of winter break (Christmas) during even-numbered years. Odd years: segment 1 with (parent) ____________________, Write the name of the parent who gets the children for the first part of winter break (Christmas) during odd-numbered years. Segment 1 (Christmas) consists of the day school lets out until December 26 at noon. Check this box to split winter break into two parts, with each parent getting one part. Other: Check this box if you have a different winter break plan to describe. Other: Describe your own winter break plan here if you don't want to use the two-part split. Other Holidays: List any other holidays you want to include, such as birthdays, Mother's Day, or Father's Day, and say which parent has the children. The parents will not establish a formal vacation plan, and will instead mutually agree on vacation days and times with the child(ren). Check this box if you and the other parent will simply agree on vacation days as they come up, without a set plan. Each parent may have up to (number) ______ vacation days per year with the child(ren). Check this box if you want to set a fixed number of vacation days each parent can take with the children each year. Each parent may have up to (number) ______ vacation days per year with the child(ren). Enter the number of vacation days each parent may take with the children each year. at least (number) _____ days before the planned vacation. Enter how many days ahead a parent must tell the other parent before taking a vacation.