Fillable Child( ren) Name Age (Maryland Courts)

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Child( ren) Name Age (Maryland Courts)

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Child(
ren)
Name Age
JOINT STATEMENT OF THE PARTIES CONCERNING
DECISION-MAKING AUTHORITY AND PARENTING TIME
(Md. Rule 9-204.2)
NOTE: Complete this form if you are NOT able to reach a comp
rehensive parenting plan agreement.
"Party": A person who seeks to establish or maintain a parent-child relationship with a child.
MDEC counties only: You must file a Notice Regarding Restricted Information Pursuant to
Rule 20-201.1 (form MDJ-008) with this submission.
(check one)
☐ This is a jointly-prepared statement by
Party’s Name Relationship to Child(ren)
☐ This is the statement of (a joint statement is not
filed due to an allegation of domestic violence, child abuse, substance abuse, or other reason).
1. AGREE
We agree the following provisions are in the best interest of the child(ren) (consider factors in
Md. Rule 9-204.1 and listed in the Instructions). Attach additional sheets if needed. For example,
attach a Maryland Parenting Plan Tool (CC-DR-109) or other document that lists points of agreement.
A. Parental responsibility and decision-making authority
☐ will make all major decisions for the child(ren).
☐ We will jointly make all major decisions.
☐ We will divide the major decision-making in the following way:
CC-DR-110 (Rev. 11/2020) Page 1 of 3 JSPCD
vs.
Defendant
Address
City, State, Zip
Telephone
Plaintiff
Address
City, State, Zip
Telephone
Party name
Name
CIRCUIT COURT FOR
City/County
Located at
Case No.
, MARYLAND
This form contains Restricted Information.
Parenting time/holidays
Parenting time shall be scheduled as follows:
B. Transportation and exchanges
Transportation and exchanges shall take place in the following way:
C. Communication between parents and child(ren)
We will communicate with the child(ren) as follows:
D. Child care
We will handle child care as follows:
E. Other issues
We also agree to the following:
2. DISAGREE
We do not agree on how to address the following issues (attach additional sheets if needed):
A. Parenta
l responsibility and decision-making authority
Name Proposal
B. Parenting time/holidays
Name Proposal
C. Tra
nsportation and exchanges
Name Proposal
CC-DR-110 (Re
v. 11/2020) Page 2 of 3
JSPCD
Case No.
D. Communication between parents and child(ren)
Name Proposal
E. C
hild care
Name Proposal
F. O
ther issues: (describe)
Name Proposal
CC-DR-110 (Rev. 11/2020) Page 3 of 3 JSPCD
Date
Printed Name
Date
Signature
Date
Printed Name
Case No.
Signature
Printed Name
Signature
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Child( ren) Name Age (Maryland Courts)

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Completed 1 May 2022

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