Fill - Free fillable Form 1: COURT CODE: SAO 2 Self-Represented 3 (Family Law Self Help Center) PDF form

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COURT CODE: SAO

Name: _________________________

Address: _______________________

City, State, Zip: __________________

Phone: _________________________

Email: _________________________

Self-Represented

DISTRICT COURT

CLARK COUNTY, NEVADA

________________________________

Plaintiff,

vs.

________________________________

Defendant.

CASE NO.: ____________________

DEPT: ____________________

STIPULATION AND ORDER

The parties in this matter, (Plaintiff’s name) ____________________________________

and (Defendant’s name) ______________________________________, both in Proper Person,

hereby stipulate and agree to the following which applies to the following children:

Child’s Full Name

Date of Birth

______________________________________________________________________________

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______________________________________________________________________________

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(CHECK ONLY ONE BOX)

 No hearing is currently scheduled.

OR

 The hearing currently scheduled for (date) _____________________ at

(time) _____________ ( check one)  a.m.  p.m. should be taken off

calendar.

DATED: ______________________________________, 20_____.

Respectfully Submitted:

By:

(Plaintiff’s signature)

Plaintiff’s Name:

Address:

City, State, Zip:

Phone:

Email:

By:

(Defendant’s signature)

Defendant’s Name:

Address:

City, State, Zip:

Phone:

Email:

ACKNOWLEDGMENT (Plaintiff)

STATE OF NEVADA )

)

COUNTY OF CLARK )

On this (day) _______ day of (month) ___________________, 20_____, before me, the

undersigned Notary Public in and for the said County and State, personally appeared (Plaintiff’s

name) _____________________________________, known to me to be the person described in

and who executed the foregoing Stipulation and Order, and who acknowledged to me that he /

she did so freely and voluntarily and for the uses and purposes therein mentioned.

WITNESS my hand and official seal.

_______________________________________

Signature of notarial officer

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ACKNOWLEDGMENT (Defendant)

STATE OF NEVADA )

)

COUNTY OF CLARK )

On this (day) _______ day of (month) ___________________, 20_____, before me, the

undersigned Notary Public in and for the said County and State, personally appeared

(Defendant’s name) _____________________________________, known to me to be the

person described in and who executed the foregoing Stipulation and Order, and who

acknowledged to me that he / she did so freely and voluntarily and for the uses and purposes

therein mentioned.

WITNESS my hand and official seal.

_______________________________________

Signature of notarial officer

ORDER

UPON A READING of the foregoing Stipulation of the parties and good cause appearing,

IT IS HEREBY ORDERED that the parties’ stipulation is adopted and made an Order of

this Court.

IT IS FURTHER ORDERED that hearing presently scheduled for (date) ______________

at (time) ____________ ( check one)  a.m.  p.m. shall be taken off calendar.

IT IS FURTHER ORDERED that each party shall submit the information required in

NRS 125B.055, NRS 125.130 and NRS 125.230 on a separate form to the Court and the

Welfare Division of the Department of Human Resources within ten days from the date this

Decree is filed. Such information shall be maintained by the Clerk in a confidential manner and

not part of the public record. The parties shall update the information filed with the Court and

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the Welfare Division of the Department of Human Resources within ten days should any of that

information become inaccurate.

NOTICE IS HEREBY GIVEN of the following provision of NRS 125C.0045(6):

PENALTY FOR VIOLATION OF ORDER: THE ABDUCTION, CONCEALMENT OR

DETENTION OF A CHILD IN VIOLATION OF THIS ORDER IS PUNISHABLE AS A

CATEGORY D FELONY AS PROVIDED IN NRS 193.130. NRS 200.359 provides that

every person having a limited right of custody to a child or any parent having no right of

custody to the child who willfully detains, conceals or removes the child from a parent,

guardian or other person having lawful custody or a right of visitation of the child in

violation of an order of this court, or removes the child from the jurisdiction of the court

without the consent of either the court or all persons who have the right to custody or

visitation is subject to being punished for a category D felony as provided in NRS 193.130.

NOTICE IS HEREBY GIVEN that the terms of the Hague Convention of October 25,

1980, adopted by the 14th Session of the Hague Conference on Private International Law, apply

if a parent abducts or wrongfully retains a child in a foreign country. The parties are also put on

notice of the following provision of NRS 125C.0045(8):

If a parent of the child lives in a foreign country or has significant commitments in a foreign

country:

(a) The parties may agree, and the court shall include in the order for custody of the

child, that the United States is the country of habitual residence of the child for the purposes

of applying the terms of the Hague Convention as set forth in subsection 7.

(b) Upon motion of one of the parties, the court may order the parent to post a bond if

the court determines that the parent poses an imminent risk of wrongfully removing or

concealing the child outside the country of habitual residence. The bond must be in an

amount determined by the court and may be used only to pay for the cost of locating the

child and returning him to his habitual residence if the child is wrongfully removed from or

concealed outside the country of habitual residence. The fact that a parent has significant

commitments in a foreign country does not create a presumption that the parent poses an

imminent risk of wrongfully removing or concealing the child.

NOTICE IS HEREBY GIVEN that the parties are subject to the relocation requirements

of NRS 125C.006 & NRS 125C.0065. If joint or primary physical custody has been established

pursuant to an order, judgment or decree of a court and one parent intends to relocate his or her

residence to a place outside of this State or to a place within this State that is at such a distance

that would substantially impair the ability of the other parent to maintain a meaningful

relationship with the child, and the relocating parent desires to take the child with him or her,

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the relocating parent shall, before relocating: (a) attempt to obtain the written consent of the

non-relocating parent to relocate with the child; and (b) if the non-relocating parent refuses to

give that consent, petition the court for permission to move and/or for primary physical custody

for the purpose of relocating. A parent who desires to relocate with a child has the burden of

proving that relocating with the child is in the best interest of the child. The court may award

reasonable attorney's fees and costs to the relocating parent if the court finds that the non-

relocating parent refused to consent to the relocating parent's relocation with the child without

having reasonable grounds for such refusal, or for the purpose of harassing the relocating

parent. A parent who relocates with a child pursuant to this section without the written consent

of the other parent or the permission of the court is subject to the provisions of NRS 200.359.

NOTICE IS HEREBY GIVEN that the parties are subject to the provisions of NRS

31A and 125.007 regarding the collection of delinquent child support payments.

NOTICE IS HEREBY GIVEN that either party may request a review of child support

every three years pursuant to NRS 125B.145.

DATED: ______________________________________, 20_____.

____________________________________

DISTRICT COURT JUDGE

Respectfully submitted by:

(Your signature)

(Your name)

/s/

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