Fillable Form 1: DECS Self-Represented (Family Law Self Help Center)

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Form 1: DECS Self-Represented (Family Law Self Help Center)

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© 2020 Family Law Self-Help Center Decree of Separate Maintenance (With Children)
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DECS
Your Name: _________________________
Address: ____________________________
City, State, Zip: ______________________
Phone: _____________________________
Email: ______________________________
Self-Represented
DISTRICT COURT
CLARK COUNTY, NEVADA
_
_____________________________
Plaintiff,
vs.
_
_____________________________
Defendant.
CASE NO.: ____________________
DEPT: _____________________
DATE OF HEARING: ___________
TIME OF HEARING: ____________
DECREE OF SEPARATE MAINTENANCE
(WITH CHILDREN)
This Decree was submitted (☒ check one) after a hearing without a hearing before
the above-entitled court, and after a review of the pleadings and papers on file and the testimony
given, if any, this Court finds as follows:
1. That Plaintiff or Defendant is now and has been an actual bona fide resident of the State
of Nevada and has been actually domiciled in the State of Nevada for more than six
weeks immediately prior to the commencement of this action.
2. That Plaintiff and Defendant were married on (date) ___________________ in the city
of ________________________, State of _________________________ and have since
remained married.
© 2020 Family Law Self-Help Center Decree of Separate Maintenance (With Children)
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3. Pregnancy. (☒ check one)
Neither spouse is pregnant.
The following spouse is pregnant: (name of pregnant spouse) _________________.
The other spouse (☒ check one) is / is not the parent of the unborn child. The
child is due to be born on (date): _________________.
4. That Plaintiff and Defendant have (number) ______ minor children in common who are
either biological or adopted. The names and dates of birth are:
Child’s Name: Date of Birth
5. Child Residency. (☒ check one)
The children are residents of Nevada and have lived here for at least the past 6
months. Nevada is the habitual residence of the child, and this Court has the
necessary UCCJEA jurisdiction to enter orders regarding custody and visitation.
The children are not residents of Nevada or have not lived here for at least the
past 6 months. The children live in (state) _____________________ which is
the habitual residence of the child, and this Court does not have the necessary
UCCJEA jurisdiction to enter orders regarding custody and visitation.
6. That any custody and visitation orders made herein are in the best interest of the
children.
7. That the amount of child support ordered herein is in compliance with the guidelines
established by the Administrator of the Division of Welfare and Supportive Services or
© 2020 Family Law Self-Help Center Decree of Separate Maintenance (With Children)
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has been stipulated to by the parties with the required certifications and disclosures
required by the guidelines.
8. That this Court has complete jurisdiction to enter this Decree and the orders regarding
the distribution of assets, debts, and alimony.
9. That the Plaintiff or Defendant should be granted a Decree of Separate Maintenance for
the reasons set forth in the Complaint or Counterclaim.
10. That any other necessary findings of fact are attached and incorporated herein.
NOW THEREFORE, IT IS HEREBY ORDERED that the parties are granted a Decree
of Separate Maintenance, but the bonds of matrimony shall be maintained.
IT IS FURTHER ORDERED that (☒ check one)
The parties are granted joint legal custody of the minor child(ren).
The Plaintiff is granted sole legal custody of the minor child(ren).
The Defendant is granted sole legal custody of the minor child(ren).
Nevada is not the home state of the child(ren) and does not have jurisdiction.
IT IS FURTHER ORDERED that (☒ check one)
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.
Primary physical custody of the minor child(ren) shall be awarded to (☒ check one)
Plaintiff / Defendant. The parties shall exercise a regular and/or holiday
timeshare as outlined in Exhibit 1 which is incorporated herein.
Sole physical custody of the minor child(ren) shall be awarded to (☒ check one)
Plaintiff / Defendant.
Nevada is not the home state of the child(ren) and does not have jurisdiction.
© 2020 Family Law Self-Help Center Decree of Separate Maintenance (With Children)
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COURT FINDS that Plaintiff’s gross monthly income is $_____________ and Defendant’s
gross monthly income is $_____________. Under the guidelines, child support would be
paid by (parent name) __________________________________________ in the amount
of $________ per month. (
☒
check one)
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.
Court finds that child support should be set at $__________ based on the
following adjustments from the guidelines:
ACCORDINGLY, IT IS HEREBY ORDERED that child support is set at (
☒
check one)
$0 per month / $ _________ per month paid by (parent who will pay)
__________________________________________ based on: (☒ check one)
The worksheet calculation and/or the guidelines established by the Administrator
of the Division of Welfare and Supportive Services.
The amount already established by the District Attorney, Family Support
Division, case (insert case number) R__________________.
The amount determined by the court.
IT IS FURTHER ORDERED that (☒ check one)
A wage withholding is entered against the obligor parent to secure payment of child
support.
A wage withholding is not entered against the obligor parent, as good cause exists to
postpone the withholding of income for child support.
© 2020 Family Law Self-Help Center Decree of Separate Maintenance (With Children)
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IT IS FURTHER ORDERED that (☒ check one)
There are no child support arrearages or the entitled custodial parent waived his/her
right to child support arrearages.
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.
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.
IT IS FURTHER ORDERED that (☒ check one)
There are no child care costs for either parent.
The monthly child care costs for the child(ren) are: $_________. The monthly
amount should be paid by Plaintiff Defendant both parents equally.
IT IS FURTHER ORDERED that medical support for the child(ren) shall be provided
through(☒ check one)
Medicaid.
Private / Employer insurance. The monthly premium should be paid by Plaintiff
Defendant both parents equally.
Other: ______________________________________________________________
IT IS FURTHER ORDERED that (☒ check one)
Any medical expenses not covered by insurance shall be paid equally by both
parties.
Any medical expenses not covered by insurance shall be paid by (name of parent)
______________________________________ due to the following extraordinary
circumstances (explain):
© 2020 Family Law Self-Help Center Decree of Separate Maintenance (With Children)
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IT IS FURTHER ORDERED that (☒ check one)
The 30/30 Rule shall apply to all unreimbursed medical and dental expenses.
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The 30/30 Rule shall NOT apply to unreimbursed medical and dental expenses.
IT IS FURTHER ORDERED that (☒ check one)
The Plaintiff shall claim the following children as dependents for tax purposes every
year: (insert child(ren)’s names): _________________________________________
The Defendant shall claim the following children as dependents for tax purposes
every year: (insert child(ren)’s names): _____________________________________
The tax deduction shall alternate, with Plaintiff claiming the child(ren) in (☒ check
one) even / odd years, and Defendant claiming the child(ren) the other years.
The tax deduction shall be allocated per federal law.
*IRS rules state that the custodial parent usually has the right to claim the child on their
taxes regardless of what the Decree says. The custodial parent can waive this right by
filling out IRS Form 8332. Talk to a tax professional if you are not sure what to do.
THE COURT FINDS AND THEREFORE ORDERS that (☒ check one)
There is no community property to divide or the property has already been divided.
There is community property which shall be equally divided as follows:
Property To Plaintiff:
1. ______________________________________________________
2. ______________________________________________________
3. ______________________________________________________
4. ______________________________________________________
Property To Defendant:
1. ______________________________________________________
2. ______________________________________________________
3. ______________________________________________________
4. ______________________________________________________
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The “30/30 Rule:” If a parent pays a medical or dental expense for a child that is not paid by insurance, that parent
must send proof of the expense to the other parent within 30 days of incurring the expense. The other parent then
has 30 days to reimburse the paying parent ½ the cost.
© 2020 Family Law Self-Help Center Decree of Separate Maintenance (With Children)
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THE COURT FINDS AND THEREFORE ORDERS that (☒ check one)
There is no community debt to divide or the debt has already been divided.
There are community debts which shall be equally divided as follows:
Debts To Plaintiff:
1. ______________________________________________________
2. ______________________________________________________
3. ______________________________________________________
4. ______________________________________________________
Debts To Defendant:
1. ______________________________________________________
2. ______________________________________________________
3. ______________________________________________________
4. ______________________________________________________
THE COURT FINDS AND THEREFORE ORDERS that (☒ check one)
There is no spousal support awarded.
The Plaintiff shall pay $__________ per month in spousal support for (number)
__________ years. This amount is just and equitable.
The Defendant shall pay $__________ per month in spousal support for (number)
__________ years. This amount is just and equitable.
IT IS FURTHER ORDERED that (☒ check all that apply)
Neither party changed their name or neither party wishes to have a former or maiden
name restored.
The name of (spouse’s name) ___________________________________ should be
restored to his / her former or maiden name of (write full name the party wants to go
back to) .
The name of (spouse’s name) ___________________________________ should be
restored to his / her former or maiden name of (write full name the party wants to go
back to) .
© 2020 Family Law Self-Help Center Decree of Separate Maintenance (With Children)
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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
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,
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
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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.
NOTICE IS HEREBY GIVEN that if you want to adjust the amount of child support
established in this order, you must file a motion to modify the order with or submit a stipulation
to the court. If a motion to modify the order is not filed or a stipulation is not submitted, the
child support obligation established in this order will continue until such time as all children
who are the subject of this order reach 18 years of age or, if the youngest child who is subject to
this order is still in high school when he or she reaches 18 years of age, when the child
graduates from high school or reaches 19 years of age, whichever comes first. Unless the
parties agree otherwise in a stipulation, any modification made pursuant to a motion to modify
the order will be effective as of the date the motion was filed.
DATED this (day) _____ day of (month) ______________________, 20_____.
____________________________________
DISTRICT COURT JUDGE
Respectfully Submitted By:
________________________________ ________________________________
(Plaintiff’s signature) (Defendant’s signature)
________________________________ _________________________________
(Plaintiff’s printed name) (Defendant’s printed name)
/s/
/s/
EXHIBIT 1: Parenting Timeshare and Holiday Schedule
No Visitation Requested Because: (explain) ______________________________
Regular Schedule:
Be very specific. Include
the times and days of the
week for each parent’s
timeshare.
(ex.: Mom: Saturday 7pm –
Wednesday 3pm,
Dad: Wednesday 3pm –
Saturday 7pm)
Summer Schedule:
Same as the regular schedule.
Other: ____________________________________________
Mother’s Day and Mother’s
Birthday:
Mother every year from 9am – 7pm.
Other: ____________________________________________
Father’s Day and Father’s
Birthday:
Father every year from 9am – 7pm.
Other: ____________________________________________
Child’s Birthday:
Even years with (parent) ___________________________.
Odd years with (parent) ____________________________.
*Time shall be from 9am – 7pm.*
Other: ___________________________________________
3 Day Weekends: Even Years: MLK Jr. Day, Memorial Day, Labor Day with
(parent) _________________________________,
President’s Day, Independence Day, Nevada Admissions
Day with the other parent.
Odd Years: MLK Jr. Day, Memorial Day, Labor Day with
(parent) _________________________________,
President’s Day, Independence Day, Nevada Admissions
Day with the other parent.
*Time begins when school lets out the day before the holiday
weekend (or 3pm if no school), and ends the day following
the holiday weekend when school resumes (or 9am).*
**If Independence Day falls on a Tuesday, Wednesday, or
Thursday, the time shall be from July 3 at 9am until July 5
at 9am.**
Other: ____________________________________________
Easter / Spring Break:
Even years with (parent) _____________________________.
Odd years with the other parent.
*Time shall begin the day school lets out until noon the day
before school resumes.*
Other: ____________________________________________
Thanksgiving:
Odd years with (parent) _____________________________.
Even years with the other parent.
*Time shall begin the day school lets out until noon the day
before school resumes.*
Other: ____________________________________________
Winter Break / Christmas:
Segment 1 (Christmas) consists of the day school lets out until
December 26 at noon.
Segment 2 (New Year’s) consists of December 26 at noon
until noon the day before school resumes.
Even years: segment 1 with (parent) ____________________,
segment 2 with the other parent.
Odd years: segment 1 with (parent) ____________________,
segment 2 with the other parent.
Other: ____________________________________________
_________________________________________________
Other Holidays:
__________________________________________________
__________________________________________________
__________________________________________________
__________________________________________________
Vacation: The parents will not establish a formal vacation plan, and will
instead mutually agree on vacation days and times with the
child(ren).
Each parent may have up to (number) ______ vacation days
per year with the child(ren). The parent shall notify the other
parent of the vacation and provide a general vacation itinerary
at least (number) _____ days before the planned vacation.
Vacation time is not allowed during a holiday allotted to
the other parent.
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Form 1: DECS Self-Represented (Family Law Self Help Center)

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Completed 9 February 2021

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