d.
a.
(name):
will be as follows:
The parties will go to child custody mediation or child custody recommending counseling at (specify date, time, and
No Visitation (Parenting Time)
Visitation (Parenting Time) for the
petitioner
respondent other
location):
-page document See the attached
b.
c.
e.
Reasonable right of visitation to the party without physical custody (not appropriate in cases involving domestic
violence)
(1)
at
(day of week) (time)
from
1st 2nd 3rd 4th 5th weekend of the month
p.m./ if applicable, specify:a.m.
at
(day of week) (time)
to
a.m.
p.m./ if applicable, specify:
after school
start of school
after school
start of school
(Note: The first weekend of the month is the first weekend with a Saturday.)
(date):
Weekends starting
(b)
(a)
having the initial fifth weekend, which starts (date):
The parties will alternate the fifth weekends, with the
other parent/party
respondent
petitioner
even numbered months.odd
The other parent/party respondentpetitioner will have the
CHILD CUSTODY AND VISITATION (PARENTING TIME)
ORDER ATTACHMENT
Family Code, §§ 3020, 3022, 3025,
3040–3043, 3048, 3100, 6340, 7604
www.courts.ca.gov
Form Approved for Optional Use
Judicial Council of California
FL-341 [Rev. July 1, 2016]
5.
7.
Page 1 of 3
Penalties for violating this order. If you violate this order, you may be subject to civil or criminal penalties, or both.
4.
6.
THIS IS A COURT ORDER.
CHILD CUSTODY AND VISITATION (PARENTING TIME) ORDER ATTACHMENT
TO
Stipulation and Order fo Custody and/or Visitation of Children (form FL-355)
Findings and Order After Hearing (form FL-340) Judgment (form FL-180) Judgment (form FL-250)
Other (specify):
1.
2.
Jurisdiction. This court has jurisdiction to make child custody orders in this case under the Uniform Child Custody Jurisdiction and
Enforcement Act (Fam. Code, §§ 3400–3465).
Notice and opportunity to be heard. The responding party was given notice and an opportunity to be heard, as provided by the
laws of the State of California.
3. Country of habitual residence. The country of habitual residence of the child or children in this case is
(specify):
Other
the United States
Child Custody. Custody of the minor children of the parties is awarded as follows:
Child abduction prevention. There is a risk that one of the parties will take the children out of California without the other
party's permission. (Child Abduction Prevention Orders Attachment (form FL-341(B)) must be attached and must be obeyed.)
Visitation (Parenting Time)
Child's Name
Legal custody to: (person who makes
decisions about health, education, etc.)
Birth Date
Physical custody to:
(person with whom child lives)
FL-341
CASE NUMBER:
PETITIONER:
RESPONDENT:
OTHER PARENT/PARTY:
fifth weekend in
March 1, 2019
02/02/2009
JOINT
RESPONDENT
JENNIFER SMITH
01/01/2008
JOINT
RESPONDENT
BOBBY SMITH
D19-00000
JOHN SMITH
10.
a.
c.
b.
(specify):
the state of California.
the following counties
other places
(specify):
9.
b.
c.
d.
a.
(address):
(specify):
Transportation to begin the visits will be provided by the
Transportation from the visits will be provided by the
The exchange point at the beginning of the visit will be at
The exchange point at the end of the visit will be at
During the exchanges, the party driving the children will wait in the car and the other party will wait in his or her
home (or exchange location) while the children go between the car and the home (or exchange location).
Other (specify):
other
respondent petitioner
(address):
(specify):
other
respondent petitioner
The children must be driven only by a licensed and insured driver. The car or truck must have legal child restraint
devices.
f.
g.
e.
8.
(specify):
FL-341 [Rev. July 1, 2016]
(You must attach Supervised Visitation Order (form FL-341(A).)
must have written permission from the other parent or a court order to take the children out of
The
(name):
will have supervised visitation (parenting time) with the minor children according to the schedule set forth on page 1.
(2)
Alternate weekends starting
(date):
at
(day of week) (time)
from
a.m.
p.m./ if applicable, specify:
at
(day of week)
to a.m.
p.m./ if applicable, specify:
after school
start of school
after school
start of school
after school
start of school
after school
start of school
(time)
(3)
(date):
Weekdays starting
at
(day of week) (time)
from
at
(day of week) (time)
to
(4)
Other visitation (parenting time) days and restrictions are:
listed in Attachment 7e(4) (form
as follows:
MC-025 may be used for this purpose)
p.m./ if applicable, specify:
a.m.
a.m.
p.m./ if applicable, specify:
e.
Visitation (Parenting Time) (continued)
Supervised visitation (parenting time). Until
Transportation for visitation (parenting time)
further order of the court other
other
respondent petitioner
Travel with children. The
petitioner respondent other parent/party
(name):
CHILD CUSTODY AND VISITATION (PARENTING TIME)
ORDER ATTACHMENT
Page 2 of 3
THIS IS A COURT ORDER.
FL-341
CASE NUMBER:
PETITIONER:
RESPONDENT:
OTHER PARENT/PARTY:
7.
6:00
FRIDAY
8:00
MONDAY
6:00
WEDNESDAY
8:00
THURSDAY
D19-00000
JOHN SMITH
MARY SMITH
12.
13.
15.
attached schedule. (Additional Provisions—Physical Custody Attachment (form FL-341(D)
) may be used for this purpose.)
(Joint Legal Custody Attachment (form FL-341(E)
) may be used for this purpose.)
11. The children will spend holiday time as listed
Holiday Schedule Attachment (form FL-341(C)
) may be used for this purpose.)
Other (specify):
FL-341 [Rev. July 1, 2016]
CHILD CUSTODY AND VISITATION (PARENTING TIME)
ORDER ATTACHMENT
Page 3 of 3
THIS IS A COURT ORDER.
Holiday schedule.
below
in the attached schedule (Children's
The parties will follow the additional custody provisions listed
Additional custody provisions.
below in the
The parties will share joint legal custody as listed Joint legal custody.
in the attached schedule. below
14. Access to children's records. Both the custodial and noncustodial parent have the right to access records and information
about their minor children (including medical, dental, and school records) and consult with professionals who are providing services
to the children.
FL-341
CASE NUMBER:
PETITIONER:
RESPONDENT:
OTHER PARENT/PARTY:
D19-00000
JOHN SMITH
MARY SMITH
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