Fillable IN THE SUPERIOR COURT OF BIBB COUNTY STATE

Fill Online, Printable, Fillable, Blank IN THE SUPERIOR COURT OF BIBB COUNTY STATE Form

Use Fill to complete blank online OTHERS pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

IN THE SUPERIOR COURT OF BIBB COUNTY STATE

On average this form takes 18 minutes to complete

The IN THE SUPERIOR COURT OF BIBB COUNTY STATE form is 66 pages long and contains:

0 signatures
42 check-boxes
54 other fields

Country of origin: OTHERS
File type: PDF

BROWSE OTHERS FORMS

Related forms

Kindergarten Diploma - Kindergarten Grad Fillable
Residential Electric Construction Application
TOWN ROAD AND BRIDGE STANDARDS
, Plaintiff , Defendant PROTECTION FROM STALKING, SEXUAL
IN THE DISTRICT COURT OF COUNTY, KANSAS Plaintiff
APPLICATION FOR A U.S. PASSPORT PLEASE DETACH AND
Form 54: (676) (456) (679) Form 1. 2.
Two Stall with Hay Storage and Tack Floor
Three Stall with Hay Storage and Tack Floor
Two Stall with Hay Storage and Tack Floor
Three Stall with Hay Storage, Tack, and Wash
Four Stall Floor Plan #34 Single Breezeway 3/12
20 Stall with 10 Overhang Floor Plan Back-to-Back
Four Stall with Tack and Hay Storage Floor
Three Stall with Tack, Hay Storage, and Wash
Two Stall with Tack Floor Plan #15 Shedrow
Three Stall with Feed and Tack
Three Stall with Feed and Tack
Two Stall with Tack and Hay Storage Floor
PATIENT HISTORY QUESTIONNAIRE

Fill has a huge library of thousands of forms all set up to be filled in easily and signed.

Fill in your chosen form

Sign the form using our drawing tool

Send to someone else to fill in and sign.

find another form

Redo

Arial Font

Arial
Calibri
Roboto
Open Sans

AFont color

AB
A.B
A..B
A...B
A....B

Remove Field

ADD FIELDS

[1] wcwa

IN THE SUPERIOR COURT OF BIBB COUNTY

STATE OF GEORGIA

______________________________ )

)

Plaintiff, )

)

v. ) Civil Action File No.:_________________

)

______________________________ )

)

Defendant )

)

______________________________________________________________________________

COMPLAINT FOR DIVORCE

Plaintiff, ______________________________________________, comes before this Court and

shows this Court the following:

Plaintiff is a resident of __________________ County, Georgia, and has been a resident of

Georgia for at least six months prior to the filing of this action.

Defendant is a resident of ___________________ County, Georgia, and has acknowledged service

of the Complaint and Summons and has waived further service of process.

Plaintiff and Defendant were lawfully married on ______________________________________.

Plaintiff and Defendant separated on _____________________________ and have remained in a

bona fide state of separation since that date.

[2] wcwa

There are _________ minor children born of the marriage.

Plaintiff is entitled to a divorce upon the statutory grounds that the marriage is irretrievable

broken and there is no hope of reconciliation. O.C.G.A. § 19-5-3(13).

The parties have both signed a settlement agreement that resolves all issues as to an equitable

division of property and debts.

WHEREFORE, Plaintiff respectfully requests:

a) That the parties herein be totally divorced;

b) That the Court adopt and incorporate the parties; settlement agreement into a final

judgment and decree in this manner;

c) The Plaintiff’s name be restored to ___________________________________.

d) That the Court grant temporary and permanent custody as requested and agreed upon

by the parties.

e) That the Plaintiff have such other and further relief as this Court deems equitable and

just.

Respectfully submitted, this _______ day of _________________________, 20_____.

______________________________

Plaintiff Pro Se

[3] wcwa

STATE OF GEORGIA

COUNTY OF BIBB

VERIFICATION

Personally appeared before the undersigned officer authorizes by law to

administer oaths, the deponent herein, who, an oath, deposes and says that the

facts contained in the foregoing document are true and correct.

PLAINTIFF

Sworn to and subscribed before me

this day of , 20 .

Notary Public

[4] wcwa

AFFIDAVIT FOR PERSON FILING CASE WITH NO ATTORNEY

(All questions must be answered.)

Plaintiff

vs. Civil Action No.

Defendant

PERSONALLY appeared before me the undersigned officer,

(Affiant)

who after being duly sworn deposes and states under oath the following:

(1) That affiant has this date filed a suit for divorce or other complaint in this County and

does not have an attorney at law representing affiant.

(2) (a) Affiant further states that the following person prepared the Complaint and/or other

papers.

Name of Person (and business name) who prepared papers

Address of such person and business

Telephone number of such person and business

(b) Affiant state that said person who prepared the paper (was/was not) paid to prepare

the papers. The total amount paid $ .

(3) Affiant further states that there (is/is not) any further money due anyone for assisting in

the preparation of said papers. If affiant owes money to the preparer the amount is

$ .

(4) Affiant has not paid or given anyone any other consideration of money for helping in

preparing the paper, except the following, .

(5) Did the preparer of the papers tell you what information, or give you advice regarding the

information to put in any of your paper? (YES / NO)

(6) Did the preparer give you any advice about how to file your papers? (YES / NO)

(7) Did the preparer give you any advice about how to present your case to the judge?

(YES / NO)

(8) Are you willing to discuss this matter with a State Bar or Georgia investigator?

(YES / NO)

I have answered all the about questions truthfully, under criminal penalties of perjury.

Sworn to and subscribed before me

this day of , 20 . Affiant

Address

Notary Public

My Commission Expires City State Zip

Phone No. (required):

[5] wcwa

SUPERIOR COURT OF BIBB COUNTY

PARTIES INFORMATION SHEET

TO BE FILED WITH COMPLAINT/PETITION

Plaintiff’s Contact Information:

Plaintiff’s Name:

Address:

City: State: Zip:

Daytime Phone Number:

Cell Phone Number:

Email Address:

Defendant’s Contact Information:

Defendant’s Name:

Address:

City: State: Zip:

Daytime Phone Number:

Cell Phone Number:

Email Address:

[6] wcwa

IN THE SUPERIOR COURT OF BIBB COUNTY

Plaintiff

Vs. Civil Action No.

Defendant

ACKNOWLEDGEMENT OF SERVICE

Due and legal service of the complaint and summons in this foregoing case is hereby

acknowledged; copies of the complaint, and summons when issued, and all other service is

hereby waived.

This day of , 20 .

Sworn to and subscribed before me

this day of , 20 .

Defendant

Notary Public, State of

My Commission expires

WAIVER OF NOTICE OF HEARING AND JURY TRIAL

By consent of the parties thereto, the above case may be tried by the Court any time after

the appearance day of said case; both parties hereby waives their right to a jury trial.

This day of , 20 .

Sworn to and subscribed before me

this day of , 20 .

Plaintiff

Notary Public, State of

My Commission expires

Sworn to and subscribed before me

this day of , 20 .

Defendant

Notary Public, State of

My Commission expires

[7] wcwa

IN THE SUPERIOR COURT OF BIBB COUNTY

STATE OF GEORGIA

Plaintiff

vs. Civil Action File No.

Defendant

SETTLEMENT AGREEMENT

This is an agreement by and between hereinafter referred

to as (“Wife”) and hereinafter referred to as (“Husband”).

WHEREAS, the parties are married but are currently living in a bona fide state of

separation;

WHEREAS, the parties desire to settle between themselves all questions of division of

property, alimony and all other rights and obligations arising out of their marital relationship;

NOW THEREFORE, in consideration of the mutual covenants hereinafter contained, the

parties agree as follows:

1. Separation

The parties shall continue to live separate and apart and each shall be free from interference,

molestation, authority and control, direct or indirect by the other as fully as if sole and

unmarried, and each may reside at such place or places as he or she may select.

2. Alimony

[8] wcwa

A selection must be made or the right to alimony will be waived.

The Wife / Husband shall pay the sum of $ per [week or

month], to be paid beginning on [Date] and to continue thereafter until

the Plaintiff/ Defendant remarries or dies.

The parties expressly waive alimony for the past, present and future.

3. Division of Property

A selection must be made or no marital property will be subject to division

The parties have no marital property subject to equitable division.

The parties have previously divided their marital property to their mutual satisfaction.

The parties acknowledge that they possess various items of jointly owned property. Which

shall be divided as follows:

Wife:

Husband:

4. Division of Debts

A selection must be made or parties will be responsible for debts in their own name.

The parties acknowledge that they have no outstanding joint debts.

The parties agree to the division of debts as indicated below

Wife:

[9] wcwa

Husband:

5. Name Restoration

The parties request that the Wife’s name be restored to

6. Binding Agreement

The parties acknowledge that they have entered into this Agreement freely and voluntarily

and that it is not the result of any duress or any undue influence. This Agreement constitutes the

entire understanding of the parties. There are no representations, warranties, covenants or

undertakings other than those expressly set forth herein.

This agreement is entered into this the day of 20 .

Sworn to and subscribed before me

This day of , 20 . Plaintiff, Pro Se (Signature)

Notary Public (Seal)

My Commission Expires

Sworn to and subscribed before me

This day of , 20 . Defendant, Pro Se (Signature)

Notary Public (Seal)

My Commission Expires

IN THE SUPERIOR COURT OF BIBB COUNTY

STATE OF GEORGIA

Plaintiff

v. Civil Action No.

Defendant

DOMESTIC RELATIONS FINANCIAL AFFIDAVIT OF PLAINTIFF

1. AFFIANT’S NAME: ______________________________ Age _________

Spouse’s Name: _______________________________ Age _________

Date of Marriage: Date of Separation

Names and year of birth of children for whom support is to be determined in this action:

Name

Year of Birth Resides with

Names and year of birth of affiant’s other children:

Name

Year of Birth Resides with

2. SUMMARY OF AFFIANT’S INCOME AND NEEDS

(a) Gross monthly income (from item 3A) $

(b) Net monthly income (from item 3B)

Monthly payments to creditors +

Total

monthly expenses and payments

to creditors (item 5C)

3. AFFIANT’S GROSS MONTHLY INCOME (complete this section or attach Child Support

Schedule A)

(All income must be entered based on monthly average regardless of date of receipt.)

Salary or Wages $

ATTACH COPIES OF 2 MOST RECENT WAGE STATEMENTS

Commissions, Fees, Tips $

Income from self-employment, partnership, close corporations,

and independent contracts (gross receipts minus ordinary

and necessary expenses required to produce income)

ATTACH SHEET ITEMIZING YOUR CALCULATIONS $

Rental Income (gross receipts minus ordinary and

necessary expenses required to produce income)

ATTACH SHEET ITEMIZING YOUR CALCULATIONS $

Bonuses $

Overtime Payments $

Severance Pay $

Recurring Income from Pensions or Retirement Plans $

Interest and Dividends $

Trust Income $

Income from Annuities $

Capital Gains $

Social Security Disability or Retirement Benefits $

Workers’ Compensation Benefits $

Unemployment Benefits $

Judgments from Personal Injury or Other Civil Cases $

Gifts (cash or other gifts that can be converted to cash) $

Prizes/Lottery Winnings $

Alimony and Maintenance From Persons Not in This Case $

Assets Which are Used for Support of Family $

Fringe Benefits (if significantly reduce living expenses) $

Any Other Income (do NOT include means-tested

public assistance, such as TANF or food stamps) $

GROSS MONTHLY INCOME $

B. Affiant’s Net Monthly Income from Employment

(deducting only state and federal taxes and FICA) $

Affiant’s Pay Period (i.e., weekly, monthly, etc.)

Number of Exemptions Claimed

4. ASSETS

(If you claim or agree that all or part of an asset is non-marital, indicate the non-marital portion

under the appropriate spouse’s column and state the amount and the basis: pre-marital, gift,

inheritance, source of funds, etc.).

Description Value

Separate Separate

Basis of

Asset of Asset of the Claim

the Husband the Wife

Cash $

Stocks, Bonds $

CD’s/Money

Market

Accounts $

Bank Accounts

(list each account):

Retirement

Pensions,

401K, IRA, or

Profit Sharing $

Money owed you: $

Tax Refund

owed you: $

Real Estate:

Home: $

debt owed: $

Other:

debt owed: $

Automobiles/Vehicles:

Vehicle 1: $

debt owed: $

Vehicle 2: $

debt owed: $

Life Insurance

(net cash value): $

Furniture/Furnishings: $_

Jewelry: $

Collectibles: $

Other Assets: $

Total Assets: $

5. A. AVERAGE MONTHLY EXPENSES

HOUSEHOLD

Mortgage or Rent Payments $

Property Taxes $

Homeowner/Renter Insurance $

Electricity

Water

Garbage and Sewer $

Telephone:

Residential Line: $

Cellular Telephone: $

Gas $

Repairs and Maintenance $

Lawn Care $

Pest Control $

Cable TV $

Misc. Household and Grocery items $

Meals Outside the Home $

Other $

AUTOMOBILE

Gasoline and Oil $

Repairs $

Auto Tags and License $

Insurance $

OTHER VEHICLES

(boats, trailers, RVs, etc.)

Gasoline and Oil $

Repairs $

Tags and License $

Insurance $

CHILDREN’S EXPENSES

Child Care (total monthly cost) $

School Tuition $

Tutoring $

Private Lessons (e.g., music, dance) $

School Supplies/Expenses $

Lunch Money $

Other Educational Expenses (list)

Allowance $

Clothing $

Diapers $

Medical, Dental, Prescription

(out of pocket/uncovered expenses) $

Grooming, Hygiene $

Gifts from Children to Others $

Entertainment $

Activities (including extra-curricular,

school, religious, cultural, etc.) $

Summer Camps $

AFFIANT’S OTHER EXPENSES

Dry Cleaning/Laundry $

Clothing $

Medical, Dental, Prescription

(out of pocket/uncovered expenses) $

Affiant’s Gifts (special

holidays)

Entertainment

Recreational Expenses (e.g., fitness)

Vacations

Travel Expenses for Visitation

Publications

Dues, clubs

Religious and charities

Pet Expenses

Alimony Paid to Former Spouse

Child Support Paid for other

children

Date of Initial Order:

Other (attach sheet)

OTHER INSURANCE

Health

Child(ren)’s Portion:

Dental

Child(ren)’s Portion:

Vision

Child(ren)’s Portion:

Life

Relationship of Beneficiary:

Disability $

Other (specify):

TOTAL ABOVE EXPENSES

B. PAYMENTS TO CREDITORS

(please check one)

To Whom: Balance Due Monthly Payment

Joint Plaintiff

Defendant

TOTAL MONTHLY PAYMENTS TO CREDITORS: $

C. TOTAL MONTHLY EXPENSES: $

Personally appeared before me, an officer authorized to administer oaths, the undersigned affiant,

who upon being sworn, swears that he/she is legally competent to make this affidavit, that the

affidavit is based upon personal knowledge, and that the contents of the affidavit are true.

__________________________

Affiant

Sworn to and subscribed before me, this _______ day of _______________________, 20_____.

Notary Public

My commission expires:

INFORMATION FOR COMPLETING REQUIRED

CHILD SUPPORT WORKSHEET

1. Child Support Worksheet is required by the State of Georgia.

2. Bibb County Judges require that the Child Support Worksheet be

printed.

3. Complete the worksheet to the best of your ability. The Superior

Court Clerk’s Office cannot help fill out the forms.

4. Go to http://csc.georgiacourts.gov/ complete the form, submit it

and print it out.

5. You MUST file the worksheet along with your case.

IN THE SUPERIOR COURT OF BIBB COUNTY

STATE OF GEORGIA

Plaintiff

v. Civil Action No.

Defendant

DOMESTIC RELATIONS FINANCIAL AFFIDAVIT OF DEFENDANT

1. AFFIANT’S NAME: ______________________________ Age _________

Spouse’s Name: _______________________________ Age _________

Date of Marriage: Date of Separation

Names and year of birth of children for whom support is to be determined in this action:

Name

Year of Birth Resides with

Names and year of birth of affiant’s other children:

Name

Year of Birth Resides with

2. SUMMARY OF AFFIANT’S INCOME AND NEEDS

(a) Gross monthly income (from item 3A) $

(b) Net monthly income (from item 3B)

Monthly payments to creditors +

Total

monthly expenses and payments

to creditors (item 5C)

3. AFFIANT’S GROSS MONTHLY INCOME (complete this section or attach Child Support

Schedule A)

(All income must be entered based on monthly average regardless of date of receipt.)

Salary or Wages $

ATTACH COPIES OF 2 MOST RECENT WAGE STATEMENTS

Commissions, Fees, Tips $

Income from self-employment, partnership, close corporations,

and independent contracts (gross receipts minus ordinary

and necessary expenses required to produce income)

ATTACH SHEET ITEMIZING YOUR CALCULATIONS $

Rental Income (gross receipts minus ordinary and

necessary expenses required to produce income)

ATTACH SHEET ITEMIZING YOUR CALCULATIONS $

Bonuses $

Overtime Payments $

Severance Pay $

Recurring Income from Pensions or Retirement Plans $

Interest and Dividends $

Trust Income $

Income from Annuities $

Capital Gains $

Social Security Disability or Retirement Benefits $

Workers’ Compensation Benefits $

Unemployment Benefits $

Judgments from Personal Injury or Other Civil Cases $

Gifts (cash or other gifts that can be converted to cash) $

Prizes/Lottery Winnings $

Alimony and Maintenance From Persons Not in This Case $

Assets Which are Used for Support of Family $

Fringe Benefits (if significantly reduce living expenses) $

Any Other Income (do NOT include means-tested

public assistance, such as TANF or food stamps) $

GROSS MONTHLY INCOME $

B. Affiant’s Net Monthly Income from Employment

(deducting only state and federal taxes and FICA) $

Affiant’s Pay Period (i.e., weekly, monthly, etc.)

Number of Exemptions Claimed

4. ASSETS

(If you claim or agree that all or part of an asset is non-marital, indicate the non-marital portion

under the appropriate spouse’s column and state the amount and the basis: pre-marital, gift,

inheritance, source of funds, etc.).

Description Value

Separate Separate

Basis of

Asset of Asset of the Claim

the Husband the Wife

Cash $

Stocks, Bonds $

CD’s/Money

Market

Accounts $

Bank Accounts

(list each account):

Retirement

Pensions,

401K, IRA, or

Profit Sharing $

Money owed you: $

Tax Refund

owed you: $

Real Estate:

Home: $

debt owed: $

Other:

debt owed: $

Automobiles/Vehicles:

Vehicle 1: $

debt owed: $

Vehicle 2: $

debt owed: $

Life Insurance

(net cash value): $

Furniture/Furnishings: $_

Jewelry: $

Collectibles: $

Other Assets: $

Total Assets: $

5. A. AVERAGE MONTHLY EXPENSES

HOUSEHOLD

Mortgage or Rent Payments $

Property Taxes $

Homeowner/Renter Insurance $

Electricity

Water

Garbage and Sewer $

Telephone:

Residential Line: $

Cellular Telephone: $

Gas $

Repairs and Maintenance $

Lawn Care $

Pest Control $

Cable TV $

Misc. Household and Grocery items $

Meals Outside the Home $

Other $

AUTOMOBILE

Gasoline and Oil $

Repairs $

Auto Tags and License $

Insurance $

OTHER VEHICLES

(boats, trailers, RVs, etc.)

Gasoline and Oil $

Repairs $

Tags and License $

Insurance $

CHILDREN’S EXPENSES

Child Care (total monthly cost) $

School Tuition $

Tutoring $

Private Lessons (e.g., music, dance) $

School Supplies/Expenses $

Lunch Money $

Other Educational Expenses (list)

Allowance $

Clothing $

Diapers $

Medical, Dental, Prescription

(out of pocket/uncovered expenses) $

Grooming, Hygiene $

Gifts from Children to Others $

Entertainment $

Activities (including extra-curricular,

school, religious, cultural, etc.) $

Summer Camps $

AFFIANT’S OTHER EXPENSES

Dry Cleaning/Laundry $

Clothing $

Medical, Dental, Prescription

(out of pocket/uncovered expenses) $

Affiant’s Gifts (special

holidays)

Entertainment

Recreational Expenses (e.g., fitness)

Vacations

Travel Expenses for Visitation

Publications

Dues, clubs

Religious and charities

Pet Expenses

Alimony Paid to Former Spouse

Child Support Paid for other

children

Date of Initial Order:

Other (attach sheet)

OTHER INSURANCE

Health

Child(ren)’s Portion:

Dental

Child(ren)’s Portion:

Vision

Child(ren)’s Portion:

Life

Relationship of Beneficiary:

Disability $

Other (specify):

TOTAL ABOVE EXPENSES

B. PAYMENTS TO CREDITORS

(please check one)

To Whom: Balance Due Monthly Payment

Joint Plaintiff

Defendant

TOTAL MONTHLY PAYMENTS TO CREDITORS: $

C. TOTAL MONTHLY EXPENSES: $

Personally appeared before me, an officer authorized to administer oaths, the undersigned affiant,

who upon being sworn, swears that he/she is legally competent to make this affidavit, that the

affidavit is based upon personal knowledge, and that the contents of the affidavit are true.

__________________________

Affiant

Sworn to and subscribed before me, this _______ day of _______________________, 20_____.

Notary Public

My commission expires:

Version 1.1.18

General Civil and Domestic Relations Case Filing Information Form

☐ Superior or ☐ State Court of ______________________________ County

For Clerk Use Only

Date Filed _________________________ Case Number _________________________

MM-DD-YYYY

Plaintiff(s) Defendant(s)

__________________________________________________ __________________________________________________

Last First Middle I. Suffix Prefix Last First Middle I. Suffix Prefix

__________________________________________________ __________________________________________________

Last First Middle I. Suffix Prefix Last First Middle I. Suffix Prefix

__________________________________________________ __________________________________________________

Last First Middle I. Suffix Prefix Last First Middle I. Suffix Prefix

__________________________________________________ __________________________________________________

Last First Middle I. Suffix Prefix Last First Middle I. Suffix Prefix

Plaintiff’s Attorney ________________________________________ Bar Number __________________ Self-Represented ☐

Check One Case Type in One Box

General Civil Cases

☐ Automobile Tort

☐ Civil Appeal

☐ Contract

☐ Garnishment

☐ General Tort

☐ Habeas Corpus

☐ Injunction/Mandamus/Other Writ

☐ Landlord/Tenant

☐ Medical Malpractice Tort

☐ Product Liability Tort

☐ Real Property

☐ Restraining Petition

☐ Other General Civil

Domestic Relations Cases

☐ Adoption

☐ Dissolution/Divorce/Separate

Maintenance

☐ Family Violence Petition

☐ Paternity/Legitimation

☐ Support – IV-D

☐ Support – Private (non-IV-D)

☐ Other Domestic Relations

Post-Judgment – Check One Case Type

☐ Contempt

☐ Non-payment of child support,

medical support, or alimony

☐ Modification

☐ Other/Administrative

☐ Check if the action is related to another action(s) pending or previously pending in this court involving some or all

of the same parties, subject matter, or factual issues. If so, provide a case number for each.

____________________________________________ ____________________________________________

Case Number Case Number

☐ I hereby certify that the documents in this filing, including attachments and exhibits, satisfy the requirements for

redaction of personal or confidential information in O.C.G.A. § 9-11-7.1.

☐ Is an interpreter needed in this case? If so, provide the language(s) required. ________________________________

Language(s) Required

☐ Do you or your client need any disability accommodations? If so, please describe the accommodation request.

_________________________________________________________________________________________________________________________

ATTACHMENTS

Parenting Plan

Child Support Order Addendum

Case Disposition Form & 3907 Form

Other

BIBB COUNTY SUPERIOR COURT

STATE OF GEORGIA

Plaintiff

vs. Civil Action No.

Defendant

PARENTING PLAN

( ) The parties have agreed to the terms of this plan and this information has been furnished by

both parties to meet the requirements of OCGA Section 19-9-1. The parties agree on the terms of

the plan and affirm the accuracy of the information provided, as shown by their signatures at the

end of this order.

( ) This plan has been prepared by the judge.

This plan ( ) is a new plan.

( ) modified an existing Parenting Plan dated .

( ) modified an existing Order dated .

Child’s Name

Date of Birth

I. Custody and Decision Making:

A. Legal Custody shall be (choose one:)

( ) with the Mother

( ) with the Father

( ) Joint

B. Primary Physical Custodian

For each of the children named below the primary physical custodial shall be:

Y/O/B:

( ) Mother

( ) Father

( ) Joint

Y/O/B:

( ) Mother

( ) Father

( ) Joint

Y/O/B:

( ) Mother

( ) Father

( ) Joint

Y/O/B:

( ) Mother

( ) Father

( ) Joint

Y/O/B:

( ) Mother

( ) Father

( ) Joint

Y/O/B:

( ) Mother

( ) Father

( ) Joint

WHERE JOINT PHYSICAL CUSTODY IS CHOSEN BY THE PARENTS OR ORDERED BY

THE COURT, A DETAILED PLAN OF THE LIVING ARRANGEMENTS OF THE

CHILD(REN) SHALL BE ATTACHED AND MADE A PART OF THIS PARENTING PLAN.

C. Day-To-Day Decisions

Each parent shall make decisions regarding the day-to-day care of a child while the child is

residing with that parent, including any emergency decisions affecting the health or safety of a

child.

D. Major Decisions

Major decisions regarding each child shall be made as follows:

Education decisions ( ) mother ( ) father ( ) joint

Non-emergency health care ( ) mother ( ) father ( ) joint

Religious upbringing ( ) mother ( ) father ( ) joint

Extracurricular activities ( ) mother ( ) father ( ) joint

( ) mother ( ) father ( ) joint

E. Disagreements

Where parents have elected joint decision making in Section I. D above, please explain how any

disagreements in decision-making will be resolved.

II. Parenting Time/Visitation Schedules

A. Parenting Time/Visitation

During the term of this parenting plan the non-custodial parent shall have at a minimum the

following rights of parenting time/visitation (choose an item):

( ) The first and third weekend of each month.

( ) The first, third, and fifth weekend of each month.

( ) The second and fourth weekend starting on .

( ) Each start at a.m./p.m. and ending

a.m./p.m.

( ) Other:

( ) and weekday parenting time/visitation on (choose an item):

( ) None

( ) Every Wednesday Evening

( ) Every other Wednesday during the week prior to a non-visitation weekend.

( ) Every and evening.

( ) Other

For purposes of this parenting plan, a weekend will start at a.m./p.m. on [Thursday/

Friday/Saturday/Other: ] and end at a.m./p.m. on [Sunday/

Monday/Other: ].

Weekend visitation will begin at a.m./p.m. and will end [ p.m./ when the

child(ren) return(s) to school or day care the next morning / Other ].

This parenting schedule begins:

( ) (day and time) OR ( ) date of the Court’s Order

B. Major Holidays and Vacation Periods

Thanksgiving

The day to day schedule shall apply unless other arrangements are set forth:

beginning .

Winter Vacation

The ( ) mother ( ) father shall have the child(ren) for the first period from the day and time

school is dismissed until December at a.m./p.m. in ( ) odd number years

( ) even number years ( ) every year. The other parent will have the child(ren) for the second

period from the day and time indicated above until 6:00 p.m. on the evening before school

resumes. Unless otherwise indicated, the parties shall alternate the first and second periods each

year.

Other agreement of the parents:

Summer Vacation (if applicable)

Define:

The day to day schedule shall apply unless other arrangements are set forth:

beginning .

Fall Vacation (if applicable)

Define:

The day to day schedule shall apply unless other arrangements are set forth:

beginning .

C. Other Holiday Schedule (if applicable)

Martin Luther King Day

Presidents’ Day

Mother’s Day

Memorial Day

Father’s Day

July Fourth

Labor Day

Halloween

Child(ren)’s Birthday(s)

Mother’s Birthday

Father’s Birthday

Religious Holidays:

Other:

D. Other extended periods of time during school, etc. (refer to the school schedule)

E. Start and end dates for holiday visitation

For the purposes of this parenting plan, the holiday will start and end as follows (choose one):

( ) Holidays that fall on Friday will include the following Saturday and Sunday

( ) Holidays that fall on Monday will include the preceding Saturday and Sunday

( ) Other:

F. Coordination of Parenting Schedules

Check if applicable:

( ) The holiday parenting time/visitation schedule takes precedence over the regular parenting

time/visitation schedule.

( ) When the child(ren) is/are with a parent for an extended parenting time/visitation period

(such as summer), the other parent shall be entitled to visit with the child(ren) during the

extended period, as follows:

G. Transportation Arrangements

For visitation, the lace of meeting for the exchange of the child(ren) shall be :

The will be responsible for transportation of the child at the beginning of

visitation.

The will be responsible for transportation of the child at the conclusion of

visitation.

Transportation costs will be allocated as follows:

Other provisions:

H. Contacting the child

When the child or children are in the physical custody of one parent, the other parent will have

the right to contact the child or children as follows:

( ) Telephone

( ) Other:

( ) Limitations on contact:

I. Supervision of Parenting time

( ) Check here if Applicable

The day-to-day parenting time outlined above shall be conducted under supervision to ensure the

safety of the child(ren) and/or parent as provided for in O.C.G.A. § 19-9-7 (a):

Place:

Person/Organization supervising:

Responsibility for cost:

( ) mother ( ) father ( ) both equally

J. Communication Provisions

Please check:

( ) Each parent shall promptly notify the other parent of a change of address, phone number or

cell phone number. A parent changing residence must give at least 30 days notice of the change

and provide the full address of the new residence.

( ) Due to prior acts of family violence, the address of the child(ren) and victim of family

violence shall be kept confidential. The protected parent shall promptly notify the other parent,

through a third party, of any change in contact information necessary to conduct visitation.

III. Access to Records and Information

Rights of the Parents

Absent agreement to limitations of court ordered limitations, pursuant to

O.C.G.A.§ 19-9-1 (b) (1) (D), both parents are entitled to access to all of the child(ren)’s records

and information, including, but not limited to , education, health, extracurricular activities, and

religious communications. Designation as a non-custodial parent does not affect a parent’s right

to equal access to these records.

Limitations on access rights:

Other Information Sharing Provisions:

IV. Modification of Plan or Disagreements

Parties may, by mutual agreement, vary the parenting time/visitation; however, such agreement

shall not be a binding court order. Custody shall only be modified by court order.

Should the parents disagree about this parenting plan or wish to modify it, they must make a

good faith effort to resolve the issue between them.

V. Special Considerations

Please attach an addendum detailing any special circumstances of which the Court should be

aware (e.g., health issues, education issues, etc.)

VI. Parents’ Consent

Please review the following and initial:

1. We recognize that a close and continuing parent-child relationship and continuity in the

child’s life is in the child’s best interest.

Mother’s Initials Father’s Initials

2. We recognize that our child’s needs will change and grow as the child matures; we have

made a good faith effort to take these changing needs into account so that the need for

future modifications to the parenting plan are minimized.

Mother’s Initials Father’s Initials

3. We recognize that the parent with physical custody will make the day-to-day decisions

and emergency decisions while the child is residing with such parent.

Mother’s Initials Father’s Initials

( ) We knowingly and voluntarily agree on the terms of this Parenting Plan. Each of us

affirms that the information we have provided in this Plan is true and correct.

Mother’s Signature Father’s Signature

ORDER

The Court has reviewed the foregoing Parenting Plan, and it is hereby made the order of this

Court.

This Order entered on , 20 .

JUDGE

BIBB COUNTY SUPERIOR COURT

STATE OF GEORGIA

Plaintiff

vs. Civil Action No.

Defendant

CHILD SUPPORT ADDENDUM

Instructions: All parts of this Addendum must be completed and it must be attached to all final orders and

judgments determining the amount of child support. However, it is not required for orders of contempt motions.

[You must check of the following boxes]

( )

The parties have agreed to the terms of this order and this information has been furnished

by both parties to meet the requirements of OCGA § 19-6-15. The parties agree on the

terms of the order and affirm the accuracy of the information provided, as shown by their

signatures at the end of this addendum.

( ) This addendum includes findings of fact and conclusions of law and fact made by the

Court, in compliance with the OCGA § 19-6-15

Application of Child Support Guidelines. The statutory requirements of OCGA § 19-6-15

have been applied in reaching the amount of child support provided under the final order in this

action. The specifics are as follows:

1. Gross Income - The Father’s gross monthly income (before taxes) is

$___________; The Mother’s gross monthly income (before taxes) is

$___________.

2. Number of Children - The number of children for whom support is being provided

under this order is _____________________________.

3. Attachments – The Child Support Worksheet and Schedule E are attached and made

a part of this addendum, along with any other applicable schedules.

4. Child Support Amount – The shall pay to the

, for the support of the minor children, the sum of

Dollars ($ ) per month, beginning on

, 20 .

5. Duration of Child Support:

[You must check and complete only one of the following paragraphs.]

( )

(a) Beyond Age 18 for High School – The child support shall continue monthly

thereafter until each child reaches the age of eighteen, dies, marries, or otherwise

become emancipated; provided that is a child becomes eighteen years old while

while in and attending secondary school or fulltime basis, then the child support

shall continue for the child until the child has graduated from secondary school or

reaches twenty years of age, whichever occurs first.

( ) (b) Stops at Age 18 – The child support shall continue monthly thereafter until

each child reaches the age of eighteen, dies, marries, or otherwise become

emancipated.

( ) (c) Until Further Order – This is not a final order, so the child support shall

shall continue until further order of this Court.

( ) (d) Until Specific Date – The child support shall continue monthly thereafter

until__________________________________________________.

6. Deviation from Presumptive Amount:

[You must check and complete only one of the following paragraphs]

( ) (a) No Deviation – It has been determined that one or more of the Deviations

allowed under OCGA § 19-6-15 applies in this case, as shown by the attached

Scheduled E. The amount of support in Paragraph 4 above is the Presumptive

Amount of Child Support shown on the attached Child Support Worksheet.

( ) (b) Deviation – It has been determined that one or more of the Deviations allowed

under OCGA § 19-6-15 applies in this case, as shown by the attached Schedule E.

The Presumptive Amount of Child Support that would have been required under

OCGA § 19-6-15 if the deviations had not been applied is $______________ per

month, as shown on the attached Child Support Worksheet. The attached

Schedule E explains the reasons for the deviation, how the application of the

guidelines would be unjust or inappropriate considering the relative ability of

each parent to provide support, and how the best interest of the children who are

subject to this child support determination is served by deviation from the

presumptive amount of the child support.

7. Health, Dental & Vision Insurance for Children:

[You must check and complete all parts of only one of the following paragraphs. (a) or (b)]

( ) (a) Insurance Available - The following insurance for the children involved in

this action is available at a reasonable cost to the ________________ through that

parent’s employer or the PeachCare program.

( ) Health (medical, mental health and hospitalization ( ) Dental and/or

( ) Vision – So long as it remains available to that parent, the ______________

shall maintain the types of insurance checked above for the benefit of the minor

children, until each child reaches the age of eighteen, dies, marries, or otherwise

become emancipated; except that if a child becomes eighteen years old while

enrolled in and attending secondary school on a full-time basis, then the insurance

hall be continued for the child until the child has graduated from secondary school

or reaches twenty years of age, whichever occurs first.

(1) The parent of who maintains the insurance shall provide the other parent with

an insurance identification card or such other acceptable proof of insurance

coverage and shall cooperate with the other parent in submitting claims under

the policy.

(2) All money received by one of the parties for claims processed under the

insurance policy shall be paid within five (5) days after the party receives the

money, to the other party (if that party paid the applicable health care service

provider) or the applicable health care provider (if the provider has not been

paid by one of the parties.

( ) (b) Insurance Not Available – Insurance (other than Medicaid) is not available at

this to either party at a reasonable cost. If health insurance for the children later

becomes available to the parent who is required to pay child support for these

children then that parent must obtain the following types of insurance, unless it is

then being provided by the other parent:

( ) Health (medical, mental health and hospitalization

( ) Dental

( ) Vision

When insurance has been obtained by either party, Paragraphs 7 (a)(1) and (2)

shall apply.

8. Uninsured Health Care Express – The shall pay _______%

and the _____________________shall pay ________% of all expenses incurred for the

children’s health care (including medical, dental, mental health, hospital and vision care)

that are not covered by insurance. The party who incurs a health care expense for one of

the children shall provide verification of the amount to the other party. That other party

shall reimburse the incurring party (or pay the health expense, within fifteen (15) days

after receiving the verification of particular health care expense.

9. Parenting Time Amounts – The approximate amount of parenting time according to the

visitation order is _________________ for the Father and ___________for the Mother.

(Express as a percentage of the year or as the number of 24-hour periods the child is with

a parent.

10. Social Security Benefits:

[you must check and complete only one of the following paragraphs]

( ) (a) Not Received – The children do not receive Title II Social Security benefits

under the account the account of the parent ordered to pay child support.

( ) (b) Received - The children receive Title II Social Security benefits under the

account of the parent ordered to pay child support. The benefits received by the

children shall be counted as a child support payments, and shall be applied against

the final child support order to be paid by the parent.

(1) If the amount of benefits received is less than the amount of support

ordered, the obligor shall pay the amount exceeding the Social

Security benefit.

(2) If the amount of benefits received is equal to or more than the amount

of support ordered, the obligor’s responsibility is met and not further

support shall be paid.

(3) Any Title II benefits received for the children’s benefit shall be

retained by the custodial parent or nonparent custodian for the

children’s benefit, and it shall be used as a reason for decreasing the

final child support or reducing arrearages.

11. Modification:

[You must check and complete only one of the following paragraphs].

( ) (a) Not Modification Action – This is an initial determination of support, not a

modification action.

( ) (b) Support Not Modified – This action is a modification action, but the order

does not modify the amount of child support that was previously ordered for

these children. The date of the initial support order concerning this child support

case was: .

( ) (c) Support Amount Modified – The order modifies the amount of child

support that was previously ordered for these children. The basis for the

modification is:

( ) (1) Substantial change in the income and financial status of the Father;

( ) (2) Substantial change in the income and financial status of the Mother;

( ) (3) Substantial change in the needs of the Children;

( ) (4) The noncustodial parent failed to exercise visitation provided under the

prior order;

( ) (5) The noncustodial parent has exercised more visitation than was provided

in the prior order.

The date of the initial support order concerning this child support case was:

12. Continuing Garnishment for Child Support – Whenever, in violation of the

terms of the order, there shall have been a failure to make the support payments, so

that the amount unpaid is equal to or greater than the amount payable for one

month, the payments required to be made may also be collected by the process of

continuing garnishment for support.

13. Income Deduction Order:

[You must check and complete only one of the following paragraphs: (a), (b) or (c).]

( ) (a) An Income Deduction Order shall be entered by the Court, under OCGA §

19-6-32, for payment of the child support and alimony (if any) provided. The

Income Deduction Order shall take effect:

[To finish (a), you must check either (1) or (2). Do not check both.]

( ) (1) immediately upon entry by the Court.

( ) (2) upon accrual of a delinquency equal to one month’s support.

The Income Deduction Order may be enforced by serving a “Notice of

Delinquency,” as provided in OCGA § 19-6-32.

( ) (b) The parties agree that an Income Deduction Order is not immediately

necessary.

( ) (c) The Court finds that there is good cause not to require income deduction,

having determined that income deduction will not serve the children’s best

interests and that there has been sufficient proof of timely payment of any

previously ordered support.

Parties’ Consent – We knowingly and voluntarily agree on the terms of this order.

Each of us affirms that the information we have provided in this Addendum is true

and correct.

Father’s Signature Mother’s Signature

ORDER

The Court has reviewed the foregoing Child Support Addendum, and it is hereby made the order

of this Court.

This Order entered on , 20 .

JUDGE BIBB COUNTY SUPERIOR COURT

REPORT OF DIVORCE, ANNULMENT OR DISSOLUTION OF MARRIAGE



FORM 3907

(REVISED 12/2016)

PLEASE ADDRESS ALL CORRESPONDENCE TO THE ADDRESS BELOW.

STATE OFFICE OF VITAL RECORDS1680 PHOENIX BLVD. SUITE 100, ATLANTA, GA 30349 PHONE 404.679.4702

PLEASE PRINT OR TYPE ALL INFORMATION LEGIBLY AND CORRECTLY BELOW.

REQUIRED INFORMATION

CIVIL ACTION NUMBER

DATE DECREE GRANTED (MONTH, DAY, YEAR)

COUNTY DECREE GRANTED

FIRST NAME OF PARTY 1

MIDDLE NAME

LAST NAME

LAST NAME AT BIRTH

DATE OF BIRTH (MONTH, DAY, YEAR)

COUNTY OF RESIDENCE

NUMBER OF THIS MARRIAGE (FIRST, SECOND, ETC.)

FIRST NAME OF PARTY 2

MIDDLE NAME

LAST NAME

LAST NAME AT BIRTH

DATE OF BIRTH (MONTH, DAY, YEAR)

COUNTY OF RESIDENCE

NUMBER OF THIS MARRIAGE (FIRST, SECOND, ETC.)

SPECIFY GROUNDS FOR DIVORCE (19-5-3, OCGA)

NUMBER OF CHILDREN LESS THAN 18 AFFECTED BY THIS DECREE

This above Report may be reproduced by use of a computer. However, the finished Report

must be a close reproduction of the original, and prior review and approval must be obtained

from the State Registrar before use. (31-10-7, O.C.G.A.)

31-10-22. Record of divorce, dissolutions, and annulments.

(a) A record of each divorce, dissolution of marriage, or annulment granted by any court of

competent jurisdiction in this state shall be filed by the clerk of the court with the department

and shall be registered if it has been completed and filed in accordance with this Code section.

The record shall be prepared by the petitioner or the petitioner’s legal representative on a form

prescribed and furnished by the state registrar and shall be presented to the clerk of the court

with the petition. In all cases, the completed record shall be a prerequisite to the granting of

the final decree.

(b) The clerk of the superior court shall complete and forward to the department on or before

the tenth day of each calendar month the records of each divorce, dissolution of marriage, or

annulment decree granted during the preceding calendar month.

Version 1.1.18

General Civil and Domestic Relations Case Disposition Information Form

☐ Superior or ☐ State Court of ______________________________ County

For Clerk Use Only

Date Disposed _________________________ Case Number ________________________________________

MM-DD-YYYY

Case Style ____________________________________________