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JDF1113 (Colorado Judicial Branch)

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JDF 1113 R2/18 PARENTING PLAN Page 1 of 10
District Court Juvenile Court
_______________________ County, Colorado
Court Address:
In re:
The Marriage of:
Parental Responsibilities concerning:
______________________________________________________
Petitioner:
and
Co-Petitioner/Respondent:
COURT USE ONLY
Attorney or Party Without Attorney (Name and Address):
Phone Number: E-mail:
FAX Number: Atty. Reg. #:
Case Number:
Division Courtroom
PARENTING PLAN
You must submit to the Court some form of written Parenting Plan addressing all of the issues which are relevant
to the facts of your case. The written Parenting Plan must contain provisions for the allocation of parental
responsibilities including decision-making and parenting time. You may use this form as a Parenting Plan to submit
to the Court. This standard form does not include every possible issue that may be relevant to the facts of your
case. A section entitled "Other Terms" is available for you to identify unique issues that you may have in your case.
If you need more space than is provided, attach additional pages to the form. Any additional pages must
include signatures.
To promote agreement among parties where the children are involved, parties may jointly create a written Parenting
Plan. If you do not enter into a joint written Parenting Plan, you must each file your own written Parenting Plan.
Without an agreement, the Court must enter its own plan which may be a plan filed by one of the parties or may be
entirely different. Whether the Court approves your plan or enters its own, the Parenting Plan will become a Court
Order.
This is a:
Full Joint Parenting Plan (we agree to everything and the plan is signed by both parties.)
Partial Joint Parenting Plan (we agree to some things and the plan is signed by both parties.)
Parenting Plan prepared by one party (no agreement).
If this is a partial joint Parenting Plan or a Parenting Plan prepared by one party, please complete and file with the
Court JDF 1129 - Pretrial Statement to identify issues that you have not agreed on. This is a required form if
you have any issues that you cannot agree on. A hearing may be necessary to address the issues.
The Petitioner is the child(ren)’s:
Father Mother Other Party (state relationship to child(ren) _____________________________________
The Co-Petitioner/Respondent is the child(ren)’s:
Father Mother Other Party (state relationship to child(ren)_____________________________________
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JDF 1113 R2/18 PARENTING PLAN Page 2 of 10
The child(ren) are:
Full Name of Child
Present Address
Date of Birth
Section A: Allocation of Parental Responsibilities (Decision-making)
1. The parties understand that day-to-day decisions such as minor training or correction, minor medical and dental
care, curfew, chores, allowance, clothing, hygiene, etc. will be made by the party who has the child(ren) at the
time such decisions are necessary.
2. Each party will inform the other party of any changes with their address and/or phone numbers in advance.
3. Both parties will provide the names, addresses, and telephone numbers of all medical, dental, and mental health
care providers. Either party may authorize emergency care, but if possible both parties agree to contact the
other party first.
4. Unless otherwise ordered by the Court for good cause shown, state law provides that both parties have access
to the records of the child(ren) including school, medical, dental, and mental health records, pursuant to §14-
10-123.8, C.R.S.
5. For purposes of school attendance only, the child(ren)’s residence will be with the:
Mother Father Other Party
We have identified below whether the major decisions (Education, Medical/Dental Mental Health, and Religious)
will be joint or will be made by one party. If major decision will be made by someone other than one of the parents,
check the “Other Party” column. Note: The Other Party must be named in the case as the Petitioner, Co-
Petitioner/Respondent or an Intervenor to be included in this Parenting Plan.
Type of Major Decision-Making
Joint
Mother
Father
Other
Party
Educational, if needed specify:
Medical/Dental/Mental Health, if needed specify:
Religious, if needed specify:
Extracurricular and Recreational Activities, if needed
specify:
Other (please identify):
Other (please identify):
Other (please identify):
Other (please identify):
JDF 1113 R2/18 PARENTING PLAN Page 3 of 10
Section B: Allocation of Parental Responsibilities (Parenting Time)
Parties are encouraged to create a Parenting Plan that meets the needs of the child(ren) and
individual needs of their family. If you have any unique issues, please identify them under “other”
or provide an attachment to this Parenting Plan. If a party fails to comply with a provision of this
plan, child support is not affected, unless the Child Support Order is modified and then only with
respect to future payments of child support.
1. Weekday and Weekend Schedule during the School Year
The child(ren) will be in the care of the Mother. List the days of the week and times.
The child(ren) will be in the care of the Father. List the days of the week and times.
The child(ren) will be in the care of (name of Other Party).
Note: This party must be named in the case as the Petitioner, Co-Petitioner/Respondent or an Intervenor to
be included in this Parenting Plan. Do not list babysitters and day care providers as the Other Party. List the
days of the week and times.
Transportation and drop-off/pick-up arrangements will be as follows:
JDF 1113 R2/18 PARENTING PLAN Page 4 of 10
2. Summer Schedule
The weekday and weekend schedule above will apply for all 12 calendar months with no specific changes
during the summer.
or
During the summer months, the child(ren) will be in the care of the Mother. List the days of the weeks and
times.
During the summer months, the child(ren) will be in the care of the Father. List the days of the weeks and
times.
The child(ren) will be in the care of (name of Other Party).
Note: This party must be named in the case as the Petitioner, Co-Petitioner/Respondent or an Intervenor to
be included in this Parenting Plan. Do not list babysitters and day care providers as the Other Party. List the
days of the week and times.
Transportation and drop-off/pick-up arrangements will be as follows:
3. Holidays and Special Occasions
The following schedule will take priority over the schedules in Sections 1 and 2. Please check all that apply, place
the name of the party with whom the children will be spending the holiday in the appropriate box (odd/even/all
years), and indicate the time and place of exchange. Identify any unique situations under “Other”. If a box is not
checked, the regular parenting time schedule will apply to that holiday event.
JDF 1113 R2/18 PARENTING PLAN Page 5 of 10
Event
Odd years
Even years
All Years
Time & Place of
exchange
Spring Break
Easter
Mother’s Day/Weekend
Memorial Day/Weekend
Father’s Day/Weekend
July 4
th
Labor Day/Weekend
Halloween
Thanksgiving Day/Break
Christmas Eve
Christmas Day
Week 1 of Winter Break
Week 2 of Winter Break
Children’s Birthdays
Other (Identify)
Other (Identify)
Other (Identify)
Other parenting time arrangements:
4. Number of Overnights: Based upon the foregoing schedule(s), Mother will have ____ total overnights
per year and Father will have ______ total overnights per year. Note: These two numbers must equal 365.
5. Telephone Access
Each party may have reasonable telephone contact with the child(ren) during the child(ren)’s normal waking
hours.
Other:
6. Travel and Vacation Plans
The parties agree that should either of them require out-of-state or any type of overnight travel with the
child(ren), each party will inform the other party of such travel and vacation plans, including notice and contact
information.
Other:
JDF 1113 R2/18 PARENTING PLAN Page 6 of 10
Section C: Relocation
Relocation refers to moving the child(ren)’s residence so that the geographic ties between the child(ren) and the
other party are substantially changed requiring a modification of allocation of parental responsibilities (decision-
making and parenting time).
The parties understand that after the Decree or Final Order is issued, if a party wants to relocate, he/she must file
a Motion with the Court, pursuant to §14-10-129, C.R.S. and obtain court permission to relocate, unless the parties
have submitted to the Court a written agreement/stipulation (with verified signatures of all parties) allowing one of
the parties to relocate with the minor child(ren) together with a new proposed parenting plan which addresses how
the parties intend to address all the parenting issues given the fact that one of the parties is now relocating with the
minor child(ren).
Neither the Mother or Father have current plans to relocate with the child(ren).
The Mother Father Other Party is planning to relocate with the child(ren) to ____________________(city)
________________ (state) on ______________________ (date) and we have agreed to the following terms:
Section D: Financial Obligations for the Benefit of the Child(ren)
1. Child Support (all child support agreements must be reviewed by the Court to see if the agreement
complies with the child support guidelines):
a. Child Support Calculation
Child Support shall be paid per a previously issued Administrative or Court Order in ______________
(DHS number or case number) issued on (date) in (County).
or
The amount of child support agreed to by the parties is based upon the attached Child Support
Worksheet which reflects an amount of child support of $___________ per month.
or
The amount of child support agreed to by the parties is not based upon the attached Child Support
Worksheet which reflects an amount of child support of $__________ per month. Please identify the agreed
upon amount and the reasons why you agree to deviate from the amount identified in the Child Support
Worksheet. (The Court must approve any deviation from the guideline amount and will do so only
for compelling reasons if this amount is lower than the guideline amount.)
b. Child Support Agreement
The Mother Father shall pay child support to the Mother Father Other Party in the sum of
$____________ per month beginning on _________________________ (date).
JDF 1113 R2/18 PARENTING PLAN Page 7 of 10
Child support payments shall be paid: (check one)
To the Family Support Registry (FSR), P. O. Box 2171, Denver, CO 80201-2171.
Directly to the Mother Father Other Party
Child support payments shall be paid: (check one)
weekly bi-weekly twice a month monthly Other: ________________________ and will be paid
on the _____________ day of the week month.
It is the responsibility of the Obligee (the person receiving the payment) to complete the
appropriate forms to activate an income assignment, pursuant to §14-14-111.5(3)(a)(II), C.R.S.
Please see JDF 1801 - Instructions, if applicable.
2. Medical, Dental, Vision, and Mental Health Insurance and Extraordinary/Out-of Pocket
Medical Expenses
Mother shall provide medical dental vision mental health insurance for the child(ren). If not all
children, please identify the names of the children who will be receiving insurance:
_________________________________________
and/or
Father shall provide medical dental vision mental health insurance for the child(ren). If not all children,
please identify the names of the children who will be receiving insurance:
_______________________________________________________________________________________
and/or
________________________________ (name of party) shall provide medical dental vision mental
health insurance for the child(ren). If not all children, please identify the names of the children who will be receiving
insurance:
_______________________________________________________________________________________
Extraordinary Medical Expenses are defined as uninsured expenses, including co-payments and deductible
amounts in excess of $250.00 per child per calendar year. The parties agree that extraordinary medical, dental,
vision, or mental health expenses for the child(ren) shall be divided with the Mother paying ___________ %, the
Father paying ____________%, and the Other Party paying _____________%.
Other:
A “Notice to Employer to Deduct for Health Insurance” (JDF 1809) can be completed by the Obligee
(person receiving) and served upon the Obligor (person paying) and Obligor’s employer.
3. Extraordinary Expenses (Private schools, school/sport/extracurricular activities, etc.)
You may use this section to document any agreements made between the parties that are not required by law to
be addressed such as private schools, extracurricular and recreational activities, automobile access or insurance,
or any other agreements affecting the general welfare of the child(ren). Note: Agreements made under this
provision, if approved by the Court and made a part of the Decree or Order, become enforceable by the
Court.
JDF 1113 R2/18 PARENTING PLAN Page 8 of 10
The parties agree to the following:
4. OPTIONAL - Post-Secondary Expenses (college, trade school, etc.)
You may use this section to document any agreements made between the parties that are not required by
law to be addressed.
Post-secondary education expenses cannot be ordered by the Court without an agreement. If you agree that they
should be paid by the parties, please indicate the terms of the agreement below.
NOTE: Agreements made under this provision, if approved by the Court and made a part of the Decree or
Final Order, become enforceable by the Court.
Post-secondary education expenses for the child(ren) shall be divided with the Mother paying _________% and
Father paying __________% of every expense checked below. Post-secondary expenses include the following:
Tuition (indicate any restrictions or maximum monetary amounts)
Room and Board
Books
Fees
Travel
Other:
Section E: Child Tax Exemption
Only one party may claim a deduction for each child on his/her income tax return. Both parties agree to prepare
appropriate IRS forms, for example, Form 8332 “Release of Claim to Exemption for Child of Divorced or Separated
Parents” IRS link to forms: http://www.irs.gov/formspubs/index.html
Note:
If there is no agreement, the dependency exemption will be divided in accordance with §14-10-115(12),
C.R.S. These rights shall be allocated between the parties in proportion to their contributions to the
costs of raising their children.
A party shall not be entitled to claim a child as a dependent, if he or she has not paid all court-ordered
child support for that tax year or if claiming the child as a dependent would not result in any tax benefit
pursuant to §14-10-115(12), C.R.S.
“M” = Mother “F” = Father “O” = Other party
Full Name of Child
Deduction to be
claimed every year
by:
Deduction to be
claimed during odd
years
Deduction to be
claimed during
even years
M
F
O
M
F
O
M
F
M
F
O
M
F
O
M
F
M
F
O
M
F
O
M
F
M
F
O
M
F
O
M
F
JDF 1113 R2/18 PARENTING PLAN Page 9 of 10
Other:
Section F: Other Terms
If the parties cannot reach an agreement in the future on any issues involving the child(ren), they agree to enter
into mediation arbitration parenting coordinator decision-maker at their own cost.
The parties will exchange financial information on an annual basis, for example, income, verification of insurance
and its costs.
Identify below any issues or agreements not already identified in this agreement.
Minor changes may be made at any time if both parties agree to the changes. A written agreement
to modify child support, the primary caretaking party, or other substantial changes to the
parenting plan should be filed with the Court along with a proposed order for the Court to approve
the modification.
Please re-read this document carefully to make sure it accurately reflects your entire agreement. Items
agreed upon outside of this document may not be enforceable.
By checking this box, I am acknowledging I am filling in the blanks and not changing anything else on the
form.
By checking this box, I am acknowledging that I have made a change to the original content of this form.
Signature
___________________________________ _________________________________________________
(printed name of Petitioner) Signature of Petitioner Date
________________________________________________________________________________________
Petitioner’s Address City State Zip Code
________________________________________________________________________________________
(Area Code) Home Telephone Number Area Code) Work Telephone Number
___________________________________
Signature of Attorney if applicable Date
_______________________________________________________
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JDF 1113 R2/18 PARENTING PLAN Page 10 of 10
Signature
___________________________________ _________________________________________________
(printed name of Co-Petitioner/Respondent) Signature of Co-Petitioner/Respondent Date
________________________________________________________________________________________
Co-Petitioner/Respondent’s Address City State Zip Code
________________________________________________________________________________________
(Area Code) Home Telephone Number Area Code) Work Telephone Number
___________________________________
Signature of Attorney if applicable Date
IF ONLY ONE PARTY SIGNS THE PARENTING PLAN,
COMPLETE THE CERTIFICATE OF SERVICE BELOW.
I certify that on ________________________ (date) a true and accurate copy of the PARENTING PLAN was
served on the other party(ies) by:
Hand Delivery, E-filed, Faxed to this number: ___________________, or
by placing it in the United States mail, postage pre-paid, and addressed to the following (include name and
address):
To: _______________________________________
_______________________________________
_______________________________________
To: _______________________________________
_______________________________________
_______________________________________
____________________________________
Your signature
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JDF1113 (Colorado Judicial Branch)

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Completed 19 May 2021

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