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Filling out the Caption on your form

	“Attorney or Party without Attorney” - if you do not have an attorney, fill in your name, address, and telephone number. If you would like the court to communicate with you by fax or email, you may give them that contact information, but you do not have to. “Attorney For (Name)” – if you do not have an attorney, write “self represented.”
	“SUPERIOR COURT OF CALIFORNIA, COUNTY OF” – write the name of the County where you are filing your case. Click here for location of courts.
	“Petitioner” – The person that filled out the first form to start the case. Write that person’s name here. "Respondent” – The other parent is called the Respondent. Write that person’s name here.
	This is the TITLE of the form. Leave as is.
	“For Court Use Only” – Leave blank.
	“Case Number” – Write in the case number.

Filling out the rest of your form

Stipulation and Order for Custody and/or Visitation of Children

The parties signing this stipulation agree that: – This section states that the court can make orders regarding the children in this case because:

1. The children live in California.
2. The children normally live in the United States.
3. This section explains that the parties signing this form understand that if anyone violates this order, they can be punished by fines or jail or both.
4. Answer either “a” or “b”:
   
   
   1. If you and the other party have a written agreement regarding custody and visitation of the children on a document other than a Judicial Council form, write the date of the document and the number of pages here;
      
      OR
   2. If you and the other party wrote your agreement regarding custody and visitation of the children on Judicial Council forms, check the boxes of the forms that you used, and attach the forms to this Stipulation.

The Petitioner must write the date that he or she signs this form, type or print his or her full name, and sign the form.

The Respondent must write the date that he or she signs this form, type or print his or her full name, and sign the form.

If the Petitioner has an attorney, the attorney must write the date that he or she signs this form, type or print his or her full name, and sign the form.

If the Respondent has an attorney, the attorney must write the date that he or she signs this form, type or print his or her full name, and sign the form.

If there is person listed as “Other,” he or she must write the date that he or she signs this form, type or print his or her full name, and sign the form.

If the person listed as “Other” has an attorney, that attorney must write the date that he or she signs this form, type or print his or her full name, and sign the form.


FINDINGS AND ORDER - Leave this section blank for the court to fill out.