Texas Divorce Form – Fill Out and Use This PDF

It is ‘default’ – Your spouse does not file an answer with the Court after being officially served with your divorce paperwork.

REMEMBER: It is always best to have the advice of a lawyer. The court clerks, librarians, and judges want to help you, but they cannot give you legal advice, help you fill out your forms, or tell you what to do. If you proceed without a lawyer, you will be responsible for protecting yourself.

You do not have to have a lawyer to get a divorce, but it’s a good idea especially if:

•You and your spouse do not agree (the divorce is contested).

•Your spouse has a lawyer.

•You are afraid for your safety or your children’s safety.

•You are unsure how to divide property such as retirement and real estate correctly.

Getting a divorce can be complicated. If you make a mistake, it could affect your children, your property, and your income. Try to speak to a lawyer about your legal rights before you file your Petition for Divorce. Some lawyers will unbundle their services. They will “coach” you to represent yourself and only charge for the services you request. Other lawyers are available only if you hire them to handle every step of the case. If you can’t afford to hire a lawyer, contact your local Legal Aid office.

What forms do I need?

There are several form packets to choose from on www.TexasLawHelp.org.

Choose the Divorce without Children forms if you do not have minor children of the marriage or if you have child support and visitation orders already in place.

Choose the Divorce with Children forms if children were born or adopted during the marriage and the children are younger than 18 or have not graduated from high school. Exception: If you already have final court orders for custody and support of the children, and you are not asking for a change to those orders in the divorce process, then use the Divorce without Children forms and attach a copy of the current custody and support orders (showing the judge’s signature) to the Decree.

If you cannot afford the court filing fees, you should also file an Affidavit of Inability to Pay Costs. This form tells the court about your income and assets and asks the court to waive the filing fee.

The Default Judgment Kit explains what you need to do to get a final judgment when your spouse will not respond to the divorce. This kit includes instructions and explanations about what you must do, a checklist for the forms you need, and the forms you can use.

If you cannot find your spouse, review the Legal Notice, the Service by Posting, and the Service by Publication, kits on www.TexasLawHelp.org.

Divorce in Texas – Know the Steps

Step 1. Fill out the Original Petition for Divorce.

This form tells the judge and your spouse that you want a divorce.

Step 2. Make 2 copies of your completed Original Petition for Divorce.

Step 3. File your Original Petition for Divorce.

Take the original and 2 copies of your completed Original Petition for Divorce to the Courthouse. File your papers with the District Clerk’s Office.

The clerk will ask you to pay a fee (around $250 - $300) to file your Original Petition for Divorce. If you cannot afford the fee, you should also file an Affidavit of Inability to Pay Costs.

This form tells the court about your income and assets and asks the court to waive the filing fee.

The clerk will stamp your papers with the date you file. She will also assign a cause number and a judicial district. The clerk will keep the original and give back your copies. Keep a copy for yourself in a safe place. You will need the other copy to give legal notice to your spouse.

Step 4. Give Your Spouse “Legal Notice.”

You must notify your spouse that you are asking the court for a divorce and you must prove to the court that you did so. This is called giving “legal notice.” There are 4 ways to give legal notice:

hearings are scheduled, then s/he should sign and file an Answer instead of a Waiver. If your spouse files an Answer, s/he must also agree to and sign the Decree of Divorce to finish your divorce without a contested hearing. You do not need to have your spouse officially served.

Texas Divorce Brochure © Partnership for Legal Access 12/14/09

Step 5. Wait.

61 Day Waiting Period – (Applies in Most cases)

In most cases, you must wait at least 61 days from the day you filed your Original Petition for Divorce before you can finish your divorce. You can always wait longer than 61 days, but your divorce cannot be finished in less than 61 days. When counting the 61 days, count the day you filed your Original Petition for Divorce on a calendar, and then count out 61 more days.

The 61 Day Waiting Period can be waived in cases of domestic violence if:

You have an active Protective Order against your spouse who committed family violence during your marriage, or your spouse has received deferred adjudication or a final conviction for committing family violence against you or a member of your household.

Other Waiting Periods

21 Day Answer Period – (Applies in Official Service cases only)

If your spouse was served with legal notice by an official process server, you must wait at least 21 days after your spouse was served, to see if your spouse will file an answer. This 21-day period may or may not fall within the 61 day waiting period. When counting the 21 days, count the day your spouse was served on a calendar, and then count out 21 more days. Go to the next Monday on the calendar. This is the last official day of your spouse’s answer period. However, your spouse can file an answer any time before you finish your divorce.

7 Day Waiting Period – (Applies in Posting cases only)

If you spouse was served by Posting add an additional 7 days to the 21 day answer period. Go to the next Monday on the calendar. This is the last official day of your spouse’s answer period. However, your spouse can file an answer any time before you finish your divorce.

10 Day Waiting Period – (Applies in Official Service cases only)

If your spouse was served with legal notice by an official process server, the official process server fills out a return of service form stating when and where your spouse was served. The return of service must be on file with the District Clerk’s office for 10 days. When counting the 10 days, do not count the day your spouse was served or the day you go to court. There must be 10 days in between.

Step 7. Find out when the Court hears

uncontested divorce cases.

Bring all of your paperwork to the courthouse on the

day the court in your county hears uncontested divorce cases. Read “Are you ready for court?” on page 7.

Step 10. Finish your divorce by filing your decree in the District Clerk’s Office.

Take your paperwork back to the Clerk’s Office after it is signed by the Judge. Your divorce is not final until the paperwork is filed. File the “Information on Suit Affecting the Family Relationship” form.

NOTE: In some counties, the court, not you, files the signed Decree in the Clerk’s Office.

The clerk will keep the original documents and make copies for you for a fee. You might consider asking the clerk for a certified copy of your Decree of Divorce. If you have child support orders, ask the clerk what you need to do to set up your child support account and wage withholding. There will be a fee.

Giving Legal Notice in Agreed and Default Divorces:

Proving to the Court You Notified your Spouse of the Divorce

Are you ready for court?

Be prepared:

Get to the courthouse early to find parking and your courtroom.

When the courtroom opens, go in and tell the clerk you are present. The clerk usually sits next to the judge’s bench.

Most courtrooms do not allow children.

Common Questions

If my spouse and I do not own any property together, do we still have to fill out the property and debt sections on the Decree of Divorce form?

Yes. Anything you or your spouse purchased during your marriage, even if it was purchased after you separated, is community property. Any debts you or your spouse incurred during your marriage, even if they were incurred after you separated, are community debts. Answer each section carefully so you will be able to keep any property that belongs to you.

If my spouse filed an Answer, but later agrees to sign the Decree of Divorce, can I still go to an Uncontested Docket?

Yes, if your spouse has signed the Decree of Divorce.

How much will child support be?

In most cases, the court uses a special formula to calculate child support. This is called Guideline support. Usually, the supporting parent pays the following amounts to the parent with whom the children live most of the time.

*Important Note:

The formula is different if the supporting parent also has children with someone else. Use the child support calculator at www.TexasLawHelp.org or talk to a lawyer.

The Court can order a child support amount different from guideline support if the Court determines that amount to be in the best interest of the child.

Where do I send my child support payments?

The State Disbursement Unit, P.O. Box 659791, San Antonio, Texas, 78265-9791.

Can child support be paid directly to the other parent?

No. Unless the court orders otherwise, all child support payments must be sent to the State Disbursement Unit, P.O. Box 659791, San Antonio, Texas, 78265-9791.

What if I already have court orders regarding my children?

If there is a final court order for the custody and support of your children and you are not asking to change that order, you can file your divorce using the Divorce No Children forms at www.TexasLawHelp.org. When you fill out your Original Petition for Divorce include information about your children and your current custody and support order. You must attach a copy of your current custody and support order to your Decree of Divorce.

If there is a final order for the custody and support of your children and you do want to change those orders talk to a lawyer

Respondent’s Forms

3.Waiver of Service (2 Pages).

4.Answer (2 Pages).

Final Decree

5. Final Decree of Divorce (8 Pages).

Parenting Plan Exhibits

6.Exhibit Conservatorship (Custody), Rights and Duties Order (3 Pages).

7.Exhibit Possession and Access (Visitation) Order (6 Pages).

8.Exhibit Child Support Order (3 Pages).

9.Exhibit Medical Support Order (3 Pages).

10.Exhibit Family Information (3 Pages).

11.Employer’s Order to Withhold Earnings for Child Support (3 Pages).

11/2/2011

Cause Number:

(The Clerk’s office will fill in the Cause Number and Court Number when you file this form.)

IN THE MATTER OF THE MARRIAGE OF

Print first, middle and last name of other spouse.

(List children of this marriage who are under 18):

1.________________________ 2._______________________ 3. ______________________

4.________________________ 5._______________________ 6. ______________________

Original Petition for Divorce

Print your answers.

Parties

My name is: __________________________________________________________________________.

My spouse’s name is: __________________________________________________________________.

My spouse is the Respondent.

1. Discovery

The discovery level in this case, if needed, is Level 2.

I have lived in this county for the last 90 days.

My spouse has lived in this county for the last 90 days.

State of Residence

(Check all boxes that apply.)

I have lived in Texas for the last six months.

My spouse has lived in Texas for the last six months.

Out-of-State Respondent

(Check all boxes that apply.)

My spouse does not live in Texas, and

My spouse agrees that a Texas court can make orders dividing our property and orders for custody and support of our children.

Texas is the last state where we lived together as a married couple. This petition is filed less than two years after we separated.

The children live in Texas because of my spouse’s actions. My spouse has lived in Texas with the children.

My spouse has lived in Texas and provided prenatal expenses or support for the children.

My spouse had sexual intercourse in Texas, and the children may have been conceived by that act of intercourse.

Our child was born in Texas and my spouse registered with the paternity registry maintained by the bureau of vital statistics or signed an acknowledgment of paternity.

My spouse will be personally served with citation in Texas.

Note: If your spouse does NOT live in Texas, you must complete and attach the Exhibit: Out-of-State Party Affidavit.

Waiver of Waiting Period Based on Family Violence

(Check only if applicable.)

I ask the Court to waive the 60 day waiting period for divorce because: (Check one box.)

My spouse has been convicted of or received deferred adjudication for a crime involving family violence against me or a member of my household.

I have an active protective order or an active magistrate’s order for emergency protection against my spouse because of family violence during our marriage. The order includes a finding that my spouse committed family violence.

3. Marriage, Separation, and Grounds for Divorce

My spouse and I got married on or about: ____________________________.

Month Day Year

We stopped living together as spouses on or about: ____________________________.

Month Day Year

I ask the Court to grant me a divorce.

The marriage has become insupportable due to discord or conflict of personalities that destroys the legitimate ends of the marital relationship and prevents any reasonable expectation of reconciliation.

and your spouse do not get along and do not plan to get back together.)

©TexasLawHelp.org - Petition for Divorce – With Children October, 2011 Texas Family Code, Titles I and V.

4. Children

A. Children you and your spouse have together –

List all adopted and biological children of this marriage who are under 18.

If you have a disabled child, talk to an attorney to see if child support should continue after the child turns 18.

Important: If the wife is pregnant and the husband is not the biological father of the child, paternity of the child must be established before you can finish your divorce.

Paternity may be established by:

●filing, with the court, a case to Adjudicate Parentage, or

●filing, with the bureau of vital statistics, an Acknowledgement of Paternity signed by the genetic father and a Denial of Paternity signed by the husband.

The Office of the Attorney General may be able to help establish paternity of the child. Get more information about establishing paternity at www.TexasLawHelp.org.

If the wife is pregnant and the husband is the biological father of the child, you must wait until the child is born to finish your divorce.

Child(ren) included in order: ___________________________________________________________

County/State where order was made: ___________________________________________________

Date of order: ________________________ Cause #: ___________________________________

Name of order: _____________________________________________________________________

There is a court order in effect now for ALL of the children listed above.

County/State where order was made: ___________________________________________________

Date of order: ______________________ Cause #: _____________________________________

Name of court order in effect now: ______________________________________________________

(Note: The court cannot change an order made in a

different county, unless the case is transferred to the county where you file for divorce.)

_________________________________________________________________________________

_________________________________________________________________________________

_________________________________________________________________________________

E. Custody, Visitation, and Child Support

My spouse and I will try to make an agreement about custody, visitation, and support. If we cannot make an agreement, I ask the court to make decisions on these issues that are best for our children, including, if applicable, orders for current and retroactive child support and medical support.

F.Children’s Health Insurance

Private Health Insurance is in effect: (Complete, if the children have private health insurance.)

Name of insurance company: _____________________________________________________________

Policy number: ________________________________________________________________________

Cost of premium: $ _____________________________________________________________________

Name of person who pays for insurance: ____________________________________________________

Private Health Insurance NOT in effect: (Complete, if the children do NOT have private health insurance.)

Cost of premium (if any): ________________________________________________________________

G. Children’s property

(Check one box.)

The children do not own any property.

The children own the following property: _______________________________________________

H.Children born during the marriage, but husband is not the father

(Check one box and fill in the requested information, if applicable.)

The wife did not have children with another man while married to the husband.

The wife did have children with another man while married to the husband.

All of the children born during the marriage that are not the husband’s adopted or biological children are named below:

1.

2.

3.

4.

5.

6.

If more than 6 children, list them on another sheet and write Attachment B at the top. Then attach it to this form.

(Check one box.)

Paternity of the children named above has not been established. I understand that paternity of the children must be established before I can finish my divorce.

Paternity of the children named above has been established: (Check one box.)

A court order has determined the father of each child named above. I understand I must attach a file-stamped copy of the order to my Final Decree of Divorce.

An Acknowledgement of Paternity signed by the genetic father and a Denial of Paternity signed by the Husband has been filed with the bureau of vital statistics for each child named above. I understand I must attach a copy of these documents to my Final Decree of Divorce.

Important: If the wife had children with another man while married to the husband, paternity of the children must be established before you can finish your divorce.

Paternity may be established by:

●filing, with the court, a case to Adjudicate Parentage, or

●filing, with the bureau of vital statistics, an Acknowledgement of Paternity signed by the genetic father and a Denial of Paternity signed by the husband.

The Office of the Attorney General may be able to help establish paternity of the children.

Get more information about establishing paternity at www.TexasLawHelp.org.

5. Property

Community Property

My spouse and I will try to make an agreement about how to divide our community property and debts. If we cannot agree, I ask the Court to divide our property and debts according to Texas law.

Separate Property

List all property that you owned before you were married, including real estate, and all gifts, inheritance, or money damages you received from a lawsuit during your marriage, if the money was not compensation for lost wages.

4.Inheritance, gifts, or money from a lawsuit (not for lost wages) given only to you (describe):

5.Other property that you owned before you were married (describe):

I ask the Court to confirm this property as my separate property in my Final Decree of Divorce.

(Check one box and fill in the requested information, if applicable.)

I do not have a Protective Order against my spouse and I have not asked for one.

I have filed paperwork at the courthouse asking for a Protective Order against my spouse, but a judge has not decided if I should get it. I asked for a Protective Order on

____________ in __________________ County. The case number is ________________________.

Date Filed Name of County

I do have a Protective Order against my spouse. I got the Protective Order on

______________ in _______________________ County, ___________________.

Date Ordered Name of CountyName of State

The case number for the Protective Order is _____________________________________________.

Protective Order Against ME

(Check one box and fill in the requested information if applicable.)

My spouse does not have a Protective Order against me and has not asked for one.

My spouse has filed paperwork asking to get a Protective Order against me, but a judge has not decided if my spouse will get it. My spouse asked for a Protective Order on

____________ in __________________ County. The case number is __________________________.

Date Filed Name of County

My spouse does have a Protective Order against me. The Order was made in

________________________ County, ________________________ on _________________.

Name of CountyName of StateDate Ordered

The case number for the Protective Order is ______________________________________________.

7. Family Information

(Check one box.)

I will fill out and file the Family Information form when I file the Final Decree of Divorce, as required by Texas Family Code Section 105.006.

I believe my children or I will be harassed, abused, seriously harmed, or injured if I am required to give my spouse the information checked below for myself and the children:

(Check the boxes below to tell the judge which information you want to be kept confidential.)

I ask the Court to Order that I not have to give this information or notice of changes in this information to my spouse. I also ask the Court to keep this information confidential.

Note: Ask the Court to sign the Order on Request to Keep Family Information Confidential form when you go to court. Find this form at www.FreeTexasForms.org in the Divorce in Texas with Children section.

8. Name Change

I ask the Court to change my name back to a name I had before my marriage:

(Check one box.)

I will have a sheriff, constable, or process server give a copy of this Petition to my spouse here:

_________________________________________________________________________________

Street AddressCityStateZip

If this is a work address, name of business: _______________________________________________

I ask the clerk to issue citation. I understand that I will need to pay the fee (or file the form to show the Court that I am unable to pay the fee) and arrange for service by a sheriff, constable or process server.

Do not send a sheriff, constable, or process server to give a copy of this Petition to my spouse, at this time. I think my spouse will sign a Waiver of Service, or file an Answer.

10.Prayer

I ask the Court to grant me a divorce and make the other orders I have asked for in this Petition and any other orders I am entitled to.

I ask the court for general relief.

I understand that I must let the Court, my spouse, and my spouse’s attorney (if my spouse has an attorney) know in writing if my mailing address or phone number changes during this case.

Exhibit: Out-of-State Party Affidavit

Required by Texas Family Code, Section 152.209

Important! If you, the other parent, or anyone else named as a party in your case lives outside of Texas, you must:

Fill out this form – Do not sign it until you are in front of the notary!

After signing, file it in the Clerk’s Office.

Keep a copy for your records.

(All information must be true and correct. Print your answers.)

The person who signed this affidavit appeared, in person, before me and stated under oath:

“My name is __________________________________. I am above the age of eighteen (18) years, and I

am fully competent to make this affidavit. The facts stated in this affidavit are within my personal knowledge and are true and correct.

1. Personal Information

My name is: ________________________________________________________.

I am representing myself in this case.

Do you believe the health, safety or liberty of you or your children would be jeopardized by disclosure of

If yes, ask the Clerk’s Office to seal this affidavit and not disclose the information to the other party or the public, until and unless the court orders the information disclosed after a hearing in which the court takes into consideration the health, safety and liberty of you and your children. This is required by Texas Family Code, section 152.209 (e).

2. Children in this case (under 18)

What is the present address of that person or persons?

2nd Child’s Name:

Check here if this child has always lived with the 1st child and skip to next question.

When did this child start living at this address? (Month, day, year)

What is the present address of that person or persons?

3rd Child’s Name:

Check here if this child has always lived with the 1st child and skip to next question.

When did this child start living at this address? (Month, day, year)

What is the present address of that person or persons?

Who did the child live with?

What is the present address of that person or persons?

If there are more than 3 children, make a copy of this page for each child and attach it to this form.

3. Other Court Cases

Have you taken part in any other court case about any of these children, in Texas or in any other state

Do you know of any other court case that could affect this case, including custody, visitation, child support, civil or criminal cases for domestic violence, protective orders, termination of parental rights,

Warning: You must tell the court if you later find out about a court case about these children, in Texas or in any other state or country.

4. Other People Who Claim Custody or Visitation

“Do you know of any other person who has physical possession of the children or claims the right to

Notary fills out below.

State of Texas,

County of

(Print the name of county where this statement is notarized)

Sworn to and subscribed before me, the undersigned authority, on this date:

(Notary’s seal here)

Notary’s Signature

WARNING: By signing this form, you give up all your legal rights in this case. Do not sign it if you want to know what the court will order in your divorce. You can waive your right to be served, but keep your other rights, by filing an Answer instead. You can find an Answer form at www.FreeTexasForms.org with the Divorce – With Children forms.

Instructions: If you decide to use this Waiver of Service form:

●Make sure the Petitioner has already filed a Petition for Divorce with the court. Do not sign this Waiver of Service until after the Petition is filed and you have been given a copy. If you sign it before the Petition is filed, it must be redone. The official court stamp on the Petition will tell you when it was filed.

●Fill out the Waiver of Service completely. You MUST include your address.

●Sign the Waiver of Service in front of a notary.

●Give the Waiver of Service to the Petitioner or file it in the clerk’s office.

Cause Number:

Names of the children born to Petitioner and Respondent who are under 18:

1.___________________________ 2._________________________ 3. _________________________

4.___________________________ 5._________________________ 6. _________________________

Waiver of Service – Divorce (With Children)

The person who signed this affidavit appeared, in person, before me, the undersigned notary, and stated under oath:

“I am the Respondent in this case.

“My name is: _________________________________________________________________.

FirstMiddleLast

“My mailing address is: _________________________________________________________.

“I have been given a copy of the Petition for Divorce filed in this case. I have read the Petition for Divorce and understand what it says.

“I understand that I have the right to be given a copy of the Petition for Divorce and official notice of this case by a constable, sheriff or other official process server. This process is called issuance and service of citation. I do not want to be given official notice. I give up my right to issuance and service of citation in this case and enter my appearance in this case for all purposes.

“I also give up my right to be notified of any and all hearings in this case.

“I agree that a Judge or Associate Judge in the county and state where this case is filed may make decisions about my divorce, even if the divorce should have been filed in another county. I do not want a court reporter to make a record of the testimony in this case.

“I understand that I must let the Court, my spouse and my spouse’s attorney(if my spouse has an attorney) know in writing if my mailing address or phone number changes during this case

“If I am in the military, I waive all rights, privileges, and exemptions I may have under the Servicemembers Civil Relief Act in this case, including having a lawyer appointed to represent me.

“I agree that the judge may make decisions about my divorce without further notice to me.”

(Check only one):

________________________________________________________________________________.

”

Respondent’s signature

Notary fills out below

State of Texas, County of ___________________________________________

(Print the name of county where this affidavit is notarized.)

Sworn to and subscribed before me, the undersigned Notary, on this date: _______________________

by _______________________________________________.

(Print the first and last names of the Respondent who is signing this affidavit.)

I, the Notary Public, who signature appears below, certify that I am not an attorney in this case.

WARNING: Without the advice and help of an attorney, you may be putting yourself, your children, your property, and your money at risk. Call your local lawyer referral service or the State Bar of Texas Lawyer Referral Information Service at 1-800-252-9690 for help finding a lawyer. If you or your child is a victim of domestic violence, you can get legal help by calling 1-800-374-4673.

WARNING: Filing an Answer with the Court enters your appearance in this case. Talk to a lawyer before filing an Answer if you 1) do not live in Texas and 2) do not agree that a Texas court should have the power to make orders that impose a personal obligation on you. Such orders could include orders dividing your property and debts, ordering you to pay child support, and (if requested by the Petitioner) ordering you to pay spousal maintenance, court costs and attorney fees. If you file an Answer (or any other pleading) before filing a Special Appearance, you will give up your right to argue that Texas lacks the power to make such orders because you live out-of-state. Call the State Bar of Texas Lawyer Referral Information Service at 1(800) 252- 9690 for help finding a Texas lawyer.

(Print court information exactly as it appears on the Petition for Divorce)

Cause Number:

Names of the children who are under 18 or still in high school:

1.___________________________ 2.__________________________ 3. _________________________

4.___________________________ 5.__________________________ 6. _________________________

Respondent’s Answer to Divorce

Print your answers.

My name is: __________________________________________________________________.

1. General Denial

I enter a general denial. I want to be notified of all hearings in this case.

However, if my spouse (the Petitioner) and I reach an agreement I will sign the Final Decree of Divorce. If I sign the Final Decree of Divorce, then I agree that the Court can finalize this case without my getting notice of the hearing and without my coming to Court.

2. Contact Information

My mailing address is: ___________________________________________________________.

Print Mailing Address City State Zip

My phone number is: (_____) ______-____________.

I understand I must notify the Court and Petitioner or Petitioner’s attorney (if Petitioner has an attorney) in writing if my mailing address or phone number changes during this case. I understand that unless I give the Court and Petitioner or Petitioner’s attorney (if Petitioner has an attorney) written notice of changes in my mailing address, all information about this case, including the date and time of hearings, will be sent to me at the address on this form.

3. Name Change

(Check one.)

I am NOT asking the court to change my name.

I ask the Court to change my name back to a name I used before:

________________________________________________________________________________.

I am not asking the court to change my name to avoid criminal prosecution or to avoid payment of debt.

4. Prayer

I ask the Court to grant me a divorce. I also ask the Court to make the other orders I have asked for in this Answer and any other orders to which I am entitled.



Respondent’s SignatureDate

5. Certificate of Service

I swear that I gave a true copy of this document to Petitioner or Petitioner’s attorney (if Petitioner has an attorney) in person, by fax, or by certified mail, return receipt requested.

(Print court information exactly as it appears on your Petition)

Cause Number:

IN THE MATTER OF THE MARRIAGE OF

Print first, middle and last name of other spouse.

(List children of this marriage who are under 18):

1.________________________ 2._______________________ 3. ______________________

4.________________________ 5._______________________ 6. ______________________

Final Decree of Divorce

A hearing took place today, and the following people were present. There was no jury as neither the husband nor wife asked for one.

1. Appearances

Petitioner

The Petitioner’s name is: ____________________________________________________________________.

The Petitioner was present, representing him/herself, and has agreed to the terms of this Decree of Divorce.

The Petitioner was not present but has signed below, agreeing to the terms of this Decree.

Respondent

The Respondent’s name is:___________________________________________________________________.

The Respondent was present, representing him/herself, and agrees to the terms in this Decree.

The Respondent was not present but was served, filed an Answer, or signed a Waiver of Citation, and:

(Check all that apply.)

has signed below, agreeing to the terms in this Decree.

agreed in the Waiver that the judge can finalize the divorce, without giving the Respondent notice of this hearing.

has defaulted. The Petitioner has filed a Certificate of Last Known Address and an Affidavit of Non-Military Status. The Petitioner has also arranged for a court reporter to record the hearing.

2. Record

(Check one box.)

A Court reporter recorded today’s hearing.

A Court reporter did not record today’s hearing because the Husband, Wife, and judge agreed not to make a record.

A Statement of the Evidence was signed by the Court.

3. Jurisdiction

The Court heard evidence and finds that it has jurisdiction over this case and the parties, that the residency and notice requirements have been met, and the Petition meets all legal requirements.

The Court finds that::

(Check one box.)

the Petition was filed more than 60 days ago.

Petitioner has an active Protective Order under Title 4 of the Texas Family Code, or an active magistrate’s order for emergency protection under Article 17.292 of the Texas Code of Criminal Procedure against the Respondent because the Respondent committed family violence during the marriage.

Respondent has a final conviction or has received deferred adjudication for a crime involving family violence against the Petitioner or a member of Petitioner’s household.

The Court finds that the Husband and Wife are the parents of the children listed below, and that there are no other children of this marriage expected or entitled to receive support.

(List all adopted and biological children of this marriage who are under 18.)

1

2

3

4

5

6

(If more than 6 children, list them on another sheet and write Attachment A at the top. Attach it to this form.)

B. Pregnancy

The Court finds that the Wife is not pregnant.

Remember: You cannot finish your divorce

while the wife is pregnant.

A court order has determined the father of each of child named below. A copy of the order is attached to and made part of this Final Decree of Divorce for all purposes.

An Acknowledgement of Paternity signed by the genetic father and a Denial of Paternity signed by the Husband has been filed with the bureau of vital statistics for each child named below. A copy of this document, or documents, is attached to and is made part of this Final Decree of Divorce for all purposes.

(List all children born during the marriage, who are not the adopted or biological children of the husband.) (Paternity of each child must already have been established.)

1.

2.

3.

4.

5.

6.

If more than 6 children, list them on another sheet and write Attachment B at the top. Then attach it to this form.

5. Divorce

IT IS ORDERED that the Petitioner and the Respondent are divorced on the grounds of insupportablity.

6. Parenting Plan

The Court FINDS that the orders found in the attached Parenting Plan Exhibits are in the best interest of the children, and makes the following orders regarding custody, visitation, child support, and health insurance, as included in this section and the attached Parenting Plan Exhibits.

Note! You must include a Parenting Plan with this Decree of Divorce, as required by Texas Family Code, Section 153.603. Complete and attach the following Parenting Plan Exhibits to this Decree of Divorce.

Parenting Plan Exhibits

The following Exhibits are attached to this Decree of Divorce and are made a part of this Decree for all purposes. Exhibit: Conservatorship (Custody) Order

Exhibit: Rights and Duties Order

Exhibit: Possession and Access (Visitation) Order

Exhibit: Child Support Order

Exhibit: Medical Support Order

Exhibit: Family Information

7. Property And Debts

Note: Additional forms are needed to divide retirement benefits and to transfer title to real estate.

If you plan to divide retirement benefits or you jointly own a house or land with your spouse, do NOT use this form without first talking to a lawyer.

You can hire a lawyer just to give you advice and/or draft the documents you need for a flat fee. Call your local lawyer referral service or the State Bar of Texas Lawyer Referral Information Service at 1(800) 252-9690 for help finding a lawyer.

Texas is a community property state. This means that any new property or debt that either party obtains from the minute they are married until the minute the judge grants the divorce is community property, even if the property or debt is only in one spouse’s name.

All community property and debt should be included in the Final Decree of Divorce. There are a few exceptions to the law of community property. If either party receives a gift, an inheritance, or money from a lawsuit that does not compensate for lost wages, it is separate property. It is a good idea to confirm separate property obtained during the marriage as that individual’s separate property in the Final Decree of Divorce. More information about community and separate property can be found in the Texas Family Code, chapters 3,4, and 5.

The Court makes the following orders regarding the parties’ community and separate property:

Husband’s Property

Husband’s Separate Property

The Court confirms that the Husband owns the following property as his separate property:

3.Cars, trucks, motorcycles or other vehicles

Husband owned these vehicles before marriage or received them as a gift or inheritance during the marriage:

4.Other Money or Property

Husband owned the following money or property before the marriage or inherited or received it as a gift during the marriage.

Husband received the following money from a lawsuit during the marriage. This money was not compensation for lost wages.

Husband’s Community Property

The Court ORDERS that the Husband is awarded (gets) the following Community Property, and the Wife is divested of (doesn’t get) any interest, title or claim she may have to the property listed below.

Wife IS ORDERED to sign any deeds or documents needed to transfer any property listed below to the Husband. Husband is responsible for preparing the documents.

1.All property in Husband’s care, custody or control, or in Husband’s name, that this Order does not give to the Wife.

2.House or land located at:

Legal Description:

3. Other real property located at:

Legal Description:

(Check ALL that apply.)

4. All of the Husband’s employment benefits, including retirement, pension, 401(k), profit-sharing, and stock option plans that are in his name alone, along with all individual retirement accounts, such as IRAs that are in his name alone. (Note: If you want to divide retirement or employment benefits do NOT use this form. You will need additional forms. Talk to an attorney.)

Husband’s Debts

(Check all that apply.)

The Husband shall pay the debts listed below:

Wife’s Property

Wife’s Separate Property

The Court confirms that Wife owns the following property as her separate property:

3.Cars, trucks, motorcycles or other vehicles

Wife owned these vehicles before the marriage or received them as a gift or inheritance during the marriage:

4.Other Money or Property

Wife owned the following money or property before the marriage or inherited or received it as a gift during the marriage.

Wife received the following money from a lawsuit during the marriage. This money was not compensation for lost wages.

Wife’s Community Property

The Court ORDERS that Wife is awarded (gets) the following Community Property, and Husband is divested of (doesn’t get) any interest, title, or claim he may have to the property listed below.

Husband IS ORDERED to sign any deeds or documents needed to transfer any property listed below to the Wife. Wife is responsible for preparing the documents.

1.All property in Wife’s care, custody, or control, or in Wife’s name, that this Order does not give to the Husband.

2.House or land located at:

Legal Description:

3. Other real property located at:

Legal Description:

Wife’s Community Property (continued)

(Check all that apply.)

4. All of the Wife’s employment benefits, including retirement, pension, 401(k), profit-sharing, and stock option plans that are in her name alone, along with all individual retirement accounts, such as IRAs that are in her name alone. (Note: If you want to divide retirement or employment benefits do NOT use this form. You will need additional forms. Talk to an attorney.)

Wife’s Debts

(Check all that apply.)

The Wife shall pay the debts listed below:

8. Name Change

The Court ORDERS the name of the:

(Check all boxes that apply.)

Husband changed back to a name used before marriage, as it appears below.

Wife changed back to a name used before marriage, as it appears below.

9. Court Costs

The Husband will pay for his court costs; the Wife will pay for her court costs.

10.Other Orders

The court has the right to make other orders, if needed, to clarify or enforce the orders above.

Any orders requested that do not appear above are denied.

Exhibit: Conservatorship (Custody), Rights and Duties Order

The Court makes the following orders:

1. Conservatorship (Custody) and Primary Home

The Court ORDERS that the parties in this case are (check one):

Joint Managing Conservators, One Party Chooses Child’s Primary Home, Geographic Limit on Child’s Primary Home:

Both parties share legal custody. One party decides where the child’s primary home is located. There is a geographic limit on the location of the child’s primary home.

The party who has the exclusive right to decide where the child’s primary home is located

is:____________________________________________________________

(Print the name of the parent who has the exclusive right to decide where the child’s home is located.)

There is a geographic limit on the location of the child’s primary residence. The child’s primary home will be located:

Joint Managing Conservators, One Party Chooses Child’s Primary Home, No Geographic Limit on Child’s Primary Home:

Both parties share legal custody. One party decides where the child’s primary home is located. There is no geographic limit on the location of the child’s primary home.

The party who has the exclusive right to decide where the child’s primary home is located is:

___________________________________________________________

(Print the name of the parent who has the exclusive right to decide where the child’s home is located.)

OR

Separate Conservators, One Party Chooses Child’s Primary Home, No Geographic Limit on Child’s Primary Home:

One party decides where the child’s primary home is located and makes the major decisions about the child’s health, education, and welfare. There is no geographic limit on the location of the child’s primary home.

The Sole Managing Conservator is (name): _______________________________________.

The Sole Managing Conservator has the exclusive right to decide where the child’s primary home is located.

The Possessory Conservator is (name):___________________________________________.

OR

THIS OPTION CAN BE SELECTED ONLY IF THE PARTIES AGREE TO IT.

Joint Managing Conservators, No Party Chooses Child’s Primary Home, Geographic Limit on Child’s Primary Home:

Both parties share legal custody. Neither party has the right to decide where the child’s primary home is located.

©TexasLawHelp.org, Exhibit: Conservatorship (Custody), Rights and Duties Order, March 2011

There is a geographic limit on the location of the child’s primary home. BY AGREEMENT, the child’s primary home will be located:

in the school district of __________________________________.

2. Rights and Duties At All Times

The Court ORDERS that both parents always have the following rights: (Texas Family Code, Section 153.073)

1.To receive information from the other parent or conservator about the child/ren’s health, education, and welfare.

2.To talk or confer with the other parent, to the extent it is possible, about upcoming decisions concerning the child/ren’s health, education, and welfare.

3.To have access to the child/ren’s medical, dental, psychological, and educational records.

4.To talk or consult with the child/ren’s doctors, dentists, and psychologists.

5.To talk or consult with school officials, including teachers, and school staff, about the child/ren’s welfare and educational status and school activities.

6.To attend the child/ren’s school activities.

7.To be designated as an emergency contact on their child/ren’s records.

8.To give consent for emergency medical, dental, and surgical treatment if the child/ren’s health or safety is in immediate danger.

9.Each parent has the right to manage the child/ren’s estate(s) if he or she created it for the child/ren or if that parent’s family created it for the child/ren.

The Court ORDERS that both parents always have the following duties: (Texas Family Code, Section 153.076)

1.To inform the other parent or conservator, in a timely manner, about significant information concerning the child/ren’s health, education and welfare.

2.Each parent has a duty to inform the other parent or conservator if the parent:

resides with for at least 30 days,

marries, or

intends to marry

a person who the parent knows is a registered sex offender under Chapter 62 of the Texas Code of Criminal Procedure, or who is currently charged with an offense that would require the person to register as a sex offender under that chapter, if convicted.

The parent IS ORDERED to give this notice as soon as practicable, but no later than the 40th day after the date the parent or conservator begins to reside with the person, or within 10 days of marrying the person.

The notice must include a description of the offense that required the person to register as a sex offender or the offense that the person is charged with that may require the person to register as a sex offender.

©TexasLawHelp.org, Exhibit: Conservatorship (Custody), Rights and Duties Order, March 2011

3, Rights and Duties During Periods of Possession

The Court ORDERS that both parents have the following rights and duties when the child/ren are with them: (Texas Family Code, Section 153.074)

1.To care for, control, protect, and reasonably discipline the child/ren.

2.To support the children, providing them with food, clothing, and shelter, and medical and dental care that does not involve an invasive procedure.

3.To consent to non-invasive medical and dental care for the child/ren.

4.To direct the child/ren’s moral and religious training.

4.Other Rights and Duties

The Court ORDERS the parties shall share the following rights and duties as marked below: (Texas Family Code, Section 153.132)

Name of other person: ________________________________________________________________

Relationship to child/ren: ______________________________________________________________

©TexasLawHelp.org, Exhibit: Conservatorship (Custody), Rights and Duties Order, March 2011

Exhibit: Standard Possession (Visitation) and Access Order

The Court ORDERS that each conservator shall comply with all terms and conditions of this standard possession (visitation) order.

The Court ORDERS that this standard possession (visitation) order is effective immediately and applies to all periods of possession occurring on and after the date the Court signs the order to which this exhibit is attached.

Designation of Conservators

The Court ORDERS that the conservators are designated in this exhibit as Home Parent and Co-parent.

The conservator known as the ‘Home Parent’ is: (name) ______________________________________

The conservator known as the ‘Co-Parent’ is: (name) _________________________________________

Mutual Agreement

The Court ORDERS that Home Parent and Co-Parent shall have possession of the child/ren at any and all times mutually agreed to in advance by Home Parent and Co-Parent.

In the absence of mutual agreement, the Court ORDERS that Home Parent and Co-Parent shall have possession of the child/ren as ordered below.

Undesignated Times

The Home Parent shall have the right to possession of the child/ren at all times not specifically ordered for Co-Parent.

Definitions

“School” means the primary or secondary school where a child is enrolled, or if the child is not enrolled in a primary or secondary school, the public school district where the child primarily resides.

“Child” includes each child, whether one or more, who is part of this case while that child is under the age of eighteen years and not otherwise emancipated.

A “weekend” begins on the 1st, 3rd, and 5th Friday of each month at 6pm, and ends on the following Sunday at 6 pm, except when:

The box “After school** is checked, then during the regular school year, the weekend begins at the time the child/ren’s school is dismissed before the 1st, 3rd, or 5th weekend of each month.

The box “Next school day*** is checked, then during the regular school year, the weekend ends at the time the child/ren’s school starts on the next school day after the 1st, 3rd, or 5th weekend of each month (if Co-Parent cannot return the children to school on time, s/he must notify the school and the other parent).

The 1st, 3rd, or 5th weekend coincides with a student holiday or teacher’s in-service day or federal, state or local holiday that falls on a Monday, then the weekend begins on Friday, and ends on Monday; if the holiday falls on a Friday, then the weekend begins on Thursday, and ends on Sunday.

If a weekend or midweek visit conflicts with the holiday or summer schedule, you must follow the holiday or summer schedule.

3. Child’s Birthday, Mother’s Day and Father’s Day

Home Parent and Co-Parent shall also have the right to possession of the child/ren as follows, notwithstanding the weekend and midweek periods of possession ordered for Co-parent and regardless of the distance between the residence of a parent and the child:

Child’s Birthdays

The Parent who does not already have a scheduled visit on the child’s birthday shall have the right to possession of the child on the child’s birthday, from 6 p.m. to 8 p.m., provided he or she picks up the child from the residence of the parent entitled to possession, and returns the child to the same place.

(Check here only if you want to include the child’s minor siblings for this birthday visit.)

This visit shall include the child’s minor siblings.

Father’s Day

If a conservator, the Father shall have possession of the child/ren on Father’s Day weekend, provided he picks up the child/ren from the residence of the parent entitled to possession, and returns the child/ren to the same place.

The weekend starts Friday before Father’s Day at 6 p.m. and ends at:

6 p.m. Sunday or 8 a.m. on the Monday after Father’s Day

Mother’s Day

If a conservator, the Mother shall have possession of the child/ren on Mother’s Day weekend, provided she picks up the child/ren from the residence of the parent entitled to possession, and returns the child/ren to the same place.

The weekend starts Friday before Mother’s Day at 6 p.m. and ends at: 6 p.m. Sunday or 8 a.m. on the Monday after Mother’s Day

4. General terms and Conditions

Except as otherwise expressly provided in this standard Possession Order, the following terms and conditions apply regardless of the distance between the residence of a parent and the child:

Exchange of Children at Start of Co-parent’s Possession

The Court ORDERS the Home Parent to surrender the child/ren to the Co-Parent at the beginning of Co- parent’s possession at: (Check one.)

Home parent’s residence.

Co-Parent’s residence.

The following location: ______________________________________________________________

If a period of possession begins at the time the child/ren’s school is regularly dismissed, the Court ORDERS the Home parent to surrender the child to Co-parent at the beginning of each such period of possession at the school in which the child is enrolled.

If the child is not in school, Co-parent shall pick up the child at the location designated above and the Court ORDERS the Home parent to surrender the child to Co-parent at the location designated above at 6 pm.

If the children will not be in school, the Home-Parent shall immediately notify the Co-Parent.

Exchange of Children at End of Co-Parent’s Possession

The Court ORDERS the Co-Parent to surrender the child/ren to the Home Parent at the end of Co- Parent’s possession at: (Check one.)

Home parent’s residence.

Co-Parent’s residence.

The following location: _____________________________________________________________

However, if the Home Parent and Co-Parent live in the same county when the order is signed and the Co-Parent remains in the county, but the Home Parent moves out of the county, then beginning on the date Home Parent moves, Co-Parent shall return the child/ren to the Home parent at: (Check one.)

Co-Parent’s residence.

the location designated above.

If a period of possession ends at the time the child/ren’s school resumes, the Court ORDERS the Co- Parent to surrender the child/ren to Home Parent at the end of each such period of possession at the school in which the child is enrolled or, if the child is not in school, at the residence of Home Parent at 7 a.m.

If the child/ren will not be delivered to school on that day, Co-Parent shall immediately notify the school and Home Parent that the child/ren will not or has not been returned to school.

Child/ren’s Personal Effects

The Court ORDERS each conservator to return with the child/ren the personal effects that the child brought at the beginning of the period of possession.

Designation of Competent Adult

Each conservator may designate any competent adult to pick up and return the child/ren, as applicable. The Court ORDERS that a conservator or designated competent adult be present when the child/ren is/are picked up or returned.

Notice if Unable to Exercise Possession

The Court ORDERS each conservator to give notice to the person in possession of the child on each occasion that the conservator will be unable to exercise that conservator’s right of possession for any specified period.

Written Notice

Written notice shall be deemed to have been timely made if received or postmarked before or at the time that notice is due.

5. Warnings —

FAILURE TO OBEY A COURT ORDER FOR CHILD SUPPORT OR FOR POSSESSION OF OR ACCESS TO A CHILD MAY RESULT IN FURTHER LITIGATION TO ENFORCE THIS ORDER, INCLUDING CONTEMPT OF COURT. A FINDING OF CONTEMPT MAY BE PUNISHABLE BY CONFINEMENT IN JAIL FOR UP TO SIX MONTHS, A FINE OF UP TO $500 FOR EACH VIOLATION, AND A MONEY JUDGMENT FOR PAYMENT OF ATTORNEY’S FEES AND COURT COSTS.

FAILURE OF A PARTY TO MAKE A CHILD SUPPORT PAYMENT TO THE PLACE AND IN THE MANNER REQUIRED BY A COURT ORDER MAY RESULT IN THE PARTY’S NOT RECEIVING CREDIT FOR MAKING THE PAYMENT.

FAILURE OF A PARTY TO PAY CHILD SUPPORT DOES NOT JUSTIFY DENYING THAT PARTY COURT-ORDERED POSSESSION OF OR ACCESS TO A CHILD. REFUSAL BY A PARTY TO ALLOW POSSESSION OF OR ACCESS TO A CHILD DOES NOT JUSTIFY FAILURE TO PAY COURT- ORDERED CHILD SUPPORT TO THAT PARTY.

EACH PERSON WHO IS A PARTY TO THIS ORDER IS ORDERED TO NOTIFY EVERY OTHER PARTY, THE COURT, AND THE STATE CHILD SUPPORT REGISTRY OF ANY CHANGE IN THE PARTY’S CURRENT RESIDENCE ADDRESS, MAILING ADDRESS, HOME TELEPHONE NUMBER, NAME OF EMPLOYER, ADDRESS OF EMPLOYMENT, DRIVER’S LICENSE NUMBER, AND WORK TELEPHONE NUMBER. THE PARTY IS ORDERED TO GIVE NOTICE OF AN INTENDED CHANGE IN ANY OF THE REQUIRED INFORMATION TO THE OTHER PARTY, THE COURT, AND THE STATE CASE REGISTRY ON OR BEFORE THE 60TH DAY BEFORE THE INTENDED CHANGE. IF THE PARTY DOES NOT KNOW OR COULD NOT HAVE KNOWN OF THE CHANGE IN SUFFICIENT TIME TO GIVE NOTICE OF THE CHANGE TO PROVIDE 60-DAYS NOTICE, THE PARTY IS ORDERED TO GIVE NOTICE OF THE CHANGE ON OR BEFORE THE 5TH DAY AFTER THE DATE THAT THE PARTY KNOWS OF THE CHANGE.

THE DUTY TO FURNISH THIS INFORMATION TO EVERY OTHER PARTY, THE COURT, AND THE STATE CASE REGISTRY CONTINUES AS LONG AS ANY PERSON, BY VIRTUE OF THIS ORDER, IS UNDER AN OBLIGATION TO PAY CHILD SUPPORT OR ENTITLED TO POSSESSION OF OR ACCESS TO A CHILD.

FAILURE BY A PARTY TO OBEY THE ORDER OF THIS COURT TO PROVIDE EVERY OTHER PARTY, THE COURT, AND THE STATE CASE REGISTRY WITH THE CHANGE IN THE REQUIRED INFORMATION MAY RESULT IN FURTHER LITIGATION TO ENFORCE THE ORDER, INCLUDING CONTEMPT OF COURT. A FINDING OF CONTEMPT MAY BE PUNISHABLE BY CONFINEMENT IN JAIL FOR UP TO SIX MONTHS, A FINE OF UP TO $500 FOR EACH VIOLATION, AND A MONEY JUDGMENT FOR PAYMENT OF ATTORNEY’S FEES AND COURT COSTS.

NOTICE SHALL BE GIVEN TO EVERY OTHER PARTY BY DELIVERING A COPY OF THE NOTICE TO EACH PARTY BY REGISTERED OR CERTIFIED MAIL, RETURN RECEIPT REQUESTED. NOTICE SHALL BE GIVEN TO THE COURT AND THE STATE CASE REGISTRY BY DELIVERING A COPY OF THE NOTICE EITHER IN PERSON TO THE CLERK OF THE COURT OR BY REGISTERED OR CERTIFIED MAIL ADDRESSED TO THE CLERK.

NOTICE TO ANY PEACE OFFICER OF THE STATE OF TEXAS: YOU MAY USE REASONABLE EFFORTS TO ENFORCE THE TERMS OF CHILD CUSTODY SPECIFIED IN THIS ORDER.

A PEACE OFFICER WHO RELIES ON THE TERMS OF A COURT ORDER AND THE OFFICER’S AGENCY ARE ENTITLED TO THE APPLICABLE IMMUNITY AGAINST ANY CLAIM, CIVIL OR OTHERWISE, REGARDING THE OFFICER’S GOOD FAITH ACTS PERFORMED IN THE SCOPE OF THE OFFICER’S DUTIES IN ENFORCING THE TERMS OF THE ORDER THAT RELATE TO CHILD CUSTODY.

ANY PERSON WHO KNOWINGLY PRESENTS FOR LAW ENFORCEMENT AN ORDER THAT IS INVALID OR NO LONGER IN EFFECT COMMITS AN OFFENSE THAT MAY BE PUNISHABLE BY CONFINEMENT IN JAIL FOR AS LONG AS TWO YEARS AND A FINE OF AS MUCH AS $10,000.

This concludes the Possession (Visitation) Order.

After that, the person ordered to pay child support is ORDERED to pay:

After that, the person ordered to pay child support is ORDERED to pay:

After that, the person ordered to pay child support is ORDERED to pay:

4.Person Ordered to Receive Child Support (Obligee)

IT IS ORDERED that child support is payable to ________________________________________,

(Name of person to receive child support)

but must be sent to the place of payment listed below.

5.Place of Payment

The person ordered to pay child support is ORDERED to send all child support payments to the Texas Child Support State Disbursement Unit, PO Box 659791, San Antonio, TX 78265, for distribution according to law.

Include the following information with each payment:

Name of person ordered to pay child support, and

Name of person ordered to receive child support, and

Cause Number and County of Decree or Order, and

Attorney General Case Number, if applicable.

6.No Credit for Informal Payments

IT IS ORDERED that money paid by the person ordered to pay child support directly to the person ordered to receive child support or spent while in possession of the children does NOT count as child support and shall be deemed in addition to and not instead of the support ordered in this order.

7.Guideline or Non-Guideline Support

Check Guideline Support if the child support amount or amounts listed are based on the guidelines set out in Texas Family Code, Chapter 154, Subchapter C.

Check and complete Non-Guideline Support, if the child support amount or amounts listed are not based on the statutory guidelines.

Guideline Support: The amount of child support is approximately the amount recommended in the Texas Family Code Guidelines, Chapter 154.

Non-Guideline Support: The amount of child support differs significantly from the amount recommended in the Texas Family Code Guidelines, Chapter 154. The court finds that guideline support would be unjust or inappropriate under the circumstances because (explain):

_________________________________________________________________________________________

_________________________________________________________________________________________

_________________________________________________________________________________________

The net monthly income (from all sources) of the person paying child support is $ ______________. The net monthly income (from all sources) of the person receiving child support is $ ____________.

Actual monthly child support is $_______________, which is_______ % of the paying person’s net monthly income.

8.Child Support Account / Fees Each party is ORDERED to:

Fill out any forms necessary to set up a child support account, and

Take the forms to the local Domestic Relations Office or county child support liaison within 5 days after the judge orders child support, and

Pay when due, all fees charged to that party by the state disbursement unit and any other agency authorized by law to a charge a fee.

9.Income Withholding

IT IS ORDERED that any employer of the person ordered to pay child support is ordered to withhold child support from the person’s disposable earnings.

If an income withholding for support order is served on the employer of the person ordered to pay child support, the employer shall withhold child support payments from the employee’s pay, and send it to the Texas Child Support State Disbursement Unit, PO Box 659791, San Antonio, TX 78265, where the payments shall be recorded, and forwarded to the person ordered to receive child support. All child support withheld and paid in accordance with this order shall be credited against the child support obligation.

If the employer withholds less than 100% of the child support ordered, the person ordered to pay child support is ORDERED to send the balance owed to the Texas Child Support State Disbursement Unit, PO Box 659791, San Antonio, TX 78265.

If an income withholding for support order is not served on the employer, or if the person paying child support is self-employed or unemployed, the person ordered to pay child support is ORDERED to send all child support payments to the Texas Child Support State Disbursement Unit, PO Box 659791, San Antonio, TX 78265.

IT IS ORDERED that the Clerk of this Court shall cause a certified copy of the income withholding for support order to be delivered to any employer of the person ordered to pay child support, if asked to do so by the person ordered to pay or receive child support, a prosecuting attorney, the title IV-D agency, a friend of the Court, or a domestic relations office.

10.Suspension of Income Withholding

Check here if all parties agree not to have the employer withhold child support payments at this time.

The parties agree, and the Court ORDERS that an income withholding for support order shall not be served on the employer unless: 1) child support payments are more than 30 days late, 2) the past due amount is the same or more than the monthly child support amount, 3) another violation of this child support order occurs or 4) the Office of the Attorney General Child Support Division is providing services to the person ordered to receive child support. The person ordered to pay child support is ORDERED to send all child support payments to the Texas Child Support State Disbursement Unit, PO Box 659791, San Antonio, TX 78265, where the payment will be recorded, and forwarded to the person ordered to receive child support.

11.Child Support After Death

If the person ordered to pay child support dies before this child support order ends, any unpaid child support shall become the obligation of his or her estate.

12.Life Insurance Policy

Check here if the person ordered to pay child support should also be ordered to maintain a life insurance policy for as long as child support is ordered.

As additional child support, the person paying child support under this order is ORDERED to obtain and maintain a life insurance policy on his or her life for as long as child support is ordered. The value of the policy shall be at least as much as the total child support obligation. The person receiving child support under this order must be named as the primary beneficiary for the benefit of the children.

13.Required Notices

EACH PERSON WHO IS A PARTY TO THIS ORDER IS ORDERED TO NOTIFY EVERY OTHER PARTY, THE COURT, AND THE STATE CHILD SUPPORT REGISTRY OF ANY CHANGE IN THE PARTY’S:

CURRENT RESIDENCE ADDRESS,

MAILING ADDRESS,

HOME TELEPHONE NUMBER,

NAME OF EMPLOYER,

ADDRESS OF EMPLOYMENT,

DRIVER’S LICENSE NUMBER, AND

WORK TELEPHONE NUMBER.

THE PARTY IS ORDERED TO GIVE NOTICE OF AN INTENDED CHANGE IN ANY OF THE REQUIRED INFORMATION TO THE OTHER PARTY, THE COURT, AND THE STATE CASE REGISTRY ON OR BEFORE THE 60TH DAY BEFORE THE INTENDED CHANGE. IF THE PARTY DOES NOT KNOW OR COULD NOT HAVE KNOWN OF THE CHANGE IN SUFFICIENT TIME TO GIVE NOTICE OF THE CHANGE TO PROVIDE 60-DAYS NOTICE, THE PARTY IS ORDERED TO GIVE NOTICE OF THE CHANGE ON OR BEFORE THE 5TH DAY AFTER THE DATE THAT THE PARTY KNOWS OF THE CHANGE.

THE DUTY TO FURNISH THIS INFORMATION TO EVERY OTHER PARTY, THE COURT, AND THE STATE CASE REGISTRY CONTINUES AS LONG AS ANY PERSON, BY VIRTUE OF THIS ORDER, IS UNDER AN OBLIGATION TO PAY CHILD SUPPORT OR ENTITLED TO POSSESSION OF OR ACCESS TO A CHILD.

FAILURE BY A PARTY TO OBEY THE ORDER OF THIS COURT TO PROVIDE EVERY OTHER PARTY, THE COURT, AND THE STATE CASE REGISTRY WITH THE CHANGE IN THE REQUIRED INFORMATION MAY RESULT IN FURTHER LITIGATION TO ENFORCE THE ORDER, INCLUDING CONTEMPT OF COURT. A FINDING OF CONTEMPT MAY BE PUNISHABLE BY CONFINEMENT IN JAIL FOR UP TO SIX MONTHS, A FINE OF UP TO $500 FOR EACH VIOLATION AND A MONEY JUDGMENT FOR PAYMENT OF ATTORNEY’S FEES AND COURT COSTS.

Notice shall be given to every other party by delivering a copy of the notice to each party by registered or certified mail, return receipt requested.

Notice shall be given to the Court by delivering a copy of the notice either in person to the clerk of the Court or by registered or certified mail addressed to the clerk.

Notice shall be given to the State Case Registry by mailing a copy of the notice to the State Case Registry, Contract Services Section, MC046S, P.O. Box 12017, Austin, Texas 78711-2017.

14.WARNINGS TO PARTIES

FAILURE TO OBEY A COURT ORDER FOR CHILD SUPPORT OR FOR POSSESSION OF OR ACCESS TO A CHILD MAY RESULT IN FURTHER LITIGATION TO ENFORCE THIS ORDER, INCLUDING CONTEMPT OF COURT. A FINDING OF CONTEMPT MAY BE PUNISHABLE BY CONFINEMENT IN JAIL FOR UP TO SIX MONTHS, A FINE OF UP TO $500 FOR EACH VIOLATION AND A MONEY JUDGMENT FOR PAYMENT OF ATTORNEY’S FEES AND COURT COSTS.

FAILURE OF A PARTY TO MAKE A CHILD SUPPORT PAYMENT TO THE PLACE AND IN THE MANNER REQUIRED BY A COURT ORDER MAY RESULT IN THE PARTY’S NOT RECEIVING CREDIT FOR MAKING THE PAYMENT.

FAILURE OF A PARTY TO PAY CHILD SUPPORT DOES NOT JUSTIFY DENYING THAT PARTY COURT-ORDERED POSSESSION OF OR ACCESS TO A CHILD. REFUSAL BY A PARTY TO ALLOW POSSESSION OF OR ACCESS TO A CHILD DOES NOT JUSTIFY FAILURE TO PAY COURT-ORDERED CHILD SUPPORT TO THAT PARTY.

Exhibit: Medical Support Order

Warning! If you disobey a Court order to pay for or provide health insurance for the children, the law says you will have to pay for ALL needed and reasonable health costs, even if those costs would not have been covered by an insurance policy.

The Court makes the following orders:

1. Insuring Parent

IT IS ORDERED that ______________________________________________________________

(Name of person to pay health insurance/ medical support, Insuring Parent)

must pay for and provide health insurance / medical benefits for the children listed in the attached Decree or Order, in the manner described below, until one of the following conditions is met for each child, or one of the following events occurs:

Conditions

The child turns 18 and graduates from high school, or

The child has turned 18, and is not meeting the attendance requirements of a high school or other secondary school leading toward a high school diploma, or

The child marries, dies, or is emancipated by court order, or

The child begins active duty in the US armed forces, or

Events

The child’s parents marry each other and live with the child, or

The court changes this order.

The medical benefits must include doctor services, office visits, hospitalization, laboratory, X-ray, and emergency services.

2. Insurance / Medical Benefits

The Insuring Parent IS ORDERED to pay for and enroll the children in a health insurance policy offered through either parent’s work or membership in a union or organization, if it is available at a reasonable cost (not more than 9% of his/her annual resources), and it provides doctor services, office visits, hospitalization, laboratory, X-ray, and emergency services.

If the Insuring Parent obtains health insurance through the other parent’s work or membership in an organization, that other parent is ordered to include the child in his or her health insurance. The Insuring Parent is ordered to reimburse the other parent for the actual cost of insuring the children in this case, as described below.

If insurance is not available through either parent’s work or membership in a union or organization at a reasonable cost, the Insuring Parent IS ORDERED to get insurance / medical benefits for the children using any of these options:

1.Buy an individual policy to cover the children, and give the other parent the required health insurance information listed below, or

2.Get public health insurance. (For information, contact TexCare Partnership: 1-800-647-6558, www.texcarepartnership.com), or

3.Give the other parent $_____________/ per month in medical support for the children’s health expenses. Payments must be (check one):

Mailed to the Child Support State Disbursement Unit on the1st day each month, or Withheld by the Insuring Parent’s Employer.

The Insuring Parent is not required to make these payments if he or she obtains health insurance for the child and provides proof of insurance to the other parent, and any other party to the case.

3. Information to be Provided

The Insuring Parent must give the other parent the following information, within 30 days of the date of this Order:

Name of the health insurance company, policy number, copy of the policy, and a list of covered benefits,

Proof that the children are covered under this policy,

A health insurance membership card, claim forms, and any other information needed to submit a claim, if applicable,

The Insuring Parent’s Social Security Number and name and address of the Insuring Parent’s employer and the type of insurance available through his/her employment.

4.Notice of Changes to Insurance / Medical Benefits

1.If the insurance benefits are renewed, cancelled, or changed in any way, the Insuring Parent must send the new information to the other parent within 15 days of the change.

2.If the Insuring Parent is no longer eligible for coverage, s/he must provide other health insurance within 10 days of losing coverage. The new insurance must provide as much, or more, coverage for the children.

5.Reimbursement for Actual Cost to Insure Children in this Case

If the Insuring Parent obtains health insurance for the children through the other parent's employment, the Insuring Parent must reimburse the other parent the actual cost of insuring the children in this case (but not more than 9% of the Insuring Parent's annual resources).

If the other parent has other children covered by the same health insurance plan, determine the actual cost of insuring the children in this case by doing this: Divide the total cost of insuring all children covered by the plan by the total number of children insured. Then, multiply that number by the number of children in this case.

The Insuring Parent is ORDERED to pay the actual cost of the health insurance for the children as additional child support, with the first payment of $__________ due on the first day of the first month after

this Decree is signed, and a like payment due on the first day of each month thereafter, until there is a change in the actual cost of the health insurance for the children in this case.

Starting on the first day of the month after each change in the actual cost of health insurance for the children in this case, the Insuring Parent is ordered to pay the other parent the actual cost of insuring the children, and must continue to make like monthly payments on the first day of each month thereafter until there is another change in the actual cost of health insurance for the children in this case.