Texas Law Help Form – Fill Out and Use This PDF

TexasLawHelp Divorce Forms Set B (children together)

Use these Texas divorce forms if:

●you and your spouse have children who are under 18 or still in high school and

●there are no court orders about the children.

Note: If you have a family violence protective order that includes orders about the children, you should still use Form Set B. Attach a copy of the protective order to your Original Petition for Divorce.

Be sure to read How to File an Uncontested Divorce first! You may not need all of the forms listed or you may need additional forms.*

1. How to File an Uncontested Divorce Read this first!

2.Unsworn Declaration of Indigency (Request for Fee Waiver)

3.Original Petition for Divorce

4.Waiver of Service Only (Specific Waiver)

5.Respondent’s Original Answer

6.Final Decree of Divorce

7.Notice of Current Address

8.Out-of-State Parent Affidavit

9.Income Withholding Order for Support

10.Sample Testimony – Divorce With Children

*Additional forms are available at: www.texaslawhelp.org/resource/divorce-with- children-in-texas-1.

How to File an Uncontested Divorce

These instructions explain the steps in a simple, uncontested Texas divorce. Use them with the FREE do-it-yourself divorce forms at www.TexasLawHelp.org.

These instructions are written for people who are “pro se.” Pro se means you don’t have a lawyer.

These instructions are not a substitute for the advice and help of a lawyer. It’s a good idea to talk to a lawyer about your particular situation before filing or responding to a divorce.

Is Your Divorce Uncontested?

Your divorce is uncontested when it is:

agreed – you and your spouse agree about all the issues in your case OR

default – your spouse is given legal notice of your divorce by Official Service of Process, Publication or Posting and does not file an Answer or Waiver of Service with the Court or otherwise appear in the case.

If your divorce is contested, it is best to talk to a lawyer before filing any forms with the Court.

Steps for an Uncontested Texas Divorce

A full description of each step follows. Carefully read all the steps before you begin.

Step 1: Get help if there has been violence or you feel unsafe.

●It’s not a good idea to do your own divorce, without a lawyer, when there has been family violence. Family violence includes physical violence and sexual assault. It can also include threats of violence. You do not need to have called the police or sought medical care to be the victim of family violence.

●If you or your children have been the victim of family violence or if at any time you feel unsafe, get help by calling the:

O National Domestic Violence Hotline at 1-800-799-SAFE (7233) or O Texas Family Violence Legal Line at 1-800-374-HOPE (4673)

Step 2: Talk to a lawyer about your particular situation.

●Divorce cases can be complicated and your property, your money and your rights as a parent may be at risk. Even if you decide to represent yourself, you should see a lawyer for legal advice about your particular situation before filing anything,

●It’s really important to talk to a lawyer if:

O you’re afraid for your or your children’s safety, or

O your case is contested, or

O your spouse has a lawyer, or

O you or your spouse has a house, retirement, business, other valuable property or a lot of debt. Talking to a lawyer now, can save you time and money in the long run.

●Need help finding a lawyer? For referral to a lawyer, or if you have a low income to a free Legal Aid program, call the Lawyer Referral Information Service at 1-800-252-9690. Or, go to www.TexasLawHelp.org and click on “Find Legal Help.”

●Just want advice? You can hire a lawyer just to give you advice, review your forms, draft a document or help you prepare for a hearing. This is called limited scope representation. You may then be able to handle the other parts of your divorce yourself.

Go to http://texaslawhelp.org/resource/limited-scope-representation?ref=U6Rdg for more information about limited scope representation.

Do Not Use the TexasLawHelp Divorce Forms if:

OYou or your spouse have an ongoing bankruptcy case.

OYou want to file specific grounds for divorce, such as cruelty or adultery.

OYou want spousal maintenance, referred to as “alimony” in some states.

OYou and your spouse have a disabled child.

Step 3: Determine where to file.

●Information for Military Families: If you are serving in the armed forces outside of Texas or other government service outside of Texas or you have accompanied your spouse who is serving in the armed forces or other government service outside of Texas, you may still file for divorce in Texas if Texas has been the home state of either you or spouse for at least 6 months and the county where you plan to file the divorce has been the home county of either spouse for at least 90 days. Time spent away while serving in the armed forces or other government service counts as time spent in Texas and your home county. See Texas Family Code Section 6.303.

●Information for Immigrants: You may file for divorce in Texas even if you do not have legal status in the United States, as long as you or your spouse has lived in Texas for at least the last 6 months and in the county where you want to file for divorce for at least the last 90 days.

Things to consider…

Things to consider…

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Step 4: Choose a divorce form set.

●Choose one of the following divorce form sets at www.TexasLawHelp.org. Each set includes multiple forms that you or your spouse will need to fill out and file with (turn in to) the Court. The forms are described on the following page.

O Texas Supreme Court Divorce Form SET 1 (no children, no real property)

Use these forms if there are:

●no minor children and

●no real property (house or land).

These forms are approved for use throughout Texas by the Texas Supreme Court.

These forms come with different instructions.

O TexasLawHelp Divorce Form SET A (no children together)

Use these forms if:

●you and your spouse do not have children who are under 18 or still in high school.

OTexasLawHelp Divorce Form SET B (children together)

Use these forms if:

●you and your spouse have children who are under 18 or still in high school and

●there are no court orders regarding the children.

Note: If you have a family violence protective order that includes orders regarding the children, you should still use SET B.

O TexasLawHelp Divorce Form SET C (children together with final court order)

Use these forms if:

●you and your spouse have children together who are under 18 or still in high school and

●there is a final court order for custody and support of your children in place and you do not want to change that order.

Note: Do not use the TexasLawHelp divorce forms if you have a court order but: 1) it does not include all the children you and your spouse have together, 2) the order is a temporary order, or 3) you are asking the court to make changes to the order. If one of these situations applies, ask a lawyer to draft the appropriate forms for your case.

Things to consider…

Things to consider…

if you and your spouse don’t agree on child support.

●if you and your spouse don’t agree on child support.

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Once there is a final court order for custody and support of your children, you may use the

Once there is a final court order for custody and support of your children, you may use the TexasLawHelp Divorce SET C for your divorce.

TexasLawHelp Divorce SET C for your divorce.

For information about opening a case with the OAG call 1-800-255-8014 or go to their website For information about opening a case with the OAG call 1-800-255-8014 or go to their website at at www.oag.state.tx.us/cs.

www.oag.state.tx.us/cs.

Step 5: Fill out the Original Petition for Divorce.

●After you choose a divorce form set, fill out the Original Petition for Divorce form.

→You are the “Petitioner.” Your spouse is the “Respondent.”

→Fill out all the spaces unless instructed otherwise. Print clearly in blue or black ink.

Note: The Petition asks for your address. Your spouse will get a copy of this form. If you are concerned about your spouse knowing your address, call the Family Violence Legal Line at 1- 800-374-4673 for free advice.

●Fill out the Information on Suit Affecting the Family Relationship form.

●Fill out these additional beginning forms only if they apply to your case:

OAffidavit of Indigency – only if you can’t pay the filing fee for your divorce. Call the clerk’s office to learn the fee for your case.

Note: Do not sign this form until you are in front of a notary. Or, if you don’t have the necessary picture identification to get this form notarized attach a completed Unsworn Declaration form. If you receive public benefits (such as foodstamps) attach proof.

OExhibit: Out-of-State Party Affidavit – only if 1) you are filing a Divorce SET B and 2) you or your spouse live outside of Texas.

OAffidavit for Service by Posting or Publication – only if you can’t find your spouse after looking really hard. Read Step 7C for more information.

●Make 2 copies of each form you filled out.

Thingstotoconsider……

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Line at 1-800-374-HOPE or the National Domestic Violence Hotline at 1-800-799-SAFE. Line at 1-800-374-HOPE or the National Domestic Violence Hotline at 1-800-799-SAFE.

Step 6: File (turn in) your Original Petition for Divorce.

● File (turn in) your completed Original Petition for Divorce and additional beginning forms to the Court either in person or electronically.

OTo file your forms in person, take the original and 2 copies of your

forms to the courthouse and turn them in at the clerk’s office.

You may use the Texas Civil Courts Guide at www.TexasLawHelp.org to find the address and phone number for the clerk’s office in the county where you plan to file your divorce.

OTo file your forms electronically go to http://www.efiletexas.gov.

●Pay the filing fee (or file your Affidavit of Indigency form if you cannot afford the fee).

●Ask the clerk if there are local rules or procedures you need to know about for your divorce.

●The clerk will:

Owrite your “Cause Number” and “Court Number” at the top of the first page of your Petition. (You should write these numbers at the top of any document you file in your divorce.)

O“file-stamp” your papers with the date and time.

Oask if you want to have your spouse “served.” Served is when your spouse is given legal notice of your divorce by Official Service of Process or by Posting or Publication.

If your spouse will agree to sign a Waiver of Service or Answer, you do not need to have your spouse served. Follow the instructions set out in Step 7A.

If your spouse will not agree to sign a Waiver of Service or Answer, you must have your spouse served by Official Service of Process. Follow the instructions set out in Step 7B.

If you can’t find your spouse, you must have your spouse served by Posting or Publication. Follow the instructions set out in Step 7C.

Things to consider…

●if your children get Medicaid or TANF or got it in the past.

You MUST send a file-stamped copy of your Original Petition for Divorce to the Office of the Attorney General Child Support Division by commercial delivery, fax, email, personal delivery or through the electronic filing manager if:

1)you and your spouse have children together and

2)the children get Medicaid or TANF or got it in the past. See Texas Family Code Section 6.301.

Get contact information for the Attorney General child support office in your area at www.oag.state.tx.us/cs/fieldoffices.php. Bring proof of delivery when you go to court.

●if you and your spouse don’t agree.

If you and your spouse don’t agree on the terms of your divorce, you may want to consider mediation. In mediation, an independent person (the mediator) will try to help you reach an agreement. The divorce process is usually easier when you have an agreement. Be sure to talk to a lawyer first. A lawyer can help you understand your options and negotiate a fair agreement.

Step 7: Give “legal notice” to your spouse.

●Your spouse has the right to know that you have filed for divorce. You cannot simply tell your spouse or send your spouse a letter. You must use a legally acceptable way to give your spouse notice and prove to the Court that you did so.

●Here are 3 ways to give “legal notice” to your spouse:

7A - Waiver of Service or Answer (Use this way if your divorce is AGREED.)

7B - Official Service of Process (Use this way if your divorce is NOT AGREED.)

7C - Posting or Publication (Use this way if you can’t find your spouse.)

●Each way to give legal notice is described below. Choose the way that bests fits your situation.

7A. Waiver of Service or Answer (Use this way if your divorce is AGREED.)

●You may give your spouse legal notice by Waiver of Service or Answer if

your spouse agrees to sign the Waiver of Service Only (Specific Waiver) form or the Respondent’s Original Answer form.

● Follow these steps:

1. Mail or hand-deliver to your spouse:

a)a file-stamped copy of your Original Petition for Divorce, and

b)a blank Waiver of Service Only (Specific Waiver) or Respondent’s Original Answer form.

2.If your spouse plans to sign the Waiver of Service Only (Specific Wavier) form, tell him or her to sign it in front of a notary at least one day after you filed the Petition. Otherwise your spouse will have to redo it.

3.File the completed Waiver of Service form or Answer form at the courthouse.

TIP: If your divorce is agreed, your spouse must also sign a completed Final Decree of Divorce (Decree) form. It may save you time to fill out the Decree now and send it to your spouse with the Waiver of Service Only (Specific Waiver) or Respondent’s Original Answer form. You may also wait until later in the process to fill-out the Decree.

Warning: Do not hand-deliver any papers to your spouse if there has been violence during your relationship, especially if a judge has signed a Protective Order ordering you or your spouse to stay away from the other. Mail or give legal notice by Official Service of Process instead.

7B. Official Service of Process (Use this way if your divorce is NOT AGREED.)

●Official Service of Process is when your spouse is formally given legal notice of your divorce by a constable, sheriff, private process server or the clerk.

●Give legal notice by Official Service of Process if your spouse will not sign the Waiver of Service or Answer form or you do not want to have personal contact with your spouse.

●Follow these steps to give legal notice by Official Service of Process:

1.Tell the clerk where you filed your Petition that you want to have your spouse “served.” The clerk will print a form called the “Citation” that tells your spouse you have filed for divorce. The clerk will attach a copy of your Petition to the Citation.

3.If you choose personal service, send the Citation (with a copy of your Petition attached) to a constable, sheriff or private process server in the county where your spouse will be served.

4.The constable, sheriff, private process server or clerk will fill out a Return of Service form. Make sure the Return of Service form is filed at the courthouse.

7C - Posting or Publication (Use this way if you can’t find your spouse.)

●If you can’t find your spouse, you must give your spouse legal notice by posting or publication depending on your case. Find forms and instructions for service by posting and publication at www.TexasLawHelp.org.

Step 8: Fill out the Final Decree of Divorce.

●Fill out the Final Decree of Divorce form. Get information about property division, conservatorship (custody), possession (visitation), child support and medical support at:

www.TexasLawHelp.org,

the Family Law Handbook at www.hba.org, and

the Pro Se Divorce Handbook at www.tyla.org.

●Fill out the Income Withholding for Support Order form if child support will be ordered.

●If possible, have a lawyer review your completed forms. This is really important if you and your spouse have children together, own valuable property, have retirement accounts, a house or land, a business or a lot of debt. Remember, you can hire a lawyer just to review your forms.

Things to consider…

●if you and your spouse have debts together. A creditor’s right to collect a debt is not affected by a divorce decree. So, if the Court orders your spouse to pay a debt that is in both your names (such as a car loan) but your spouse doesn’t pay it, the creditor can still seek payment from you. Ask a lawyer how to protect yourself in this situation.

●if you and your spouse own (or are purchasing) a house or land. Not talking to a lawyer when you and your spouse have a house or land can be VERY costly. For example:

→You could lose ownership of the property and still be responsible for the mortgage. A mortgage company’s right to payment is not affected by a divorce decree. So, if you and your spouse are on the mortgage and the divorce decree gives the house or land to your spouse and your spouse does not pay the mortgage, the mortgage company can still seek payment from you. This is true even if the Court ordered your spouse to pay the mortgage. A lawyer can help you figure out how to protect yourself in this situation.

→You could be unable to enforce an agreement or order that your spouse pay you part of the value of your house or land. An order for one spouse to pay the other spouse part of the value (equity) in a house or land should usually be secured by a lien on the property. If it’s not, you may not be able to get the money awarded to you. A lawyer can help you with this.

→You could be unable to sell the property later. If you are keeping the property, a Special Warranty Deed should usually be signed by your spouse and filed with the property records office. If that doesn’t happen, you could have trouble selling the property later.

●if you or your spouse have a retirement account, such as a 401k account, pension plan, deferred compensation account or IRA account. Retirement earned by either spouse during the marriage is usually considered to be community property that can be divided by the court. This is true even if you or your spouse has not yet retired. If you want the Court to divide retirement benefits (other than an IRA) as part of your divorce, you must ask the Court to sign an additional form, usually called a Qualified Domestic Relations Order or QDRO. You should have the QDRO prepared before you go to court, so the judge can sign it when you finish your divorce.

A QDRO form is not included with the TexasLawHelp divorce sets. You may contact the employer or retirement plan administrator to see if they have a sample QDRO form. If not, you should hire a lawyer to draft the QDRO form. If you use the employer or plan administrator’s form, you should still have a lawyer review it to make sure you are not giving up important benefits.

Step 9: Wait the required waiting periods.

● Wait the waiting periods that apply to your case.

61 day waiting period 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 fewer than 61 days. When counting the 61 days, find the day you filed your Original Petition for Divorce on a calendar, and then count out 61 more days (including weekends). Note: Victims of family violence may be able to finish their divorce earlier. Call 1-800-374-4673 to get free advice from a lawyer.

20 + day answer period (default cases only) If you gave your spouse legal notice by Official Service of Process or Publication, your spouse must have at least 20 days plus the next Monday at 10 a.m. to file an Answer. Find the day your spouse was served on a calendar, count out 20 more days, then go to the next Monday. This is the last day of your spouse’s answer period. However, if your spouse files an Answer any time before you finish your divorce it will still count. The answer period may or may not fall within the 61 day waiting period. Note: If your spouse was served by Posting, he or she must have at least 27 days plus the next Monday at 10 a.m. to file an Answer.

12 day waiting period (default cases only) If you gave your spouse legal notice by Official Service of Process, Posting or Publication, the constable, sheriff, private process server or clerk will complete a Return of Service form stating when your spouse was served. The Return of Service form must be filed with the court where you filed your Original Petition for Divorce at least 12 days before your final hearing.

Step 10: Confirm your case is uncontested & get ready for court.

●Your divorce is UNCONTESTED when it is:

AGREED – you and your spouse agree about all the issues in your case or

DEFAULT – you gave your spouse legal notice of the divorce by Official Service of Process, Posting or Publication and your spouse did not file an Answer or Waiver of Service (or any other written response) with the Court or appear at a hearing.

●If your divorce is AGREED:

O Ask your spouse to review and sign the completed Final Decree of Divorce. O Make sure the Decree is completely filled out before your spouse signs it.

O If your spouse will not sign the Final Decree of Divorce your divorce is CONTESTED.

●If your divorce is a DEFAULT:

O Your spouse does not need to sign the Final Decree of Divorce.

O Fill out these additional final forms. Get them at www.TexasLawHelp.org.

→Certificate of Last Known Address

→Military Status Affidavit

→Statement of Evidence (only if your spouse was served by Posting or Publication.)

●Your divorce is CONTESTED if your spouse filed a Waiver of Service or Answer and will not sign the Final Decree of Divorce. To finish your divorce, you must set your case for a contested final hearing and give your spouse at least 45 days notice of the final hearing. Remember: It’s always best to have a lawyer if your case is contested.

Step 11: Go to court to finish your divorce.

●If your case is uncontested (agreed or default) and the waiting periods have passed, call the clerk to find out when and where the court hears uncontested divorce cases.

●You will need to give testimony to the judge when you go to court. Find sample scripts – called “prove up” testimony – at www.TexasLawHelp.org. Read the script ahead of time. Make sure everything in the script is true for

you. If not, don’t read it in court. Remember, everything you say in court must be true and correct. You can be prosecuted for lying in court.

●Bring the following with you to the courthouse on the day you plan to finish your divorce:

●Go to the clerk’s office.

O Ask if you need the court file or docket sheet (list of what has been filed).

O If your case is a default, file the Certificate of Last Known Address and the Affidavit of Military Status in the clerk’s office before you go to court. Bring a file-stamped copy of each form with you to court.

●Go to the courtroom.

O Tell the clerk you are present and give your paperwork to him or her. O Read “Tips for the Courtroom” on the next page for more information.

●After the judge signs your Final Decree of Divorce, turn it in to the clerk’s office.

Your divorce is NOT final until you do so. Get a certified copy of your Final Decree of Divorce from the clerk while you are there. The clerk may charge a fee for the certified copy. If child support was ordered, ask the clerk what you need to do to set up a child support account.

●NOTES:

O You cannot get married to someone else for 30 days after your Final Decree of Divorce is signed by the judge.

O After your divorce is final, remember to sign documents to change car titles, revise your will and life insurance policies, file deeds at the property records office in the county where the property is located, and send a certified copy of any QDROs signed by the court to the retirement plan administrator.

Tips for the Courtroom

The judge will have you raise your right hand and swear to tell the truth.

You will need to give testimony to finish your divorce. Some judges will ask you questions. Other judges will want you to read a “script” of testimony. You can find sample scripts – called “prove up testimony” – at www.TexasLawHelp.org. Read the script ahead of time. Make sure everything in the script is true for you.

When talking to a judge, call the judge “Your Honor.”

If the judge asks you questions, wait until she or he finishes speaking before you speak.

Tell the truth and don’t exaggerate. Give complete answers.

Say “yes” or “no” out loud. It’s not enough to nod or shake your head.

If you do not understand a question, say, “I don’t understand.” If you do not know an answer, say, “I don’t know.”

The judge will listen to what you say and review your papers. If everything is in order the judge will sign your Final Decree of Divorce.

NOTICE: THIS DOCUMENT CONTAINS SENSITIVE DATA.

Cause Number:

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

Unsworn Declaration of Indigency

1.I am filing this Unsworn Declaration of Indigency in place of an Affidavit of Indigency as allowed by Section 132.001 of the Texas Civil Practices and Remedies Code.

2.I am unable to pay court costs. I declare under penalty of perjury that the statements made in this Unsworn Declaration of Indigency are true and correct.

4.Government Entitlements (Check one.)

I do not currently receive any government entitlements based on indigency (poverty). I currently receive the following government entitlements based on indigency (poverty):

Government entitlements based on indigency include but are not limited to: Food Stamps/SNAP, TANF, SSI, Medicaid, WIC Chip, AABD, Needs-based VA Pension, Public Housing, County Assistance, County Health Care, General Assistance, LIS in Medicare (“Extra Help”), Community Care via DADS, Low-Income Energy Assistance, Emergency Assistance, Child Care Assistance under Child Care and Development Block Grant.

List all government entitlements based on indigency received by you or your dependents and the dollar amount of the benefit if applicable. Attach proof of the government entitlements received to this form.

5.Income

c.All other income I receive is listed below: List the source of income (i.e. unemployment, retirement, social security, interest, dividends, child support, spousal support) and the monthly amount you receive.

$

$

$

6. Dependents – The people who depend on me financially are listed below:

7. Property – I own the following property:

List the property and its value - the amount the property would sell for less the amount you still owe on it. If there is no property in a particular category, write “none.”

Bank Accounts (list bank, type of account and amount of $ in account)

$

$

Vehicles (list make and year)

$

$

Real Estate – House or Land (do not list the house you live in)

$

$

Other Property of Value (like boats, jewelry, stocks, etc.)

$

$

$

8. Monthly Expenses – I have the following monthly expenses:

9.Additional Information

List any other facts you want the court to know, such as unusual medical expenses, family emergencies, etc.

NOTICE: THIS DOCUMENT CONTAINS SENSITIVE DATA.

Cause Number:

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

AND IN THE INTEREST OF: (List all children you and your spouse have together who are under 18 or still in high school.)

1._________________________ 2. _________________________ 3. _________________________

4._________________________ 5. _________________________ 6. _________________________

Original Petition for Divorce

Print your answers.

My name is: __________________________________________________________________________.

I am the Petitioner, the person asking for a divorce.

The last three numbers of my driver’s license number are: ___ ___ ___. My driver’s license was issued in (State) ________________________.

The last three numbers of my social security number are: ___ ___ ___.

My spouse’s name is: __________________________________________________________________.

My spouse is the Respondent.

1. Discovery Level

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

2. Legal Notice (Check one box.)

I think my spouse will sign a Waiver of Service (or Answer). Do not send a sheriff, constable, or process server to serve my spouse with a copy of this Petition for Divorce at this time.

I will have a sheriff, constable, process server or clerk serve my spouse with this Petition for Divorce here:

_________________________________________________________________________________.

Street AddressCityStateZip

If this is a work address, name of business: ______________________________________________.

I ask the clerk to issue a Citation of Service (the form necessary to provide legal notice to my spouse by “Official Service of Process”). I understand that I will need to pay the fee (or file an Affidavit of Indigency form to show the Court that I am unable to pay the fee) and arrange for service.

I cannot find my spouse. I ask that my spouse be served by publication. I understand I must file an Affidavit for Citation by Publication and hire a lawyer to serve as attorney ad litem for my spouse.

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

I am serving in the armed forces or other government service outside of Texas, but Texas is the home state of either my spouse or me and has been for at least 6 months.

I have accompanied my spouse who is serving in the armed forces or other government service outside of Texas, but Texas is the home state of either my spouse or me and has been for at least 6 months.

3C.Personal Jurisdiction over Spouse

(Check one box.)

My spouse lives in Texas.

My spouse does not live in Texas. (Check any boxes that apply below.)

My spouse agrees that a Texas court can make orders in this divorce, including orders regarding conservatorship (custody), visitation, and financial support of our children and orders regarding our property and debts. My spouse will file a Waiver of Service (or Answer).

Texas is the last state where we lived together as a married couple. This Petition for Divorce 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 (official service of process) in Texas.

4. Dates of Marriage and Separation

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

MonthDayYear

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

Month DayYear

5. Grounds for Divorce

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.

6. Children

6A.Children Husband and Wife have Together

My spouse and I are the parents of the following children who are under 18 years old or over 18 years old and still in high school.

(You MUST list all children you and your spouse have together (adopted or biological) who are under 18 or over 18 and still in high school.)

1.

2.

3.

4.

5.

6.

6B.Jurisdiction over Children

(Check one box.)

The children live in Texas now and have lived in Texas for at least the past 6 months or since birth.

The children do not live in Texas now but they have been gone from Texas less than 6 months. The children lived in Texas the 6 months before they moved. A parent or person acting as a parent continues to live in Texas.

None of the above apply. (Note: Talk to a lawyer if none of the above apply.)

(Check box below only if true.)

There are no court orders about any of the children listed above. No other Court has continuing jurisdiction over this case or the children.

Note: Do not use this form if there is already a court order in place for any of the children (such as a

child support order through the Attorney General’s Office.)

Read “How to File an Uncontested Divorce” at www.TexasLawHelp.org for information about filing for

divorce when there is already a court order in place.

6C.Children’s Property (Check one box.)

The children do not own any property of significant value in their own name. The children own the following property of significant value in their own name:

_________________________________________________________________________________.

6D.Children’s Health Insurance

The children: (Check all that apply.)

have private health insurance.

Name of insurance company: _________________________________________________________

Policy number: ____________________________________ Cost of premium: $ ________________

Name of person who pays for insurance: ________________________________________________

have health insurance through Medicaid.

have health insurance through C.H.I.P. Cost of premium (if any): $____________________________

do not have health insurance.

If the children do not have private health insurance also complete the following:

6E. Conservatorship (Custody) of the Child/ren

I ask the court to make conservatorship (custody) orders as follows: (Check a, b, or c.)

(If you checked a, check a-1, a-2, or a-3.)

6F. Possession of and Access to the Child/ren (Visitation)

I ask the court to make possession and access (visitation) orders as follows: (Check a, b, c, or d.)

(Check only if you asking that a different possession order be in place while a child is under 3 years old.)

One or more of the children is under 3. Until the child turns 3, possession should be as follows:

__________________________________________________________________________________

__________________________________________________________________________________

__________________________________________________________________________________

__________________________________________________________________________________

After the child turns 3, possession should be as checked above.

(Check only if applicable.)

I am concerned that the other parent may take the child/ren to another country and refuse to return them. I ask the Court to determine if there is a risk of international kidnapping by the other parent and to take such measures as are necessary to protect the child/ren.

6G.Child Support and Medical Support for the Child/ren

I ask the court to make appropriate orders for the financial support of the child/ren, including regular child support and medical support and, if supported by the evidence, retroactive child support.

7. Is the Wife Pregnant?

(Check one box.)

The wife in this marriage is not pregnant.

The wife in this marriage is pregnant. I understand that I cannot finish the divorce until after the child is born.

(If the wife is pregnant, also check one box below.)

The husband is the father of this child. I ask the court to include orders for custody, visitation, child support and medical support for the child in the Final Decree of Divorce.

The husband is not the father of this child. I understand that paternity of the child must be established before I can finish the divorce. (Read “Texas Paternity Law: Frequently Asked Questions” at www.TexasLawHelp.org for information about establishing paternity.)

8. Did the Wife have a Child with Another Man while Married to the Husband?

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

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

The wife did have a child 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 the wife had a child or children with another man during the marriage, check one box below,)

Paternity of the child/ren named above has not been established. I understand that paternity of the child/ren must be established before I can finish my divorce. (Read “Texas Paternity Law: Frequently Asked Questions” at www.TexasLawHelp.org for information about establishing paternity.)

Paternity of the child/ren named above has been established:

(Check one box.)

A court order has established that another man is the biological father and/or the Husband is not the biological father of the child/ren listed above. I understand I must attach a file-stamped copy of the court order to my Final Decree of Divorce.

An Acknowledgement of Paternity was signed by the biological father and a Denial of Paternity was signed by the Husband for the child/ren listed above. I understand I must attach a copy of these documents to my Final Decree of Divorce.

9.Protective Order Statement (Check the appropriate boxes.)

9A. No Protective Order

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

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

9B. Pending Protective Order

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 _______________

Date Filed

in ______________ County, ___________. The cause number is ______________________.

If I get a Protective Order, I will file a copy of it before any hearings in this divorce.

My spouse has filed paperwork asking for 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 ______________

Date Filed

in _______________ County, ___________. The cause number is _____________________.

If my spouse gets a Protective Order, I will file a copy of it before any hearings in this divorce.

9C. Protective Order in Place

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

____________________________ County, ___________________ on _________________.

CountyStateDate Ordered

The cause number for the Protective Order is ______________________________________.

Cause Number

Either I have attached a copy of the Protective Order to this Petition or I will file a copy of it with the court before any hearings in this divorce.

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

_____________________________ County, _________________ on __________________.

CountyStateDate Ordered

The cause number for the Protective Order is ______________________________________.

Cause Number

Either I have attached a copy of the Protective Order to this Petition or I will file a copy of it with the court before any hearings in this divorce.

10. 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.

11. Family Information (Check only if applicable.)

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 child/ren:

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.

12. Property and Debt

Note: It is very important to talk with lawyer if you or your spouse has a house, land, business, retirement funds, other valuable property or debt. Getting advice from a lawyer now can save you time and money in the long run.

About community property: Texas is a community property state. This means that any new property that either spouse gets from the minute they are married until the minute the judge grants the divorce is probably community property, even if the property is only in one spouse’s name. About separate property: Property owned by a spouse before the marriage is that spouse’s separate property. In addition, if either spouse receives a gift, an inheritance, or a recovery for personal injuries that occurred during the marriage (not including a recovery for lost wages or medical expenses); it is that spouse’s separate property. There are exceptions to these general rules. If you have questions talk to a lawyer.

About retirement: Retirement funds (such as 401k, pension, profit sharing, stock option plans and IRAs) earned by either spouse during the marriage are usually considered to be community property that can be divided by the court. This is true even if you or your spouse has not yet retired. If you want the Court to divide retirement funds (other than an IRA), you will need to have the Court sign an additional form, usually called a “Qualified Domestic Relations Order” (QDRO), to make the division effective. You should have the QDRO prepared before you go to court, so the judge can sign it when you finish your divorce. A QDRO form is not included with this divorce set. You may be able to get a sample QDRO form from the employer or retirement fund administrator. If not, you should hire a lawyer to draft the QDRO form. If you use the employer or retirement fund administrator’s QDRO form, you should still have a lawyer review it to make sure you are not giving up important benefits. Note: If you and your spouse plan to keep your own retirement funds or do not have retirement funds, you do not need a QDRO.

About debt: A creditor’s right to collect a debt is not affected by a divorce decree. So, if the Court orders your spouse to pay a debt (such as a mortgage) that is in both of your names but your spouse doesn’t pay it, the creditor can still seek payment from you. Ask a lawyer how to protect yourself in this situation.

12A. Community Property and Debt

If my spouse and I can agree about how to divide the property and debts we got during our marriage, I ask the Court to approve our agreement. If we cannot agree, I ask the Court to divide our community property and debts according to Texas law.

12B. Separate Property

I own the following separate property. I owned this property before I was married or I received this property as a gift or inheritance during my marriage or I received this property as recovery for personal injuries that occurred during the marriage (not including any recovery for lost wages or medical expenses). I ask the Court to confirm this property as my separate property.

(Fill in all lines. If you have no property to list in a particular category, write “none.”)

House located ________________________________________________________________________

Street AddressCityState Zip

Land located at: ______________________________________________________________________

Other money or personal property I owned before I was married, received as a gift or inheritance during my marriage or property I purchased during my marriage with separate property funds:

Money I received as recovery for personal injuries that occurred during the marriage that was not for lost wages or medical expenses:

Note: You cannot use this form to change

13. Name Change (Check one box.)your name to anything other than a name you used before you got married.

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 my marriage. I am not asking the court to change my name to avoid criminal prosecution or creditors. I ask that my name be changed to:

_________________________________________________________________________________.

14.Public Benefits (Check any boxes that apply.)

The child/ren have Medicaid now or had it in the past.

The child/ren (or someone on behalf of the child/ren) get TANF (Temporary Assistance for Needy Families) now or got it in the past.

Note: If the child/ren have ever received Medicaid or TANF, you MUST send a copy of this Petition to the

Office of the Attorney General Child Support Division.

You MUST also sign the “Certificate of Service to Attorney General” at section 16 below.

15. Request for Judgment

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

Petitioner’s Name (Print)Date

I understand that I must notify the Court and my spouse’s attorney (or my spouse if my spouse does not have an attorney) in writing if my mailing address or email address changes during these divorce proceedings. If I don’t, any notices about this case including the dates and times of hearings will be sent to me at the mailing address or email address above.

16. Certificate of Service to Attorney General

(Complete this section only if the child/ren get Medicaid or TANF now or got it in the past.)

I will deliver a copy of this Petition for Divorce to the Office of the Attorney General Child Support Division* as follows:

If I file this document electronically, I will deliver it through the electronic file manager if possible. If not possible, I will deliver it in person, by mail, by commercial delivery service, by fax, or by email.

If I file a paper copy of this document, I will deliver it in person, by mail, by commercial delivery service, by fax, or by email.

*Get contact information for the Attorney General Child Support Office in your county at www.oag.state.tx.us/cs/fieldoffices.php. Bring proof of delivery when you go to Court to finish your divorce.

NOTICE: THIS DOCUMENT CONTAINS SENSITIVE DATA.

Cause Number:

Print court information exactly as it appears on the Original Petition for Divorce.

AND IN THE INTEREST OF: (List all children you and your spouse have together who are under 18 or still in high school.)

1._________________________ 2. _________________________ 3. _________________________

4._________________________ 5. _________________________ 6. _________________________

Waiver of Service Only (Specific Waiver)

WARNING to Respondent: Without the advice and help of an attorney, you may be putting yourself, your property and your money at risk. For a referral to an attorney, or if you are poor to the nearest Legal Aid Office, call the State Bar of Texas Lawyer Referral Information Service at 1-800-252-9690.

If you are a victim of domestic violence, or if at any time you feel unsafe, you can get confidential help from the National Domestic Violence Hotline at 1-800-799-7233 or legal help from the Texas Advocacy Project Family Violence Legal Line at 1-800-374-4673.

INSTRUCTIONS to Respondent: If you decide to use this form:

●Do not sign it until at least one day after the Original Petition for Divorce has been filed (turned in to the court). If you sign this form before then, you will have to redo it. Your spouse should have given you a copy of the Original Petition for Divorce. The official court stamp on your copy will tell you when it was filed.

●Fill out this form completely. You MUST include your mailing address.

●Sign this form in front of a notary. Do not sign until you are standing in front of the notary.

●File (turn in) the original signed form to the court where your spouse filed the Original Petition for Divorce. Keep a copy for your records. Give a copy to your spouse.

●Get additional information about divorce at www.TexasLawHelp.org.

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: ________________________________________________________________.

Mailing AddressCityStateZip

“My phone number is: (_________) __________-___________________.

“My email address is: _________________________________________________________________.

“My fax number (if available) is: _________________________________________________________.

“The last three numbers of my social security number are: ___ ___ ___. Or “ I do not have a social security number.

“I have been given a copy of the Original Petition for Divorce filed in this case. I have read the Original Petition for Divorce and understand what it says. I do not give up my right to review a different Petition for Divorce if it gets changed (amended).

“I understand that I have the right to be given a copy of the Original Petition for Divorce by a constable, sheriff or other official process server (legal notice). I do not want to be given legal notice. I give up my right to legal notice.

“I ask that the Court not enter any orders in this case unless the order is signed by me or unless I have received prior written notice of the date, time, and place of hearing.

“If I reach an agreement and sign a Final Decree of Divorce, the court can enter the Decree without me being present and without giving me notice. If I sign an agreed Final Decree of Divorce, I do not want a court reporter to make a record of the testimony.

“I understand that by signing this form I am entering an appearance 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 understand that I must let the Court and my spouse’s attorney (or my spouse if s/he is not represented by an attorney) know in writing if my mailing address or email address changes during this case. If I don’t, then I understand that any notices about this case will be sent to me at the mailing address or email address on this form.

Military Status (Check one box.)

Name Change (Check one box.)

_________________________________________________________________________________________

FirstMiddleLast

Signature of Respondent (Do NOT sign until you are in front of a notary.) Date

Notary fills out below.

State of

(Print name of state where this Affidavit is notarized)

County of

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

by

(Print name of person who is signing this Affidavit. NOT the notary’s name.)

NOTICE: THIS DOCUMENT CONTAINS SENSITIVE DATA.

Cause Number:

Print court information exactly as it appears on the Original Petition for Divorce.

AND IN THE INTEREST OF: (List all children you and your spouse have together who are under 18 or still in high school.)

1._________________________ 2. _________________________ 3. _________________________

4._________________________ 5. _________________________ 6. _________________________

Respondent’s Original Answer

WARNING to Respondent: Without the advice and help of an attorney, you may be putting yourself, your property and your money at risk. For a referral to an attorney, or if you are poor to the nearest Legal Aid Office, call the State Bar of Texas Lawyer Referral Information Service at 1-800-252-9690. If you are a victim of family violence, or if at any time you feel unsafe, you can get confidential help from the National Domestic Violence Hotline at 1-800-799-7233 or legal help from the Texas Advocacy Project Family Violence Legal Line at 1-800- 374-4673.

WARNING to Out-of-State Respondent: Filing an Answer with the Court enters your appearance in this case. Talk to an attorney before filing an Answer, if you 1) do not live in Texas and 2) do not want a Texas Court to have the power to make orders that would 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 your spouse) ordering you to pay spousal maintenance, court costs and attorney’s 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 can’t make such orders because you live out-of-state. Ask a Texas attorney to help you determine if Texas has personal jurisdiction over you.

INSTRUCTIONS to Respondent: If you decide to use this form:

●Do not sign it until at least one day after the Original Petition for Divorce has been filed (turned in to the court). Your spouse should have given you a copy of the Original Petition for Divorce. The official court stamp on your copy will tell you when it was filed.

●Fill out this form completely.

●File (turn in) the original signed form to the court where your spouse filed the Original Petition for Divorce. Keep a copy for your records. Give a copy to your spouse.

●Get additional information about divorce at www.TexasLawHelp.org.

Print your answers.

My name is: __________________________________________________________________.

Tips for Filling out the FINAL DECREE OF DIVORCE

What the Decree Means to You: A Final Decree of Divorce (Decree) is a very important document. Once it is signed by a judge, it determines the rights and responsibilities of both you and your ex-spouse to your property, money and children.

How to Fill-Out the Decree: Fill-out the Decree before you go to Court. Type or print in blue or black ink only. Fill in all blanks unless instructed otherwise. Do not fill in the judge’s signature. If the judge disagrees with anything you have written he or she will change it before signing the Decree.

Where to get help: It’s a good idea to have a lawyer review your completed Decree before you go to Court. You can hire a lawyer just to review your Decree. This is called limited scope representation. For referral to a lawyer, or if you have a low income to a free Legal Aid program, call the Lawyer Referral Information Service at 1-800-252-9690.

If there has been violence or you feel unsafe, get help by calling the National Domestic Violence Hotline at 1- 800-799-SAFE or the Texas Family Violence Legal Line at 1-800-374-HOPE.

Where to get information: Get information about the issues involved in a divorce including property division, spousal maintenance, child custody, visitation, child support and medical support here:

Family Law Handbook at www.hba.org

Pro Se Divorce Handbook at www.tyla.org

Facts sheets on property division, custody, visitation, child support and medical support at www.TexasLawHelp.org

Texas Advocacy Project Family Law Hotline at 1-800-777-FAIR

Note about retirement funds (for example pension, profit-sharing, deferred compensation

and stock option plans, 401(k) or IRA accounts.): If you want the Court to divide a retirement fund (other than an IRA) as part of your divorce, you will need an additional order form usually called a Qualified Domestic Relations Order or QDRO. You should have the QDRO prepared before you go to court, so the judge can sign it when you finish your divorce. A QDRO form is not included with the TexasLawHelp divorce sets. The employer or retirement plan administrator may have a sample QDRO form you can use. If not, you should hire a lawyer to draft the QDRO form. If you use the employer or plan administrator’s form, you should still have a lawyer review it to make sure you are not giving up important benefits. You should also have a lawyer review the part of your Decree that divides the retirement fund. Note: You do not need a QDRO if you and your spouse will keep your own retirement funds or do not have any retirement funds.

Note about debt: A divorce decree does not affect a creditor’s right to collect a debt. So, if the Decree orders your spouse to pay a debt that is in both your names (such as a mortgage or car loan) but your spouse doesn’t pay it, the creditor can still seek payment from you. Ask a lawyer how to protect yourself in this situation.

Note about visitation: This Decree includes the Standard Possession Order as Exhibit A. If this standard visitation schedule doesn't work for your family or would not be safe for your children, you may use a Modified Possession Order or Supervised Possession Order instead. You may hire a private lawyer to write the modified or supervised possession order. Or, get information about other resources by going to www.TexasLawHelp.org and clicking on the Free Live Chat button or by calling the Texas Advocacy Project Family Law Hotline at 1-800- 777-FAIR.

Important: Read “How to File an Uncontested Divorce” at www.TexasLawHelp.org for instructions on how to finish your divorce, including where to go and what to bring.

NOTICE: THIS DOCUMENT CONTAINS SENSITIVE DATA.

1._________________________ 2. _________________________ 3. _________________________

4._________________________ 5. _________________________ 6. _________________________

Final Decree of Divorce

A hearing took place on ________________________.

Date

There was no jury. Neither the husband nor wife asked for a jury.

1. Appearances

Petitioner

The Petitioner’s name is: _____________________________________________________________.

The Petitioner was present, representing him/herself, and announced ready for trial.

The Petitioner was present, representing him/herself, and agreed to the terms of this Final Decree of Divorce (called “Decree” throughout this document).

The Petitioner was not present but has signed on page 23, agreeing to the terms of this Decree.

Respondent

The Respondent’s name is: ___________________________________________________________.

The Respondent was present, representing him/herself, and announced ready for trial.

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

The Respondent was not present but filed an Answer or Waiver of Service and has signed on page 23 agreeing to the terms of this Decree.

The Respondent was not present but filed a Global Waiver of Service that waived Respondent’s right to notice of this hearing and did not otherwise appear.

The Respondent was not present but was served and has defaulted. The Petitioner has filed a Certificate of Last Known Address and a Military Status Affidavit.

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 for Divorce meets all legal requirements.

The Court finds that: (Check one box.)

it has been at least 60 days since the Petition for Divorce was filed.

the 60 day waiting period is not required because: (Check one box.)

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 Respondent because Respondent committed family violence during the marriage.

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

4. Divorce

IT IS ORDERED that the Petitioner and the Respondent are divorced.

5. Children

5A.Children Husband and Wife Have Together

The Court finds that the Husband and Wife are the parents of the children listed below and that there are no other children born to or adopted by Husband and Wife who are under 18 years old or still in high school.

(List all biological and adopted children you and your spouse have together who are under 18 or over 18 and still in high school.)

The Court finds that there are no other court orders regarding any of the children listed above.

5B.Wife Not Pregnant

The Court finds that the Wife is not pregnant.

5C.Did the Wife have a Child with Another Man while Married to the Husband?

(Check one box.)

The Court finds that the Wife did not have any children with another man while married to the Husband.

The Court finds that the Wife did have a child/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

The Court further finds that paternity of each child listed above has been established as set out below:

(Check one box below. Attach copy of court order or Acknowledgement and Denial of Paternity for each child.)

A court order has established that another man is the biological father and/or the Husband is not the biological father of the child/ren listed here:

_____________________________________________________________________________.

A copy of the court order is attached to this Decree as Exhibit ___.

An Acknowledgement of Paternity was signed by the biological father and a Denial of Paternity was signed by the Husband for the child/ren listed here:

_____________________________________________________________________________.

Each Acknowledgment and Denial of Paternity was filed with the Vital Statistics Unit. A copy of each Acknowledgment and Denial of Paternity is attached to this Decree as Exhibit(s) ________.

6. Parenting Plan

The Court finds that the following orders concerning the rights and duties of the Husband and Wife in relation to their child/ren, including orders for conservatorship (custody), possession and access (visitation), child support and medical support, are in the child/ren’s best interest.

The Court further finds that these orders constitute the parenting plan of the Court for the child/ren listed by name in 5A above.

7. Conservatorship (Custody)

7A.Rights and Duties of Both Parents

The Court ORDERS that both parents always have the following rights:

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

2.The right 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.The right to have access to the child/ren’s medical, dental, psychological, and educational records;

4.The right to talk or consult with the child/ren’s doctors, dentists, and psychologists;

5.The right 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.The right to attend the child/ren’s school activities;

7.The right to be designated as an emergency contact on their child/ren’s records;

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

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:

1.the duty to inform the other parent in a timely manner of significant information concerning the health, education, and welfare of the child/ren; and

2.the duty to inform the other parent if the parent resides with for at least thirty days, marries, or intends to marry a person who the parent knows is registered as a sex offender under chapter 62 of the Code of Criminal Procedure or 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. WARNING: A CONSERVATOR COMMITS AN OFFENSE PUNISHABLE AS A CLASS C MISDEMEANOR IF THE CONSERVATOR FAILS TO PROVIDE THIS NOTICE.

The Court ORDERS that each parent, during his or her periods of possession of the children, has the following rights and duties:

1.The duty to care for, control, protect, and reasonably discipline the child/ren;

2.The duty to support the child/ren, including providing them with food, clothing, and shelter, and medical and dental care that does not involve an invasive procedure;

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

4.The right to direct the child/ren’s moral and religious training.

7B.Parents Appointed Conservators

If the parents will be joint managing conservators, check box 7B(1) below and fill in the requested information.

If one parent will be the sole managing conservator and the other will be the possessory conservator, check box 7B(2) on the next page and fill in the requested information.

The Court ORDERS that the parents are appointed Joint Managing Conservators and:

(Check 7B(1)(a) or 7B(1)(b).)

7B(1)(a) One Parent Has the Exclusive Right to Decide Where the Child/ren Live.

The Court ORDERS that _________________________________________________

Print the name of the parent who will decide where the child/ren live.

has the exclusive right to designate the primary residence of the child/ren and that s/he:

(Check one box.)

may designate the child/ren’s residence without regard to geographic location. must designate the child/ren’s residence within the following geographic area:

(Check one box.)

the school attendance zone of: _____________________________________.

7B(1)(b) Neither Parent Has the Exclusive Right to Decide Where the Child/ren Live.

The Court ORDERS that neither parent has the exclusive right to designate the primary residence of the children. However, both parents are ORDERED not to move the children’s primary residence from the following geographic area:

(Check one box.)

the school attendance zone of: ________________________________________.

The Court ORDERS that the parents, as Joint Managing Conservators, also have the rights

and duties as marked below. The right or duty listed in the 1st column shall be exercised by the parent or parents as marked in the 2nd, 3rd, 4th, or 5th column.

The Court ORDERS that ____________________________________________________ is

(Print the name of the parent appointed Sole Managing Conservator of the children.)

appointed Sole Managing Conservator of the children.

The Court ORDERS that ____________________________________________________ is

(Print the name of the parent appointed Possessory Conservator of the children.)

appointed Possessory Conservator of the children.

The Court ORDERS that the Sole Managing Conservator has the following exclusive rights and duty:

1.the right to designate the primary residence of the child/ren without geographic restriction;

2.the right to consent to medical, dental, and surgical treatment for the child/ren involving invasive procedures;

3.the right to consent to psychiatric and psychological treatment of the child/ren;

4.the right to receive child support and to save or spend these funds for the benefit of the child/ren;

5.the right to represent the child/ren in legal action and to make other decisions of substantial legal significance concerning the child/ren;

6.the right to consent to marriage and to enlistment in the United States Armed Forces;

7.the right to make decisions concerning the child/ren’s education;

8.the right to the services and earnings of the child/ren;

9.except when a guardian of the child/ren’s estates or a guardian or attorney ad litem has been appointed for the child/ren, the right to act as an agent of the child/ren in relation to the child/ren’s estates if the child/ren’s action is required by a state, the United States, or a foreign government;

10.the duty to manage the estates of the child/ren to the extent the estates have been created by community property or the joint property of the parents.

7C.Order Regarding Passports for the Children

The Court ORDERS that: (Check one box.)

Mother shall have the exclusive right to apply for and renew passports for the child/ren.

Father shall have the exclusive right to apply for and renew passports for the child/ren.

Neither parent has the exclusive right to apply for or renew passports for the child/ren. A parent who applies for or renews a passport for the child/ren must obtain the written consent of the other parent.

8. Possession and Access (Visitation)

The Court ORDERS that the parents shall have possession and access to the child/ren as ordered in the:

(Check one box. Attach the appropriate Possession Order to this Decree. Write Exhibit A at the top.)

Standard Possession Order attached as Exhibit A and fully incorporated into this Decree. Modified Possession Order attached as Exhibit A and fully incorporated into this Decree. Supervised Possession Order attached as Exhibit A and fully incorporated into this Decree.

(Check only if needed. Attach a Possession and Access Order for Child Under 3.. Write Exhibit B at the top.)

The Court ORDERS that until a child is 3 years old, the parents shall have possession and access to the child as ordered in the Possession and Access Order for Child Under 3 attached as Exhibit B and fully incorporated into this Decree. The Court ORDERS that beginning on the child’s 3rd birthday, the parents shall have possession and access to the child as ordered in the Possession and Access Order attached as Exhibit A.

9. Child Support

9A.Order to Pay Child Support

The Court ORDERS ___________________________________________________ (Obligor) to pay

(Print the name of the parent who will pay child support.)

child support to _________________________________________________ (Obligee) in the amount

(Print the name of the parent who will receive child support.)

and manner described below until one of the following events that terminate child support occurs for

each child.

9B.Events that Terminate Child Support

The obligation to pay child support for a child terminates when:

●The child turns 18, unless when the child turns 18 he or she is enrolled and complying with attendance requirements in a secondary school program leading toward a high school diploma or enrolled in courses for joint high school and junior college credit then child support terminates at the end of the month in which the child graduates. -or-

●The child marries, dies, or is emancipated by court order. -or-

●The child begins active duty in the United States armed forces. -or-

●A court terminates the parent-child relationship between the man ordered to pay child support and the child based on genetic testing that determines the man is not the child’s father. -or-

●The person ordered to pay child support and the person ordered to receive child support marry or remarry each other, unless a nonparent or agency has been appointed conservator of the child.

9C.Obligor and Obligee

The Court ORDERS that the parent ordered to pay child support above is the Obligor and will be referred to as the “Obligor” throughout this section.

The Court ORDERS that the parent ordered to receive child support above is the Obligee and will be referred to as the “Obligee” throughout this section.

9D.Child Support Amount(s)

If only one child will receive support, check box 9D(1) and fill in the child support amount and start date.

If more than one child will receive support, check box 9D(2) and fill in the child support amounts and start date.

9D(1) For a Single Child

Obligor is ORDERED to pay $________________ child support per month. The 1st payment is

due on ________________________. A like payment is due on the 1st day of each month

Month / Day / Year

after that until child support terminates for the child.

9D(2) For Multiple Children

Obligor is ORDERED to pay $________________ child support per month. The 1st payment is

due on ________________________. A like payment is due on the 1st day of each month after

Month / Day / Year

that until child support terminates for one child.

After child support terminates for one child, Obligor is ORDERED to pay $______________

child support per month. The 1st payment is due on the 1st day of the 1st month after child support terminates for one child. A like payment is due on the 1st day of each month after that until child support terminates for a second child.

After child support terminates for two children, Obligor is ORDERED to pay $_____________

child support per month. The 1st payment is due on the 1st day of the 1st month after child support terminates for a second child. A like payment is due on the 1st day of each month after that until child support terminates for a third child.

After child support terminates for three children, Obligor is ORDERED to pay $_____________

child support per month. The 1st payment is due on the 1st day of the 1st month after child support terminates for a third child. A like payment is due on the 1st day of each month after that until child support terminates for a fourth child.

After child support terminates for four children, Obligor is ORDERED to pay $______________

child support per month. The 1st payment is due on the 1st day of the 1st month after child support terminates for a fourth child. A like payment is due on the 1st day of each month after that until child support terminates for a fifth child.

After child support terminates for five children, Obligor is ORDERED to pay $______________

child support per month. The 1st payment is due on the 1st day of the 1st month after child support terminates for a fourth child. A like payment is due on the 1st day of each month after that until child support terminates for a sixth child.

Warning! Do not pay child support directly to the other parent. Send all child support payments to the Texas Child Support Disbursement Unit, PO Box 659791, San Antonio, TX 78265. If you pay child support directly to the other parent, you won’t get credit and you may have to pay again!

9E.Place of Payment

The Court ORDERS Obligor 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.

The Court ORDERS Obligor to Include the following information with each payment:

●Name of parent ordered to pay child support, and

●Name of parent ordered to receive child support, and

●Cause Number and County of Decree or Order, and

●Attorney General Case Number, if applicable.

Payments should be made out to the Texas State Disbursement Unit or TXSDU.

9F. No Credit for Informal Payments

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

9G.Child Support Account / Fees

Each parent 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 parent by the state disbursement unit and any other agency authorized by law to a charge a fee for the collection and distribution of child support.

9H.Guideline or Non-Guideline Support

The Court finds that the child support ordered above is:

Guideline Support: The amount of child support is approximately the amount recommended by the Texas Family Code Child Support Guidelines. See Texas Family Code, Chapter 154, Subchapter C.

Non-Guideline Support: The amount of child support differs significantly from the amount recommended by the Texas Family Code Child Support Guidelines.

(If the amount ordered is not based on the guidelines, you must also provide the following information.)

The net monthly income/resources of the Obligor is $ __________________.

The net monthly income/resources of the Obligee is $ __________________.

Guideline child support would be ________ % of Obligor’s net monthly resources, which is

$________________ per month.

The actual monthly child support amount ordered is $_______________, which is_______ % of

Obligor’s net monthly income/resources.

Guideline child support would be unjust or inappropriate under the circumstances because:

9I. Income Withholding

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

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

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

If an income withholding for support order is not served on the employer, or if Obligor’s is self-employed or unemployed, Obligor’s is ORDERED to send all child support payments to the Texas Child Support

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 Obligor, if asked to do so by Obligor, Obligee, a prosecuting attorney, the title IV-D agency, a friend of the Court, or a domestic relations office.

9J. 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 Obligee. Obligor is ORDERED to send all child support payments to the Texas Child Support Disbursement Unit, PO Box 659791, San Antonio, TX 78265, where the payment will be recorded, and forwarded to Obligee.

9K.Change of Employment

Obligor is ORDERED to notify this Court and Obligee by U.S. certified mail, return receipt requested, of any change of address and of any termination of employment. This notice shall be given no later than 7 days after the change of address or the termination of employment. This notice or a subsequent notice shall also provide the current address of Obligor and the name and address of Obligor’s current employer, whenever that information becomes available.

9L. Child Support After Death

IT IS ORDERED that the provisions for child support in this decree shall be an obligation of Obligor’s estate and shall not terminate on his/her death. Payments received for the benefit of the child/ren, including payments from the Social Security Administration, Department of Veterans Affairs, or other governmental agency or life insurance proceeds, annuity payments, trust distributions, or retirement survivor benefits, shall be a credit against this obligation. Any remaining balance of the child support is an obligation of Obligor’s estate.

9M. 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.

10. Medical Support

10A. Parents’ Obligation to Provide Medical Support

As additional child support, the Court ORDERS the parents to provide medical support as set out in this order for each child listed in 5A above until one of the following events that terminate medical support occurs for the child.

10B. Events that Terminate Medical Support

The obligation to provide medical support for a child terminates when:

●The child turns 18, unless when the child turns 18 he or she is enrolled and complying with attendance requirements in a secondary school program leading toward a high school diploma or enrolled in courses for joint high school and junior college credit then child support terminates at the end of the month in which the child graduates. -or-

●The child marries, dies, or is emancipated by court order. -or-

●The child begins active duty in the United States armed forces. -or-

●A court terminates the parent-child relationship between the man ordered to pay child support and the child based on genetic testing that determines the man is not the child’s father. -or-

●The person ordered to pay child support and the person ordered to receive child support marry or remarry each other, unless a nonparent or agency has been appointed conservator of the child.

10C. Obligor and Obligee

The Court ORDERS that the parent ordered to pay child support is the Obligor and will be referred to as the “Obligor” throughout this section.

The Court ORDERS that the parent ordered to receive child support is the Obligee and will be referred to as the “Obligee” throughout this section.

10D. Court Findings About Health Insurance

The Court finds that private health insurance for the children:

(Check one.)

is available at a reasonable cost to the person ordered to pay child support (Obligor) through:

(Check one.)

Father’s work, membership in a union, trade association, or other organization, or other source available to Father.

Mother’s work, membership in a union, trade association, or other organization, or other source available to Mother.

is not available at a reasonable cost to either parent. The Court finds that the children are:

(Check one.)

currently covered by Medicaid.

currently covered by C.H.I.P. at this cost: $ __________________.

not currently covered by Medicaid or C.H.I.P.

10E. Orders Regarding Health Insurance and Cash Medical Support

Check box 10E(1), 10E(2), OR 10E(3) on the following pages and write in the appropriate names (and start date if cash medical support is ordered).

●Check box 10E(1) if the Obligor will provide and pay for health insurance for the children.

●Check box 10E(2) if the Obligee will provide health insurance for the children and the Obligor will pay cash medical support to reimburse the Obligee for the cost of the insurance.

●Check box 10E(3) if neither parent has access to private health insurance at a reasonable cost. Obligee will be ordered to apply for coverage under a government medical assistance program and Obligor will be ordered to pay cash medical support.

As additional child support, the Court ORDERS Obligor, ___________________________________,

(Print name of parent ordered to pay child support)

to get health insurance for the child/ren within 15 days of the date of this order through: (Check one.)

Obligor’s work or membership in a union, trade association, or other organization.

another source available to Obligor.

The health insurance must cover basic healthcare services, including usual physician services, office visits, hospitalization, and laboratory, X-ray, and emergency services.

Obligor is ORDERED to pay, as additional child support, all costs of such health insurance, including but not limited to enrollment fees and premiums.

Obligor is ORDERED to keep such health insurance in full force and effect on each child, who is the subject of this suit, until one of the above events that terminate medical support occurs for the child.

Obligor is ORDERED to give Obligee the following within 30 days of the date of this order:

OObligor’s social security number and the name and address of Obligor’s employer, and

Othe name of the insurance carrier, the policy number, and proof the child/ren are covered, and

Oa copy of the insurance policy and list of benefits covered, and

Oinsurance membership cards for the child/ren, and

Oany forms needed to use the health insurance, and

Oany forms needed to submit a claim.

Obligor is ORDERED to give Obligee the following within 3 days of receipt:

Oany insurance checks or other payments for medical expenses paid by Obligee and

Oany explanations of benefits relating to medical expenses paid or incurred by Obligee.

If health insurance benefits for the child/ren are changed in any way, Obligor is ORDERED to give Obligee information about the change and any new forms needed to use the insurance within 15 days of the change.

If health insurance benefits are cancelled, Obligor is ORDERED to get new health insurance for the children within 15 days of the date of cancellation. The new insurance must equal or exceed the prior level of coverage. The new health insurance must cover basic healthcare services, including usual physician services, office visits, hospitalization, and laboratory, X-ray, and emergency services.

If Obligor is eligible for dependent health coverage but fails to apply to obtain coverage for the child/ren, the insurer is ORDERED to enroll the child/ren on application of Obligee or others as authorized by law. See Texas Insurance Code, Section 1504.051

As additional child support, the Court ORDERS Obligee, __________________________________,

(Print name of parent who will receive child support)

to get health insurance for the child/ren within 15 days of the date of this order through: (Check one.)

Obligee’s work or membership in a union, trade association, or other organization. another source available to Obligee.

The health insurance must cover basic healthcare services, including usual physician services, office visits, hospitalization, and laboratory, X-ray, and emergency services.

Obligee is ORDERED to maintain such health insurance in full force and effect on each child until one of the above events that terminate medical support occurs for the child.

Obligee is ORDERED to give Obligor the following within 30 days of the date of this order:

OObligee’s social security number and the name and address of Obligee’s employer, and

Othe name of the insurance carrier, the policy number, and proof the child/ren are covered, and

Othe name of the insurance company and the policy number, and

Oa copy of the insurance policy and list of benefits covered, and

Oinsurance membership cards for the child/ren, and

Oany forms needed to use the health insurance, and

Oany forms needed to submit a claim.

Obligee is ORDERED to give Obligor the following within 3 days of receipt:

Oany insurance checks or other payments for medical expenses paid by Obligor and

Oany explanations of benefits relating to medical expenses paid or incurred by Obligor.

If health insurance benefits for the child/ren are changed in any way, Obligee is ORDERED to give Obligor information about the change and any new forms needed to use the insurance within 15 days of the change. If the cost of health insurance benefits for the child/ren changes, Obligee is ORDERED to give Obligor information about the change within 15 days of the change.

If health insurance benefits are cancelled, Obligee is ORDERED to get new health insurance for the children within 15 days of the date of cancellation. The new insurance must equal or exceed the prior level of coverage. The new health insurance must cover basic healthcare services, including usual physician services, office visits, hospitalization, and laboratory, X-ray, and emergency services.

If Obligee is eligible for dependent health coverage but fails to apply to obtain coverage for the child/ren, the insurer is ORDERED to enroll the child/ren on application of Obligor or others as authorized by law. See Texas Insurance Code, Section 1504.051

As additional child support, the Court ORDERS Obligor, __________________________________,

(Print name of parent ordered to pay child support)

to pay Obligee cash medical support of $ ______________ per month for reimbursement of health

insurance premiums. The 1st payment is due on ______________________. A like payment is

Month / Day / Year

due on the 1st day of each month after that until one of the above events that terminate medical

support occurs for each child.

Obligor is ORDERED to send all cash medical support payments to the Texas Child Support Disbursement Unit, PO Box 659791, San Antonio, TX 78265 for distribution according to law.

The Court ORDERS that money paid by Obligor directly to Obligee or spent while in possession of the children does NOT count as cash medical support.

The Court ORDERS that the cash medical support provisions of this order shall be an obligation of the estate of Obligor and shall not terminate on his/her death.

Warning! Do not pay cash medical support directly to the other parent. Send all payments to the

Texas Child Support Disbursement Unit, PO Box 659791, San Antonio, TX 78265.

The Court ORDERS Obligee, _______________________________________, to apply on behalf of

(Print name of parent who will receive child support)

each child for coverage under a governmental medical assistance program or health plan (i.e. Medicaid or C.H.I.P) within 15 days of the date this decree or order is signed by the Court. If the children are already covered under such a program or plan, the Court ORDERS Obligee to continue such coverage.

When such health coverage is obtained, Obligee is ORDERED to maintain the coverage in full force and effect on each child by paying all applicable fees required for the coverage, including but not limited to enrollment fees and premiums for as long as the children are eligible for such covereage.

Obligee is ORDERED to give the Office of the Attorney General Child Support Division a copy of the insurance policy and list of benefits covered within 30 days of the date of this order.

Obligee is ORDERED to give Obligor the following within 30 days of the date of this order:

Othe name of the insurance company and the policy number, and

Oa copy of the insurance policy and list of benefits covered, and

Oinsurance membership cards for the child/ren, and

Oany forms needed to use the health insurance, and

Oany forms needed to submit a claim.

Obligee is ORDERED to give Obligor the following within 3 days of receipt:

Oany insurance checks or other payments for medical expenses paid by Obligor and

Oany explanations of benefits relating to medical expenses paid or incurred by Obligor.

If Obligee is eligible for dependent health coverage but fails to apply to obtain coverage for the child/ren, the insurer is ORDERED to enroll the child/ren on application of Obligor or others as authorized by law. Texas Insurance Code, Section 1504.051

As additional child support, the Court ORDERS Obligor, __________________________________,

(Print name of parent ordered to pay child support) to pay Obligee cash medical support of $ ________________ per month. The 1st payment is due

on ______________________. A like payment is due on the 1st day of each month after that until

Month / Day / Year

one of the above events that terminate medical support occurs for each child.

The Court ORDERS Obligor to send all cash medical support payments to the Texas Child Support Disbursement Unit, PO Box 659791, San Antonio, TX 78265 for distribution according to law.

Warning! Do not pay cash medical support directly to the other parent. Send all payments to the

Texas Child Support Disbursement Unit, PO Box 659791, San Antonio, TX 78265.

The Court ORDERS that money paid by Obligor directly to Obligee or spent while in possession of the children does NOT count as cash medical support.

IT IS ORDERED that Obligor is allowed to stop paying of cash medical support, for the time Obligor is providing health insurance coverage for the children, if:

a. health insurance for the children becomes available to Obligor at a reasonable cost; and b. Obligor enrolls the child/ren in the insurance plan and pays all costs of the insurance; and

c.Obligor provides Obligee and the Texas Office of the Attorney General, Child Support Division the following information:

(1)proof that health insurance has been provided for the child/ren, and

(2)Obligor’s social security number, and

(3)name and address of the Obligor’s employer, and

(4)whether the employer is self-insured or has health insurance available, and

(i)if the employer is self-insured, a copy of the schedule of benefits, a membership card, claim forms, and any other information necessary to submit a claim, or

(ii)if the employer has health insurance available, the name of the health insurance carrier, the policy number, a copy of the policy and schedule of benefits, a health insurance membership card, claim forms, and any other information necessary to submit a claim.

Note: This provision regarding when the Obligor may stop paying cash medical support is part of section 10E3. It does not apply to any other section.

10F. Expenses Not Covered by Insurance

Obligor and Obligee are each ORDERED to pay 50 percent of all reasonable and necessary health-care expenses for the child/ren that are not covered by health insurance, unless:

10E(1) above is checked and Obligor is not providing health insurance as ordered, then Obligor is liable for 100 percent of all necessary medical expenses of the child/ren.

10E(2) above is checked and Obligee is not providing health insurance as ordered, then Obligee is liable for 100 percent of all necessary medical expenses of the child/ren.

If 10E(3) above is checked, Obligee is ORDERED to pay 50 percent of all reasonable and necessary health-care expenses for the child/ren that are not reimbursed by health insurance or covered by the cash medical support paid by Obligor and Obligor is ORDERED to pay 50 percent of the total unreimbursed health-care expenses that exceed the amount of cash medical support paid by Obligor. Obligor is liable for 100 percent of all necessary medical expenses incurred for the child/ren in any month that Obligor neither pays cash medical support nor provides health insurance for the child/ren.

Reasonable and necessary health care expenses that must be paid by the parents if not covered by insurance include: copayments for office visits and prescription drugs, the yearly deductible, if any, medical, surgical, and prescription drug expenses, mental health-care services, dental and orthodontic expenses, and eye care and ophthalmological expenses. These reasonable and necessary health-care expenses do not include expenses for travel to and from the health-care provider or for nonprescription medication.

The parent who incurs a health-care expense on behalf of a child (called the “incurring parent”) is ORDERED to give the other parent (called the “nonincurring parent”) a copy of all forms, receipts, bills, statements, and explanations of benefits that show the portion of the expense not covered by insurance within 30 days of receipt. The nonincurring parent is ORDERED to pay his or her percentage of any uninsured expense within 30 days of receiving documentation of the expense by paying the health-care provider directly or reimbursing the incurring parent, if the nonincurring parent’s portion has already been paid.

10G. Claims

Either parent may file claims and receive payments directly from the insurance carrier. Further, for the sole purpose of Texas Insurance Code Sections 1204.251 and 1204.252, the party who is not carrying the insurance policy is designated the managing conservator or possessory conservator of the children. Any reimbursement payments received from the health insurance carrier belongs to the parent who paid the expense. If the insurance carrier sends reimbursement to the parent who did not pay the expense, he or she is ORDERED to endorse the check and deliver it to the parent who paid the expense with 3 days.

10H. Health Insurance Policy Requirements

Each parent is ORDERED to follow all requirements of any health insurance policy covering the child/ren to get maximum reimbursement and direct payment from the insurance company. This includes requirements for giving advance notice to the insurance company, getting second opinions, and using “preferred providers.” If a parent incurs health-care expenses for the child/ren using “out-of-network” health-care providers or services, or fails to follow the health insurance company procedures or requirements, that parent shall pay all such health-care expenses incurred unless: the expenses are emergency health-care expenses, the parents have a written agreement regarding such health-care expenses, or the Court makes a different order. Denial of a bill by an insurance carrier does not excuse the obligation of the parents to pay the expense.

11.Parent’s Information

11A. Disclosure of Mother’s Information (Check one box.)

The Court ORDERS Mother to disclose the following information and changes in that information to Father, the Court and the State Case Registry as required by Texas Family Code 105.006 and ORDERED in section 12 of this Decree.

(Fill in the following information for the Wife/Mother.)

The Court finds, pursuant to Texas Family Code 105.006(c) and 105.007(c), that disclosure of Mother’s information to Father is likely to cause Mother or the children harassment, abuse, serious harm or injury. The Court ORDERS that Mother’s address and other identifying information not be disclosed. The Court further ORDERS that Mother is not required to give her address or other identifying information to Father or notify Father or the Court of changes in that information. The Court ORDERS Mother to provide her mailing address and changes in her mailing address to the State Case Registry, Contract Services Section, MC046S, P.O. Box 12017, Austin, Texas 78711- 2017.

11B. Disclosure of Father’s Information (Check one box.)

The Court ORDERS Father to disclose the following information and changes in that information to Mother, the Court and the State Case Registry as required by Texas Family Code 105.006 and ORDERED in section 12 of this Decree.

(Fill in the following information for the Husband/Father.)

The Court finds, pursuant to Texas Family Code Section 105.006(c) and 105.007(c), that disclosure of Father’s information to Mother is likely to cause Father or the children harassment, abuse, serious harm or injury. The Court ORDERS that Father’s address and other identifying information not be disclosed. The Court further ORDERS that Father is not required to give his address or other identifying information to Mother or notify Mother or the Court of changes in that information. The Court ORDERS Father to provide his mailing address and changes in his mailing address to the State Case Registry, Contract Services Section, MC046S, P.O. Box 12017, Austin, Texas 78711-2017.

12. Required Notices

This section is not applicable if and to the extent it conflicts with the Court’s Order regarding disclosure of information in section 11 above.

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.

13. 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.

14. Property and Debt

The Court finds that the following is a just and right division of the parties’ property and debt.

(Fill in all lines. If there is no property to declare in a particular category, write “none”.)

14A. Husband’s Separate Property

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

1. House or Land located at: __________________________________________________________

Husband owned this property before marriage.

Husband received this property as a gift or inheritance.

2.Cars, trucks, motorcycles or other vehicles Husband owned these vehicles before marriage or received them as a gift or inheritance during the marriage:

3.Other Money or Property Confirmed as Husband’s Separate Property Husband owned the following money or personal property before the marriage:

Husband inherited or received as a gift the following money or personal property during the marriage:

Husband received the following money recovery for personal injuries that occurred during the marriage that is not for lost wages or medical expenses:

14B. Husband’s Community Property

The Court ORDERS that the Husband is awarded the following community property as his sole and separate property and Wife is divested of (loses) all right, title, interest and claim in and to that property. 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 Decree does not give to the Wife.

2.House or land located at:

Legal Description:

3. Other real property located at:

Legal Description:

4.All cash and money in any bank or other financial institution listed in Husband’s name alone.

5.Any insurance policy that covers Husband’s life.

6.Husband’s cars, trucks, motorcycles or other vehicles listed below:

7. Husband will also keep the following property:

(Fill in all lines. If there is no property to declare in a particular category, write “none”.)

14C. Wife’s Separate Property

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

1. House or Land located at: __________________________________________________________

Wife owned this property before marriage.

Wife received this property as a gift or inheritance.

2.Cars, trucks, motorcycles or other vehicles Wife owned these vehicles before marriage or received them as a gift or inheritance during the marriage:

3.Other Money or Property Confirmed as Wife’s Separate Property Wife owned the following money or personal property before the marriage:

Wife inherited or received as a gift the following money or personal property during the marriage:

Wife received the following money recovery for personal injuries that occurred during the marriage that was not for lost wages or medical expenses:

14D. Wife’s Community Property

The Court ORDERS that the Wife is awarded the following property as her sole and separate property and Husband is divested of (loses) all right, title, interest and claim in and to that property. 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 Husband’s name, that this Decree does not give to the Husband.

2.House or land located at:

Legal Description:

3. Other real property located at:

Legal Description:

4.All cash and money in any bank or other financial institution listed in Wife’s name alone.

5.Any insurance policy that covers Wife’s life.

6.Wife’s cars, trucks, motorcycles or other vehicles listed below:

7. Wife will also keep the following property:

14E. Retirement Funds in Husband’s Name

(For example: pension, retirement, 401(k), 403(b), employee stock ownership, profit sharing, thrift, Keogh, and stock option plans, as well as individual retirement accounts (IRAs), annuities and variable annuity life insurance benefits.)

The Court makes the following orders regarding retirement funds in Husband’s name.

(Check 14E(1) or 14E(2).)

The Court ORDERS that the portion of each retirement fund listed above accrued between

the date of the marriage _____/_____/________ and the date this Final Decree of Divorce is

signed by the Court: (Check one.)

is awarded 50% to Husband and 50% to Wife and as more specifically described in the Qualified Domestic Relations Order signed by the Court.

is awarded $ __________________ to Wife and the remainder to Husband and as

more specifically described in the Qualified Domestic Relations Order signed by the Court.

other:

The Court ORDERS that Husband is awarded all retirement funds in Husband’s name alone that are not specifically awarded to Wife above.

The Court checks this box, if applicable.

A Qualified Domestic Relations Order was signed by the Court on the same day this Final Decree of Divorce was signed by the Court.

14F. Retirement Funds in Wife’s Name

(For example: pension, retirement, 401(k), 403(b), employee stock ownership, profit sharing, thrift, Keogh, and stock option plans, as well as individual retirement accounts (IRAs), annuities and variable annuity life insurance benefits.)

The Court makes the following orders regarding retirement funds in Wife’s name.

(Check 14F(1) or 14F(2).)

The Court ORDERS that the portion of each retirement fund listed above accrued between

the date of the marriage _____/_____/________ and the date this Final Decree of Divorce is

signed by the Court: (Check one.)

is awarded 50% to Wife and 50% to Husband and as more specifically described in the Qualified Domestic Relations Order signed by the Court.

is awarded ______% to Wife and ______% to Husband and as more specifically

described in the Qualified Domestic Relations Order signed by the Court.

is awarded $ __________________ to Husband and the remainder to Wife and as

more specifically described in the Qualified Domestic Relations Order signed by the Court.

other:

The Court ORDERS that Wife is awarded all retirement funds in Wife’s name alone that are not specifically awarded to Husband above.

The Court checks this box, if applicable.

A Qualified Domestic Relations Order was signed by the Court on the same day this Final Decree of Divorce was signed by the Court.

14G. Debts to Husband

The Court ORDERS Husband to pay the debts listed below:

1.All debts, taxes, bills, liens, and other charges, past, present and future, that are in Husband’s name alone unless this Decree requires otherwise.

2.Any debt Husband incurred after separation. Date of separation: ________________.

Month Day Year

3.The balance due on any loan or mortgage for the real property (house or land) that this Decree gives to Husband alone.

4.The balance due on any loan for any vehicles that this Decree gives to Husband alone.

5.All other debts listed below, which are not in Husband’s name alone: (such as credit cards, student loans, medical bills, income taxes)

14H. Debts to Wife

The Court ORDERS Wife to pay the debts listed below:

1.All debts, taxes, bills, liens, and other charges, present and future, that are in Wife’s name alone unless this Decree requires otherwise.

2.Any debt Wife incurred after separation. Date of separation: ______________________.

Month Day Year

3.The balance due on any loan or mortgage for the real property that this Decree gives to Wife alone.

4.The balance due on any loan for any vehicles that this Decree gives to Wife alone.

5.All other debts listed below, which are not in Wife’s name alone: (such as credit cards, student loans, medical bills, income taxes)

15. Muniment of Title

This Decree shall serve as a muniment of title to transfer ownership of all property awarded to any party in this Final Decree of Divorce. (A “muniment of title” creates an official record of ownership transfer.)

16. 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.

17. Court Costs

The costs of court shall be paid by the spouse who incurred them to the extent the party is required to pay such costs. A spouse who filed an Affidavit of Indigency that was not successfully contested is not required to pay court costs.

18. Other Orders

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

19. Final Orders

Any orders requested that do not appear above are denied. This Decree is a final judgment that disposes of all claims and all parties and is appealable.

Exhibit A: Standard Possession Order

The Court ORDERS each conservator to comply with all terms and conditions of this Standard Possession Order. The Court ORDERS that this Standard Possession Order is effective immediately and applies to all periods of possession occurring on and after the date the Court signs the Order or Decree to which this exhibit is attached.

A. Designation of Conservators

The Court ORDERS that in this Standard Possession Order the conservators are designated as Parent A and Parent B.

“Parent A” is: (name) __________________________________________________________________.

Print the name of the parent with the right to designate the child/ren’s primary residence.

“Parent B” is: (name) __________________________________________________________________.

Print the name of the other parent.

B. Mutual Agreement

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

In the absence of mutual agreement, the Court ORDERS that Parent A and Parent B shall have possession of the child/ren according to the schedules set out in this Standard Possession Order.

C. Definitions

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

“Child” or “Child/ren” includes each child, whether one or more, who is a subject of this suit while that child is under the age of eighteen years and not otherwise emancipated.

D. Undesignated Times

The Court ORDERS that Parent A shall have the right to possession of the child/ren at all times not specifically designated in this Standard Possession Order for Parent B.

Notice to Peace Officer

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 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.

E. Parent B’s Local Schedule

Except as otherwise expressly provided in this Standard Possession Order, when Parent B lives 100 miles or less from the primary residence of the child/ren, Parent B shall have the right to possession of the child/ren as follows:

(1)Weekends – Parent B shall have the right to possession of the child/ren on the 1st, 3rd and 5th weekends of each month.

If the weekend occurs during the regular school term, it shall:

If the weekend does not occur during the regular school term, it shall begin on the 1st, 3rd and 5th Friday of each month at 6 p.m. and end at 6 p.m. the following Sunday.

(2)Weekends Extended by a Holiday

If Parent B’s weekend begins on a student holiday or a teacher in-service day that falls on a Friday during the regular school term or begins on a federal, state, or local holiday that falls on a Friday during the summer break, that weekend period of possession shall begin on the Thursday before the holiday or in-service day at: (Check one box.)

6 p.m.

the time the child’s school is regularly dismissed.

If Parent B’s weekend ends on or is immediately followed by a student holiday or a teacher in-service day that falls on a Monday during the regular school term or ends on a federal, state, or local holiday that falls on a Monday during the summer months when school is not in session, that weekend period of possession shall end at 6 p.m. on that Monday.

(3)Thursdays – Parent B shall have the right to possession of the child/ren each Thursday during the regular school term:

(4)Spring Vacation – Parent B shall have the right to possession of the child/ren during Spring vacation in even-numbered years:

(5)Extended Summer Possession With Written Notice by April 1 – If Parent B gives Parent A written notice by April 1 of a year specifying an extended period or periods of summer possession for that year, Parent B shall have possession of the child/ren for 30 days beginning no earlier than the day after the child’s school is dismissed for the summer vacation and ending no later than seven days before school resumes at the end of the summer vacation in that year. The extended summer possession must be exercised in no more than two separate periods of at least seven consecutive days each, as specified in the written notice. The extended summer possession must not interfere with Father’s Day possession. These periods of possession shall begin and end at 6 p.m. on each applicable day.

(6)Extended Summer Possession Without Written Notice by April 1 – If Parent B does not give Parent A written notice by April 1 of a year specifying an extended period or periods of summer possession for that year, Parent B shall have possession of the child for 30 consecutive days in that year beginning at 6 p.m. on July 1 and ending at 6 p.m. on July 31.

F. Parent B’s Long-Distance Schedule

Except as otherwise expressly provided in this Standard Possession Order, when Parent B lives over 100 miles from the primary residence of the child/ren, Parent B shall have the right to possession of the child/ren as follows:

(1)Weekends – Unless Parent B elects the “Alternative Weekend Possession” below, Parent B shall have the right to possession of the child/ren on the 1st, 3rd and 5th weekends of each month.

If the weekend occurs during the regular school term, it shall:

If the weekend does not occur during the regular school term, it shall begin on the 1st, 3rd and 5th Friday of each month at 6 p.m. and end at 6 p.m. the following Sunday.

(Check box below if Parent B is choosing the Alternative Weekend Possession now.)

Alternative Weekend Possession – Instead of the weekend possession described in the previous paragraph, Parent B shall have the right to possession of the child/ren one weekend per month of Parent B’s choice. The weekend shall begin at 6 p.m. on the day school recesses for the weekend and end at 6 p.m. on the day before school resumes after the weekend. Parent B shall give Parent A 14 days’ notice in writing or by telephone before the chosen weekend. The weekend chosen shall not conflict with the provisions regarding Christmas, Thanksgiving, the child’s birthday, and Father’s or Mother’s Day possession below.

Parent B must choose this option now or by giving written notice to Parent A within 90 days after the parents begin to reside more than 100 miles apart.

(2)Weekends Extended by a Holiday

If Parent B’s weekend begins on a student holiday or a teacher in-service day that falls on a Friday during the regular school term or begins on a federal, state, or local holiday that falls on a Friday during the summer break, that weekend period of possession shall begin on the Thursday before the holiday or in-service day at: (Check one box.)

6 p.m.

the time the child’s school is regularly dismissed.

If Parent B’s weekend ends on or is immediately followed by a student holiday or a teacher in-service day that falls on a Monday during the regular school term or ends on a federal, state, or local holiday that falls on a Monday during the summer months when school is not in session, that weekend period of possession shall end at 6 pm on that Monday.

(3)Spring Vacation – Parent B shall have the right to possession of the child/ren during Spring vacation every year beginning at 6 p.m. on the day the child is dismissed from school for Spring Vacation and ending at 6 p.m. on the day before school resumes after that vacation.

(4)Extended Summer Possession With Written Notice by April 1 –If Parent B gives Parent A written notice by April 1 of a year specifying an extended period or periods of summer possession for that year, Parent B shall have possession of the child/ren for 42 days beginning no earlier than the day after the child’s school is dismissed for the summer vacation and ending no later than seven days before school resumes at the end of the summer vacation in that year. The extended summer possession must be exercised in no more than two separate periods of at least seven consecutive days each, as specified in the written notice. The extended summer possession must not interfere with Father’s Day possession. These periods of possession shall begin and end at 6 p.m. on each applicable day.

(5)Extended Summer Possession Without Written Notice by April 1 – If Parent B does not gives Parent A written notice by April 1 of a year specifying an extended period or periods of summer possession for that year, Parent B shall have possession of the child/ren for 42 consecutive days in that year beginning at 6 p.m. on June 15 and ending at 6 p.m. on July 27.

G. Parent A’s Local Schedule

This schedule applies when Parent B lives 100 miles or less from the primary residence of the child/ren.

Notwithstanding Parent B’s weekend and Thursday periods of possession, it is expressly ORDERED that Parent A shall have a superior right to possession of the child/ren as follows:*

(1)Spring Vacation – Parent A shall have the right to possession of the child/ren during Spring vacation in odd-numbered years:

(2)Weekend During Parent B’s Extended Summer Possession – If Parent A gives Parent B written notice by April 15 of a year, Parent A shall have possession of the child/ren on any 1 weekend beginning at 6 p.m. on Friday and ending at 6 p.m. on the following Sunday during any one period of the extended summer possession by Parent B. Parent A must pick up the child/ren from Parent B and returns the child/ren to that same place. This weekend must not interfere with Father’s Day possession.

(3)Extended Summer Possession – If Parent A gives Parent B written notice by April 15 of a year or gives Parent B 14 days’ written notice on or after April 16 of a year, Parent A may designate one weekend during which an otherwise scheduled weekend period of possession by Parent B shall not take place in that year. The weekend chosen must begin no earlier than the day after the child’s school is dismissed for the summer vacation and end no later than 7 days before school resumes at the end of the summer vacation. The weekend chosen must not interfere with Parent B’s periods of extended summer possession or with Father’s Day possession.

* Parent A has the right to possession of the child /ren at these times even if it conflicts with one or more of Parent B’s weekend or Thursday periods of possession.

H. Parent A’s Long-Distance Schedule

This schedule applies when Parent B lives over 100 miles from the primary residence of the child/ren.

Notwithstanding Parent B’s weekend periods of possession, it is expressly ORDERED that Parent A shall have a superior right to possession of the child/ren as follows:**

(1)Weekend During Parent B’s Extended Summer Possession – If Parent A gives Parent B written notice by April 15 of a year, Parent A shall have possession of the child/ren on any 1 weekend beginning at 6 p.m. on Friday and ending at 6 p.m. on the following Sunday during any 1 period of the extended summer possession by Parent B. Unless a period of possession by Parent B in that year is more than 30 days, then Parent A may have possession of the child under the terms of this provision on any 2 nonconsecutive weekends during that period. Parent A must pick up the child from Parent B and returns the child to that same place. The weekend or weekends must not interfere with Father’s Day possession.

(2)Extended Summer Possession – If Parent A gives Parent B written notice by April 15 of a year, Parent A may designate 21 days beginning no earlier than the day after the child’s school is dismissed for the summer vacation and ending no later than 7 days before school resumes at the end of the summer vacation in that year during which Parent B shall not have possession of the child. This extended summer possession must be exercised in no more than 2 separate periods of at least 7 consecutive days each. The period or periods chosen must not interfere with Parent B’s periods of extended summer possession or with Father’s Day possession. These periods of possession shall begin and end at 6 p.m. on each applicable day.

**Parent A has the right to possession of the child/ren at these times even if it conflicts with one or more of Parent B’s weekend periods of possession.

I. Holidays Unaffected by Distance

Notwithstanding the weekend and Thursday periods of possession of Parent B, Parent A and Parent B shall have the right to possession of the child/ren as follows:

(1)Christmas Holidays in Even-Numbered Years - In even-numbered years, Parent B shall have the right to possession of the child:

In even-numbered years, Parent A shall have the right to possession of the child beginning at noon on December 28 and ending at 6 p.m. on the day before school resumes after that Christmas school vacation.

(2)Christmas Holidays in Odd-Numbered Years - In odd-numbered years, Parent A shall have the right to possession of the child:

In odd-numbered years, Parent B shall have the right to possession of the child beginning at noon on December 28 and ending at 6:00 P.M. on the day before school resumes after that Christmas school vacation.

(3)Thanksgiving in Odd-Numbered Years - Parent B shall have the right to possession of the child for the Thanksgiving Holiday in odd-numbered years:

(4)Thanksgiving in Even-Numbered Years - Parent A shall have the right to possession of the child for the Thanksgiving Holiday in even-numbered years:

(5)Child’s Birthday - If a parent is not otherwise entitled under this Standard Possession Order to possession of a child on the child’s birthday, that parent shall have possession of the child beginning at 6 p.m. and ending at 8 p.m. on that day, provided that that parent picks up the child from the other parent’s residence and returns the child to that same place.

(6)Father’s Day - Father shall have the right to possession of the child each year, beginning at 6 p.m. on the Friday before Father’s Day and ending at: (Check one box.)

6 p.m. on Father’s Day

8 a.m. on the Monday after Father’s Day

If Father is not already entitled to present possession of the child, he must pick up the child from Mother’s residence and return the child to that same place.

(6)Mother’s Day - Mother shall have the right to possession of the child each year:

If Mother is not already entitled to present possession of the child, she must pick up the child from Father’s residence and return the child to that same place.

J. 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:

(1)Exchange of Children at Start of Parent B’s Possession

The Court ORDERS Parent A to surrender the child/ren to Parent B at the beginning of each period of Parent B’s possession at:

Parent A’s residence.

the following location: _____________________________________________________________

Unless a period of Parent B’s possession begins at the time the child’s school is regularly dismissed, then Parent A is ORDERED to surrender the child to Parent B 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, Parent B shall pick up the child at the location designated above at 6 p.m. and Parent A is ORDERED to surrender the child to Parent B at the location designated above at 6 p.m.

(2)Exchange of Children at End of Parent B’s Possession

The Court ORDERS Parent B to surrender the child/ren to Parent A at the end of each period Parent B’s possession at:

Parent B’s residence.

Parent A’s residence.

The following location: ____________________________________________________________

Unless a period of possession ends at the time the child’s school resumes, then Parent B is ORDERED to surrender the child to Parent A at the school in which the child is enrolled or, if the child is not in school, at the location designated above at 8:00 a.m.

However, if Parent A and Parent B live in the same county when the order is signed and Parent B remains in the county, but the Parent A moves out of the county, then beginning on the date Parent A moves, Parent B shall surrender the child to Parent A at:

Parent B’s residence.

the location designated above.

(3)Personal Effects - Each parent is ORDERED to return with the child the personal effects that the child brought at the beginning of the period of possession.

(4)Designation of Competent Adult - Each parent may designate any competent adult to pick up and return the child, as applicable. IT IS ORDERED that a parent or a designated competent adult be present when the child is picked up or returned.

(5)Inability to Exercise Possession - Each parent is ORDERED to give notice to the person in possession of the child on each occasion the parent will be unable to exercise that parent’s right of possession for any specified period.

(6)Written Notice - Written notice, including notice by email or fax is timely made if it is received or, if applicable, postmarked before or at the time that notice is due. Each parent is ORDERED to notify the other parent of any change to his or her email address or fax number within 24 hours after the change.

(7)Notice to School and Parent A - If Parent B’s time of possession of the child ends at the time school resumes and for any reason the child is not or will not be returned to school, Parent B shall immediately notify the school and Parent A that the child will not be or has not been returned to school.

This concludes the Standard Possession Order.

NOTICE: THIS DOCUMENT CONTAINS SENSITIVE DATA.

Cause Number:

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

1.________________________ 2._______________________ 3. ______________________

4.________________________ 5._______________________ 6. ______________________

Notice of Current Address

Print your full name

My address has changed. I ask that the Court’s records be updated accordingly.

My current address is:

Certificate of Service

I will give a copy of this document to the other party’s attorney or the party (if the party does not have an attorney) on the same day this document is filed with (turned in to) the Court as follows:

If I file this document electronically, I will send a copy of it to the party or the party’s attorney through the electronic file manager if possible. If not possible, I will give a copy to the party or the party’s attorney in person, by mail, by commercial delivery service, by fax, or by email.

If I file a paper copy of this document, I will give a copy of it to the other party or the other party’s attorney in person, by mail, by commercial delivery service, by fax, or by email.

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.

(explain)

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