Washington Parenting Plan Form

Should there be minor children involved in a divorce case, the spouses must complete this form to determine the custody arrangement to be enforced following the finalization of the divorce.Download

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Parenting Plan (PPP, PPT, PP) - Page 1 of 11 
WPF DR 01.0400 Mandatory (6/2008) - RCW 26.09.016, .181; .187; .194	
   
 
 
 
 
 
 
 
 
 
 	
Superior Court of Washington 
County of 
 
[ ]  In re the Marriage of: 
[ ]  In re the Domestic Partnership of: 
 
 
 Petitioner, 
and 
 
 
 Respondent.  
 	
No.   
 
Parenting Plan  
[ ] Proposed	
 (PPP) 	
[ ] Temporary	 (PPT) 	
[ ] Final Order	 (PP) 	
 
This parenting plan is: 
 
[ ]  the final parenting plan signed by the court pursuant to a decree of dissolution, legal 
separation, or declaration concerning validity signed by the court on this date or  
dated ________________________. 
[ ]  the final parenting plan signed by the court pursuant to an order signed by the court on 
this date or dated _________________________, which modifies a previous parenting 
plan or custody decree. 
[ ]  a temporary parenting plan signed by the court. 
[ ]  proposed by (name) ______________________________. 
 	
It Is Ordered, Adjudged and Decreed: 
 	
I.  General Information 	
 
This parenting plan applies to the following children: 
 
   Name	
       Age

Parenting Plan (PPP, PPT, PP) - Page 2 of 11 
WPF DR 01.0400 Mandatory (6/2008) - RCW 26.09.016, .181; .187; .194	
   	
II.  Basis for Restrictions 	
 
Under certain circumstances, as outlined below, the court may limit or prohibit a parent’s contact 
with the child(ren) and the right to make decisions for the child(ren). 
 
2.1  Parental Conduct (RCW 26.09.191(1), (2)) 
 
  [ ]  Does not apply. 
  [ ]  The [ ] petitioner’s [ ] respondent’s residential time with the child(ren) shall be limited or 
restrained completely, and mutual decision-making and designation of a dispute 
resolution process other than court action shall not be required, because [ ] this parent  
[ ] a person residing with this parent has engaged in the conduct which follows: 
 
    [ ]  Willful abandonment that continues for an extended period of time or substantial 
refusal to perform parenting functions (this applies only to parents, not to a 
person who resides with a parent). 
    [ ]  Physical, sexual or a pattern of emotional abuse of a child. 
    [ ]  A history of acts of domestic violence as defined in RCW 26.50.010(1) or an 
assault or sexual assault which causes grievous bodily harm or the fear of such 
harm. 
 
2.2  Other Factors (RCW 26.09.191(3)) 
 
  [ ]  Does not apply. 
  [ ]  The [ ] petitioner’s  [ ] respondent’s involvement or conduct may have an adverse effect 
on the child(ren)’s best interests because of the existence of the factors which follow: 
 
    [ ]  Neglect or substantial nonperformance of parenting functions. 
    [ ]  A long-term emotional or physical impairment which interferes with the 
performance of parenting functions as defined in RCW 26.09.004. 
    [ ]  A long-term impairment resulting from drug, alcohol, or other substance abuse 
that interferes with the performance of parenting functions. 
    [ ]  The absence or substantial impairment of emotional ties between the parent and 
child. 
    [ ]  The abusive use of conflict by the parent which creates the danger of serious 
damage to the child’s psychological development. 
    [ ]  A parent has withheld from the other parent access to the child for a protracted 
period without good cause. 
  [ ] Other:

Parenting Plan (PPP, PPT, PP) - Page 3 of 11 
WPF DR 01.0400 Mandatory (6/2008) - RCW 26.09.016, .181; .187; .194	
 	
III.  Residential Schedule 	
 
The residential schedule must set forth where the child(ren) shall reside each day of the year, 
including provisions for holidays, birthdays of family members, vacations, and other special 
occasions, and what contact the child(ren) shall have with each parent. Parents are encouraged 
to create a residential schedule that meets the developmental needs of the child(ren) and 
individual needs of their family.  Paragraphs 3.1 through 3.9 are one way to write your 
residential schedule.  If you do not use these paragraphs, write in your own schedule in 
Paragraph 3.13. 
 
3.1  Schedule for Children Under School Age 
 
  [ ]  There are no children under school age. 
  [ ]  Prior to enrollment in school, the child(ren) shall reside with the [ ] petitioner  
[ ] respondent, except for the following days and times when the child(ren) will reside 
with or be with the other parent: 
 
from (day and time) ____________________ to (day and time) ___________________  
 
    [ ]  every week [ ] every other week [ ] the first and third week of the month 
    [ ]  the second and fourth week of the month [ ] other: 
 
 
from (day and time) _____________________ to (day and time) __________________  
 
    [ ]  every week [ ] every other week [ ] the first and third week of the month 
    [ ]  the second and fourth week of the month [ ] other: 
 
 
 
3.2 School Schedule 
 
Upon enrollment in school, the child(ren) shall reside with the [ ] petitioner   
[ ] respondent, except for the following days and times when the child(ren) will reside with or be 
with the other parent: 
 
from (day and time) ______________________ to (day and time) _________________  
 
    [ ]  every week [ ] every other week [ ] the first and third week of the month 
    [ ]  the second and fourth week of the month [ ] other: 
 
 
 
From (day and time) ______________________ to (day and time) _________________  
 
    [ ]  every week [ ] every other week [ ] the first and third week of the month 
    [ ]  the second and fourth week of the month [ ] other:

Parenting Plan (PPP, PPT, PP) - Page 4 of 11 
WPF DR 01.0400 Mandatory (6/2008) - RCW 26.09.016, .181; .187; .194	
   
  [ ]  The school schedule will start when each child begins [ ] kindergarten [ ] first grade 
  [ ] other: 
 
 
 	
3.3  Schedule for Winter Vacation 
 
The child(ren) shall reside with the [ ] petitioner  [ ] respondent during winter vacation, except for 
the following days and times when the child(ren) will reside with or be with the other parent: 
 
 
 
 
 
 
3.4  Schedule for Other School Breaks 
 
The child(ren) shall reside with the [ ] petitioner  [ ] respondent during other school breaks, 
except for the following days and times when the child(ren) will reside with or be with the other 
parent: 
 
 
 
 
 
 
3.5 Summer Schedule 
 
Upon completion of the school year, the child(ren) shall reside with the [ ] petitioner   
[ ] respondent, except for the following days and times when the child(ren) will reside with or be 
with the other parent: 
 
  [ ]  Same as school year schedule. 
 [ ] Other: 
 
 
 
3.6  Vacation With Parents 
 
  [ ]  Does not apply. 
  [ ]  The schedule for vacation with parents is as follows: 
 
 
 
 
 
 
3.7  Schedule for Holidays

Parenting Plan (PPP, PPT, PP) - Page 5 of 11 
WPF DR 01.0400 Mandatory (6/2008) - RCW 26.09.016, .181; .187; .194	
  The residential schedule for the child(ren) for the holidays listed below is as follows: 
 
  With Petitioner  With Respondent 
  (Specify Year  (Specify Year 
 Odd/Even/Every	
) Odd/Even/Every	) 
 
  New Year’s Day   	
  	 
  Martin Luther King Day   	
  	 
 Presidents’ Day   	
  	 
 Memorial Day   	
  	 
 July 4th   	
  	 
 Labor Day   	
  	 
 Veterans’ Day   	
  	 
 Thanksgiving Day   	
  	 
 Christmas Eve   	
  	 
 Christmas Day   	
  	 
  	
  	  	 
  	
  	  	 
 
  [ ]  For purposes of this parenting plan, a holiday shall begin and end as follows (set forth 
times): 
 
 
  [ ]  Holidays which fall on a Friday or a Monday shall include Saturday and Sunday. 
 
 [ ] Other: 
 
 
 	
3.8  Schedule for Special Occasions 
 
The residential schedule for the child(ren) for the following special occasions (for example, 
birthdays) is as follows: 
    With Petitioner  With Respondent 
    (Specify Year  (Specify Year 
  Odd/Even/Every	
) Odd/Even/Every	) 
 Mother’s Day 	
  	  	 
 Father’s Day 	
  	  	 
  	
  	  	 
  	
  	  	 
  	
  	  	 
  	
  	  	 
 
 [ ] Other: 
 
 
 	
3.9  Priorities Under the Residential Schedule 
 
  [ ]  Does not apply because one parent has no visitation or restricted visitation.

Parenting Plan (PPP, PPT, PP) - Page 6 of 11 
WPF DR 01.0400 Mandatory (6/2008) - RCW 26.09.016, .181; .187; .194	
    [ ]  Paragraphs 3.3 - 3.8, have priority over paragraphs 3.1 and 3.2, in the following order: 
 
    [ ]  Rank the order of priority, with 1 being given the highest priority: 
 
  ____winter vacation (3.3)  ____holidays (3.7) 
  ____school breaks (3.4)  ____special occasions (3.8) 
  ____summer schedule (3.5)  ____vacation with parents (3.6) 
 
  [ ] Other: 
 
 
 	
3.10 Restrictions 
 
  [ ]  Does not apply because there are no limiting factors in paragraphs 2.1 or 2.2. 
  [ ]  The [ ] petitioner’s [ ] respondent’s residential time with the children shall be limited 
because there are limiting factors in paragraphs 2.1 and 2.2.  The following restrictions 
shall apply when the children spend time with this parent: 
 
 
 
  [ ]  There are limiting factors in paragraph 2.2, but there are no restrictions on the  
  [ ] petitioner’s [ ] respondent’s residential time with the children for the following 
reasons: 
 
 
 
 
 
 
 
 
 
 
3.11 Transportation Arrangements 
 
Transportation costs are included in the Child Support Worksheets and/or the Order of Child 
Support and should not be included here. 
Transportation arrangements for the child(ren), between parents shall be as follows: 
 
 
 
 
 
 
 
3.12  Designation of Custodian 
 
The children named in this parenting plan are scheduled to reside the majority of the time with 
the [ ] petitioner [ ] respondent.  This parent is designated the custodian of the child(ren) solely

Parenting Plan (PPP, PPT, PP) - Page 7 of 11 
WPF DR 01.0400 Mandatory (6/2008) - RCW 26.09.016, .181; .187; .194	
  for purposes of all other state and federal statutes which require a designation or determination of 
custody.  This designation shall not affect either parent’s rights and responsibilities under this 
parenting plan. 
 	
3.13 Other 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
3.14  Summary of RCW 26.09.430 - .480, Regarding Relocation of a Child 
 
This is a summary only. For the full text, please see RCW 26.09.430 through 26.09.480.  
If the person with whom the child resides a majority of the time plans to move, that person shall 
give notice to every person entitled to court ordered time with the child. 
If the move is outside the child’s school district, the relocating person must give notice by 
personal service or by mail requiring a return receipt.  This notice must be at least 60 days before 
the intended move.  If the relocating person could not have known about the move in time to give 
60 days’ notice, that person must give notice within 5 days after learning of the move.  The notice 
must contain the information required in RCW 26.09.440.  See also form DRPSCU 07.0500, 
(Notice of Intended Relocation of A Child). 
If the move is within the same school district, the relocating person must provide actual notice by 
any reasonable means.  A person entitled to time with the child may not object to the move but 
may ask for modification under RCW 26.09.260. 
Notice may be delayed for 21 days if the relocating person is entering a domestic violence shelter 
or is moving to avoid a clear, immediate and unreasonable risk to health and safety.   
If information is protected under a court order or the address confidentiality program, it may be 
withheld from the notice. 
A relocating person may ask the court to waive any notice requirements that may put the health 
and safety of a person or a child at risk.  
Failure to give the required notice may be grounds for sanctions, including contempt.

Parenting Plan (PPP, PPT, PP) - Page 8 of 11 
WPF DR 01.0400 Mandatory (6/2008) - RCW 26.09.016, .181; .187; .194	
  If no objection is filed within 30 days after service of the notice of intended relocation, the 
relocation will be permitted and the proposed revised residential schedule may be 
confirmed. 
A person entitled to time with a child under a court order can file an objection to the child’s 
relocation whether or not he or she received proper notice.   
An objection may be filed by using the mandatory pattern form WPF DRPSCU 07.0700, 
(Objection to Relocation/Petition for Modification of Custody Decree/Parenting Plan/Residential 
Schedule). The objection must be served on all persons entitled to time with the child. 
The relocating person shall not move the child during the time for objection unless: (a) the 
delayed notice provisions apply; or (b) a court order allows the move.  
If the objecting person schedules a hearing for a date within 15 days of timely service of the 
objection, the relocating person shall not move the child before the hearing unless there is a clear, 
immediate and unreasonable risk to the health or safety of a person or a child. 	
 	
IV.  Decision Making 	
 
4.1 Day-to-Day Decisions 
 
Each parent shall make decisions regarding the day-to-day care and control of each child while 
the child is residing with that parent. Regardless of the allocation of decision making in this 
parenting plan, either parent may make emergency decisions affecting the health or safety of the 
children. 
 
4.2 Major Decisions 
 
Major decisions regarding each child shall be made as follows: 
 
  Education decisions    [ ]  petitioner  [ ]  respondent  [ ]  joint 
  Non-emergency health care    [ ]  petitioner  [ ]  respondent  [ ]  joint 
  Religious upbringing     [ ]  petitioner  [ ]  respondent  [ ]  joint 
  	
  [ ]  petitioner  [ ]  respondent  [ ]  joint 
  
  [ ]  petitioner  [ ]  respondent  [ ]  joint 
  
  [ ]  petitioner  [ ]  respondent  [ ]  joint 
  
  [ ]  petitioner  [ ]  respondent  [ ]  joint 
  
  [ ]  petitioner  [ ]  respondent  [ ]  joint 
  
  [ ]  petitioner  [ ]  respondent  [ ]  joint 
 
 
 
 	
4.3  Restrictions in Decision Making 
 
  [ ]  Does not apply because there are no limiting factors in paragraphs 2.1 and 2.2 above. 
  [ ]  Sole decision making shall be ordered to the [ ] petitioner [ ] respondent for the following 
reasons: 
 
    [ ]  A limitation on the other parent’s decision making authority is mandated by 
RCW 26.09.191 (See paragraph 2.1).

Parenting Plan (PPP, PPT, PP) - Page 9 of 11 
WPF DR 01.0400 Mandatory (6/2008) - RCW 26.09.016, .181; .187; .194	
      [ ]  Both parents are opposed to mutual decision making. 
    [ ]  One parent is opposed to mutual decision making, and such opposition is 
reasonably based on the following criteria: 
 
      (a)  The existence of a limitation under RCW 26.09.191; 
      (b)  The history of participation of each parent in decision making in each of 
the areas in RCW 26.09.184(4)(a); 
      (c)  Whether the parents have demonstrated ability and desire to cooperate 
with one another in decision making in each of the areas in  
RCW 26.09.184(4)(a); and 
  (d)  The parents’ geographic proximity to one another, to the extent that it 
affects their ability to make timely mutual decisions. 
 
  [ ]  There are limiting factors in paragraph 2.2, but there are no restrictions on mutual 
decision making for the following reasons: 
 
 
 
 
 
 
 	
V.  Dispute Resolution 	
 
The purpose of this dispute resolution process is to resolve disagreements about carrying out 
this parenting plan.  This dispute resolution process may, and under some local court rules or 
the provisions of this plan must be used before filing a petition to modify the plan or a motion for 
contempt for failing to follow the plan. 
 
[ ]  Disputes between the parties, other than child support disputes, shall be submitted to (list person 
or agency): 
 
  [ ]  counseling by       	
, or 
 
  [ ]  mediation by       
,  if this box is checked and 
issues of domestic violence or child abuse are present, then the court finds that the victim 
requested mediation, that mediation is appropriate and that the victim is permitted to have 
a supporting person present during the mediation proceedings, or 
 
  [ ]  arbitration by       
. 
 
The cost of this process shall be allocated between the parties as follows: 
 
  [ ]  __________% petitioner  _________% respondent. 
  [ ]  based on each party’s proportional share of income from line 6 of the child support 
worksheets. 
  [ ]  as determined in the dispute resolution process. 
 
The dispute resolution process shall be commenced by notifying the other party by [ ] written 
request [ ] certified mail [ ] other:

Parenting Plan (PPP, PPT, PP) - Page 10 of 11 
WPF DR 01.0400 Mandatory (6/2008) - RCW 26.09.016, .181; .187; .194	
   
In the dispute resolution process: 
 
  (a)  Preference shall be given to carrying out this Parenting Plan. 
  (b)  Unless an emergency exists, the parents shall use the designated process to resolve 
disputes relating to implementation of the plan, except those related to financial support. 
  (c)  A written record shall be prepared of any agreement reached in counseling or mediation 
and of each arbitration award and shall be provided to each party. 
  (d)  If the court finds that a parent has used or frustrated the dispute resolution process 
without good reason, the court shall award attorneys’ fees and financial sanctions to the 
other parent. 
  (e)  The parties have the right of review from the dispute resolution process to the superior 
court. 
 
[ ]  No dispute resolution process, except court action is ordered. 
 
 	
VI.  Other Provisions 	
 
[ ]  There are no other provisions. 
[ ]  There are the following other provisions: 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 	
VII.  Declaration for Proposed Parenting Plan 	
 
[ ]  Does not apply. 
[ ]  (Only sign if this is a proposed parenting plan.)  I declare under penalty of perjury under the laws 
of the state of Washington that this plan has been proposed in good faith and that the statements 
in Part II of this Plan are true and correct.

Parenting Plan (PPP, PPT, PP) - Page 11 of 11 
WPF DR 01.0400 Mandatory (6/2008) - RCW 26.09.016, .181; .187; .194	
  Petitioner      Date and Place of Signature 
 
 
  	
  	 
Respondent      Date and Place of Signature 
 
 
 	
VIII.  Order by the Court 	
 
It is ordered, adjudged and decreed that the parenting plan set forth above is adopted and approved as an 
order of this court. 
 
WARNING:  Violation of residential provisions of this order with actual knowledge of its terms is 
punishable by contempt of court and may be a criminal offense under RCW 9A.40.060(2) or 
9A.40.070(2).  Violation of this order may subject a violator to arrest. 
 
When mutual decision making is designated but cannot be achieved, the parties shall make a good faith 
effort to resolve the issue through the dispute resolution process. 
 
If a parent fails to comply with a provision of this plan, the other parent’s obligations under the plan are 
not affected. 
 
 
Dated:  	
  	 
  	
Judge/Commissioner 	
 
Presented by:    Approved for entry: 
 
 	
  	 
Signature of Party or Lawyer/WSBA No.    Signature of Party or Lawyer/WSBA No. 
 	
  	 
Print Name    Print Name