District Court Denver Juvenile Court

El Paso County, Colorado Court Address:

270 S Tejon St Colorado Springs, CO 80901

In re: The Marriage of: Parental Responsibilities concerning: ______________________________________________________ Petitioner: Jack Hill and Respondent/Co-Petitioner: Jill Hill Attorney or Party Without Attorney (Name and Address):
Jane Solicitor 520 Ivy Lane Colorado Springs, CO 80914

COURT USE ONLY Case Number: B387-19

Phone Number: 719-555-1234 FAX Number: 719-555-5678

E-mail:solicitor@solicit&elicit.com Atty. Reg. #: 1234567

OR

Division

Courtroom

TEMPORARY ORDERS AGREEMENT

INFORMATION FOR THE COURT

The Petitioner Respondent/Co-Petitioner or both state the following: Petitioner: Date of Birth: Apr. 1, 1973 Residential Address: Same Phone Numbers: Home: 719-555-5813 Work: 719-502-3300 Cell: 719-555-2134 Respondent/Co-Petitioner: Date of Birth: Nov. 20, 1976 Residential Address: Same Phone Numbers: Home: 719-555-1123 Work: N/A Cell: N/A 1. The names(s), address(es), birth date(s) and social security numbers of the minor child(ren) is/are: Name Fetch Hill Palin Hill Crown Hill Present Address 3950 Harmony Dr Apt 404 Clo Spgs, CO 80917 Same Same Sex M M F Date of Birth Dec. 25, 2001 Feb. 14, 2003 Aug. 1, 2007 Soc. Sec. No. 570-55-5069 572-55-5069 574-55-5069 Social Security Number: 560-96-3693 Mailing Address: 3950 Harmony Dr Apt 404 Colorado Springs, CO 80917 Social Security Number: 558-96-3693 Mailing Address: 4015 Westmeadow Dr Colorado Springs, CO 80909

2. Allocation of temporary parental responsibilities (decision-making and parenting time).

A.

Decision-making should be as follows. Select only one of the 3 following options. 1. The Petitioner Respondent/Co-Petitioner (check one) will make all of the major decisions regarding the child(ren). 2.

Both parties will make ALL major decisions regarding the child(ren) together.
TEMPORARY ORDERS AGREEMENT OR INFORMATION FOR THE COURT Page 1 of 4

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3. The parties will divide decision-making as set forth in the attached identified below:

Parenting Plan or as

Education issues shall be determined by Petitioner Respondent/Co-Petitioner Both Medical, dental and mental health issues shall be determined by Petitioner Respondent/Co Petitioner Both Religious issues shall be determined by Petitioner Respondent/Co-Petitioner Both Extracurricular and recreational issues shall be determined by Petitioner Respondent/CoPetitioner Both Other significant decisions (General Welfare, Driving, Car, Car Insurance, College, etc.) shall be determined by Petitioner Respondent/Co-Petitioner Both
_____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ B. Parenting time (visitation) should be (check all that apply): 1. As set forth in the attached Parenting Plan or select either 2, 3, or 4. 2. Petitioner will have Fetch and Palin every Sun-Fri from 6PM Sun to 6 PM Fri, and every other Fri-Sun from 6PM Fri to 6PM Sun. Petitioner will have Crown every other Fri-Sun from 6PM Fri to 6PM Sun. 3. Respondent/Co-Petitioner will have Fetch and Palin every other Fri-Sun from 6PM Fri to 6PM Sun. Respondent/Co-Petitioner will have Crown every Sun-Fri from 6PM Sun to 6PM Fri, and every other Fri-Sun from 6PM Fri to 6PM Sun. 4. Other (include holidays, birthdays, special occasions): Petitioner and Respondent/Co-Petitioner will alternate visitation for birthdays and holidays on an annual basis.

3. Child Support (A Child Support Obligation Worksheet must be filed.) Both parties agree on this issue. (If you agree, please indicate the terms of agreement below.) The Petitioner Respondent/Co-Petitioner shall pay child support to the Petitioner
Respondent/Co-Petitioner (check one) in the sum of $ 707 per month pursuant to the Colorado Child Support Guidelines, beginning on 5 Oct. 2012 (date).

Child support payments will be paid to: (check one) Family Support Registry P. O. Box 2171, Denver, CO 80201-2171. The Parties request that the Court order the payment to be made directly to the appropriate
person.

Child support payments will be paid as follows: Monthly Bi-weekly Weekly Other _________________________________________ The parties do not agree on this issue. 4. Information on any prior child(ren), spousal abuse allegations or protection/restraining orders:
Respondent/Co-Petitioner has made allegations of physical and verbal spousal abuse against Petitioner and has sought and obtained a Temporary Restraining Order against him which prohibits contact beyond the minimum necessary to effect transfer of the children during visitation.

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TEMPORARY ORDERS AGREEMENT OR INFORMATION FOR THE COURT

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5. Temporary maintenance (alimony) shall be paid by Petitioner Respondent/Co-Petitioner in the amount of

$1724 per month, commencing on Oct. 5 (date). For combined gross incomes of $75,000.00 or less per year, use the formula on page 4 or double click the box above if completing this form electronically. 6. A. The following debts shall be temporarily paid by the Petitioner: Creditor/Debt
Ent Federal Credit Union mortgage on 3950 Harmony Dr Apt 404

Account Number
3446531

To by Paid by
Petitioner

B.

The following debts shall be temporary paid by the Co-Petitioner/Respondent: Creditor/Debt

MasterCard Visa Discover

Account Number
134764136456 354386454345 698731358444

To by Paid by
Respondent/Co-Petitioner Same Same

C.

Each party shall provide proof to the other party of the above-stated payments made within 7 days of payment date. 7. Property you need use of (home, car, business property, tools, etc.):

Both parties agree on this issue. (If you agree, please indicate the terms of agreement below.) The parties do not agree on this issue.
Petitioner: 1999 Ford F-150, 3950 Harmony Dr Apt 404, Ent Federal Credit Union checking account Respondent/Co-Petitioner: 2000 Dodge Caravan, 3950 Harmony Dr Apt 404, basic household furnishings Property that needs immediate protection: Ent Federal Credit Union savings account, MetLife life insurance policy 8. Other issues: ____________________________________________________________________________ _______________________________________________________________________________________ _______________________________________________________________________________________ _______________________________________________________________________________________ _______________________________________________________________________________________

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I We believe this would be a fair and equitable division of our property and debts on a temporary basis and
that the temporary allocation of parental responsibilities is in the best interest of the child(ren). (Both parties must sign if this is an agreement.) I We have attached the required financial affidavits. I We have attached the required child support worksheets (A or B). I swear/affirm under oath that I have read the foregoing temporary agreement/information and that the statements set forth therein are true and correct to the best of my knowledge.

Jack Hill
Petitioner Signature

October 1, 2012 Date

Jill Hill
Co-Petitioner Signature

October 1, 2012 Date

Jane Solicitor
Petitioners Attorney Signature, if any

John Barrister
Co-Petitioners Attorney Signature, if any

Subscribed and affirmed, or sworn to before me in the County of El Paso, State of CO, this 1st day of October, 2012.

Subscribed and affirmed, or sworn to before me in the County of El Paso, State of CO, this 1st day of October, 2012.

My commission expires: ___________________ _______________________________________

Notary Public/Clerk

My commission expires: ___________________ ______________________________________

Notary Public/Clerk

NO TE: C O M BINED INCO M E M US T BE $75,000 O R L ES S P ER YEAR T O US E T HIS W O R KS HEET .

P re s u m e d T e m p o ra ry M a in te n a n c e C a lc u la tio n
(e nter a ll in f or mation b e lo w o r do u b le c lic k to c omplete ele c tro n ic a lly )

$ $ $ $ $ $ $ $ $ $
$

1. Hus band's G ros s M onthly Inc om e a. Hus band's pre-ex is ting M aintenanc e P ay m ents (ac tually paid and not in this m arriage) b. Hus band's pre-ex is ting Child S upport P ay m ents (ac tually paid and not in this m arriage) 2. W ife's G ros s M onthly Inc om e a. W ife's pre-ex is ting M aintenanc e P ay m ents (ac tually paid and not in this m arriage) b. W ife's pre-ex is ting Child S upport P ay m ents (ac tually paid and not in this m arriage) 3. H us band's M onthly Inc om e les s pre-ex is ting m aintenanc e or c hild s upport (1-(1a+ 1b)) 4. W ife's M onthly Inc om e les s pre-ex is ting m aintenanc e or c hild s upport (2-(2a+ 2b)) 5. 40% of inc om e from higher earning s pous e (highes t inc om e tim es .40) 6. 50% of the inc om e from lower earning s pous e (lowes t inc om e tim es .50) Line 5 m inus Line 6 n u mbe r is le s s th a n or e qu a l to z ero , no te mp ora ry ma in ten a nc e a w a rd ed ) (if this

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