Everett Divorce Attorney - Residential Time Summary Report(RTSR)

Document Name:

Superior Court of Washington

County of

In re the Marriage of:

Petitioner,

and

Respondent.

No.

Residential Time Summary Report

(RTSR)

Clerks Action Required

Submit with final Parenting Plan, only. This form is for statistical reporting purposes only.

1. The Parenting Plan

The court signed the Parenting Plan on (Date) ___________________________________.

It was: [ ] by agreement of the parties

[ ] after a contested hearing or trial

[ ] by default

It is: [ ] an original order

[ ] a modification of a prior order

How many children under the parenting plan have the residential schedule summarized in paragraph 2, below? _______________

2. Residential Schedule from Part III of the Parenting Plan

If the same schedule does not apply to all children, fill out a separate Residential
Time Summary Report for each schedule.

Check the box that comes closest to representing the time spent with each parent:	% of time the children spend with the Mother	% of time the children spend with the Father
[ ]	0%	100%
[ ]	10%	90%
[ ]	20%	80%
[ ]	30%	70%
[ ]	40%	60%
[ ]	50%	50%
[ ]	60%	40%
[ ]	70%	30%
[ ]	80%	20%
[ ]	90%	10%
[ ]	100%	0%

3. Information about the Parents

Father: [ ] self-represented [ ] represented by an attorney

The court found under paragraphs 2.1 and 2.2: [ ] does not apply, or

the Father [ ] committed domestic violence [ ] abused or neglected a child

[ ] has chemical dependency issues [ ] has mental health issues

[ ] other:______________________________________________________________

Mother: [ ] self-represented [ ] represented by an attorney

The court found under paragraphs 2.1 and 2.2: [ ] does not apply, or

the Mother [ ] committed domestic violence [ ] abused or neglected a child

[ ] has chemical dependency issues [ ] has mental health issues

[ ] other:______________________________________________________________

4. Dispute Resolution from Part V. of the Parenting Plan

[ ] Arbitration [ ] Mediation [ ] Counseling [ ] No dispute resolution process except court action

Prepared by: ______________________________________, on (Date) _________________________.