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STATE OF SOUTH DAKOTA COUNTY OF

Plaintiff v.

Defendant.

) )SS. ) ) ) ) ) ) ) )

IN CIRCUIT COURT JUDCIAL CIRCUIT Civ. No. OBJECTION TO THE IMPLEMENTATION OF THE SOUTH DAKOTA PARENTING TIME GUIDLINES

I

, (person objecting) pursuant to SDCL § 25-4A-16.1,

object to the request for the Court to enter an Order implementing the South Dakota Parenting Time Guidelines. Defendant answers the Implementation Petition as follows: 1. I AGREE with the following sections of the South Dakota Parenting Time Guidelines:

2.

I DISAGREE with the following section of the South Dakota Parenting Time Guidelines:

3.

I either PARTIALLY Agree or Disagree with the following paragraphs of the South Dakota Parenting Time Guidelines:

VERIFICATION Defendant, being first duly and sworn, deposes and states that he or she verifies the facts expressed within the Objection are true. Dated , 20

Defendant's Signature Subscribed and sworn to before me this day of , 20 .

Notary Public/Clerk of Courts

Form UJS-267 Rev. 06/2009

(SEAL)

If Notary, my commission expires: NOTICE OF MAILING STATEMENT

I that I mailed my objection to

, swear and affirm, under penalty of law, by certified mail at this address:

Party's Name PO Box/Street Number City, State, Zip Code

Date:

, 20

.

Defendant's Signature

Subscribed and sworn to before me this

day of

, 20

.

(SEAL)

Notary Public/Clerk of Courts If Notary, my commission expires:

Form UJS-267 Rev. 06/2009

If you wish to explain your answers to the previous statements please use the space below. If you do not wish to explain your answers further, omit this page when you submit your Objection to the Clerk of Courts. 1.

2.

3.

4.

Form UJS-267 Rev. 06/2009