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Here is the text we could read:

PETITIONER:
RESPONDENT:
OTHER PARENT/PARTY:

CASE NUMBER:

FL-341(D)

ADDITIONAL PROVISIONS—PHYSICAL CUSTODY ATTACHMENT

Petition
Stipulation and Order for Custody and/or Visitation of Children

Request for Order

Response

Responsive Declaration to Request for Order

Findings and Order After Hearing or Judgment

Custody Order—Juvenile—Final Judgment

Other (specify):

The additional provisions to physical custody apply to (specify parties):

Petitioner

Respondent

Other Parent/Party

Notification of parties' current address.

Petitioner

Respondent

Other Parent/Party

must notify all parties within (specify number):

days of any change in his or her

address for

residence

mailing

work

e-mail

telephone/message number at
The parties may not use such information for the purpose of harassing, annoying, or disturbing the peace of the other or
invading the other's privacy. No residence or work address is needed if a party has an address with the State of
California's Safe at Home confidential address program.

the children's schools

cell phone

home

work

Notification of proposed move of child.
planned change in residence of the children. The notification must state, to the extent known, the planned address of the
children, including the county and state of the new residence. The notification must be sent by certified mail, return receipt
requested.

Each party must notify the other days before any

(specify number):

Child care.
a.
b.

The children must not be left alone without age-appropriate supervision.
The parties must let each other know the name, address, and phone number of the children's regular child-care
providers.

Right of first option of child care.
while the children are in his or her custody, the other party or parties must be given first opportunity, with as much prior
notice as possible, to care for the children before other arrangements are made. Unless specifically agreed or ordered by the
court, this order does not include regular child care needed when a party is working.

In the event any party requires child care for hours or more

(specify number):

Canceled visitation (parenting time).
a.

If the noncustodial party fails to arrive at the appointed time and fails to notify the custodial party that he or she will
be late, then the custodial party need wait for only minutes before considering the
visitation (parenting time) canceled.

(specify number):

If the noncustodial party is unable to exercise visitation (parenting time) on a given occasion, he or she must notify
the custodial party (specify):

If the children are ill and unable to participate in the scheduled visitation (parenting time), the custodial party must
give the noncustodial party (specify):

at the earliest possible opportunity.
Other (specify):

as much notice as possible.
A doctor's excuse.
Other

(specify):

Phone contact between parties and children.
a.

The children may have telephone access to the parties
children at reasonable times, for reasonable durations.

and the parties may have telephone access to the

The custodial parent must make the child available for the following scheduled telephone contact (specify child's
telephone contact with each party):

No party or any other third party may listen to, monitor, or interfere with the calls.

Form Approved for Optional Use
Judicial Council of California
FL-341(D) [Rev. July 1, 2016]

ADDITIONAL PROVISIONS—PHYSICAL CUSTODY ATTACHMENT

Page 1 of 2

Family Code, §§ 3003, 3024, 3083
www.courts.ca.gov

PETITIONER:
RESPONDENT:
OTHER PARENT/PARTY:

CASE NUMBER:

FL-341(D)

10.

11.

12.

13.

15.

16.

No negative comments. The parties will not make or allow others to make negative comments about each other or about
their past or present relationships, family, or friends within hearing distance of the children.

Discussion of court proceedings with children. Other than age-appropriate discussion of the parenting plan and the
children's role in mediation or other court proceedings, the parties will not discuss with the children any court proceedings
relating to custody or visitation (parenting time).

No use of children as messengers. The parties will communicate directly with each other on matters concerning the
children and may not use the children as messengers between them.

Alcohol or substance abuse. The
alcoholic beverages, narcotics, or restricted dangerous drugs (except by prescription) within hours
and may not permit any third party to do so in the presence of the
before or during periods of time with the children
children.

may not consume

(specify number):

other parent/party

respondent

petitioner

No exposure to cigarette or medical marijuana smoke. The parties will not expose the children to secondhand cigarette
or medical marijuana smoke.

No interference with schedule of any party without that party's consent. The parties will not schedule activities for the
children during the other party's scheduled visitation (parenting time) without the other party's prior agreement.

Third-party contact.

The children will have no contact with

(specify name):

The children must not be left alone in the presence of (specify name):

14.

Children's clothing and belongings.

Each party will maintain clothing for the children so that the children do not have to make the exchanges with
additional clothing.
The children will be returned to the other party with the clothing and other belongings they had when they arrived.

Log book. The parties will maintain a "log book" and make sure that the book is sent with the children between their
homes. Using businesslike notes (no personal comments), parties will record information related to the health, education,
and welfare issues that arise during the time the children are with them.

Terms and conditions of order may be changed. The terms and conditions of this order may be added to or changed as
the needs of the children and parties change. Such changes will be in writing, dated and signed by the parties; each party
will retain a copy. If the parties want a change to be a court order, it must be filed with the court in the form of a court
document.

17.

Other (specify):

FL-341(D) [Rev. July 1, 2016]

ADDITIONAL PROVISIONS—PHYSICAL CUSTODY ATTACHMENT

Page 2 of 2

Additional Provisions—Physical Custody Attachment

This info page is part of the LIT Lab's Form Explorer project. It is not associated with the California state courts. To learn more about the project, check out our about page.

Downloads: You can download both the original form (last checked 2023-03) and the machine-processed form with normalized data fields.

About This Form:

Sourced from selfhelp.courts.ca.gov (2023-03)
Page(s): 2
Fields(s): 81
Average fields per page: 40
Reading Level: Grade 9
LIST Grouping(s): FA-00-00-00-00.

Use our Rate My PDF tool to learn more. Go beyond the above insights and learn more about this or any pdf form at RateMyPDF.com, includes: counts of difficult words used, passive voice decetion, and suggestions for how to make the form more usable.

Identified Data Fields:

We have done our best to automaticly identify and name form fields according to our naming conventions. When possible, we've used names tied to our question library. See e.g., user1_name. If we think we've found a match to a question in our library, it is highlighted in green. Novel names are auto generated. So, you will probably need to edit some of them if you're trying to stick to the convention.

Here are the fields we could identify.

topmost_subform_page_noncustodial_parent_late_cb was topmostSubform[0].Page1[0].NoncustodialParentLate_cb[0] (0.59 conf)
topmost_page_number_minutes was topmostSubform[0].Page1[0].NumberMinutes_no[0] (0.40 conf)
page_parent_unable_visit was topmostSubform[0].Page1[0].NuncustodialParentUnableToVisit_cb[0] (0.35 conf)
page_custodial_parent_notice was topmostSubform[0].Page1[0].CustodialParentNotice_cb[0] (0.37 conf)
topmost_subform_page_doctor_excuse_cb was topmostSubform[0].Page1[0].DoctorExcuse_cb[0] (0.35 conf)
topmost_subform_page_earliest_possibile_opportunity_cb was topmostSubform[0].Page1[0].EarliestPossibileOpportunity_cb[0] (0.39 conf)
topmost_subform_page_cb__1 was topmostSubform[0].Page1[0].Other_cb[0] (0.37 conf)
topmost_much_notice_possible was topmostSubform[0].Page1[0].AsMuchNoticeAsPossible_cb[0] (0.35 conf)
topmost_page_child_sick_ft was topmostSubform[0].Page1[0].OtherIfChildIsSick_ft[0] (0.35 conf)
topmost_subform_page_cb__2 was topmostSubform[0].Page1[0].Other_cb[1] (0.37 conf)
topmost_subform_page_u_nable_ft was topmostSubform[0].Page1[0].OtherIfUNable_ft[0] (0.43 conf)
topmost_subform_page_petition was topmostSubform[0].Page1[0].Petition_cb[0] (0.40 conf)
topmost_subform_page_response_cb was topmostSubform[0].Page1[0].Response_cb[0] (0.36 conf)
topmost_subform_page_stip_ord_custody_visitation_cb was topmostSubform[0].Page1[0].StipOrdCustodyVisitation_cb[0] (0.37 conf)
topmost_subform_page_findings_order_cb was topmostSubform[0].Page1[0].FindingsOrder_cb[0] (0.35 conf)
topmost_subform_page_resp_decl_rf_cb was topmostSubform[0].Page1[0].RespDeclRFO_cb[0] (0.38 conf)
topmost_subform_page_request_order_cb was topmostSubform[0].Page1[0].RequestForOrder_cb[0] (0.37 conf)
topmost_subform_page_residence_cb was topmostSubform[0].Page1[0].Residence_cb[0] (0.34 conf)
topmost_subform_page_work_cb__1 was topmostSubform[0].Page1[0].work_cb[0] (0.40 conf)
topmost_subform_page_mailing_cb was topmostSubform[0].Page1[0].mailing_cb[0] (0.40 conf)
topmost_subform_page_home_cb was topmostSubform[0].Page1[0].home_cb[0] (0.40 conf)
topmost_page_children_schools was topmostSubform[0].Page1[0].ChildrenSchools_cb[0] (0.36 conf)
topmost_subform_page_work_cb__2 was topmostSubform[0].Page1[0].work_cb[1] (0.40 conf)
topmost_subform_page_email_cb was topmostSubform[0].Page1[0].email_cb[0] (0.40 conf)
topmost_subform_page_cellphone_cb was topmostSubform[0].Page1[0].cellphone_cb[0] (0.40 conf)
topmost_page_number_days_ft was topmostSubform[0].Page1[0].NumberDays_ft[0] (0.40 conf)
topmost_subform_page_notify_current_adress_cb was topmostSubform[0].Page1[0].NotifyCurrentAdress_cb[0] (0.42 conf)
topmost_page_number_days was topmostSubform[0].Page1[0].NumberDays_no[0] (0.40 conf)
topmost_subform_page_notification_move_child_cb was topmostSubform[0].Page1[0].NotificationMoveChild_cb[0] (0.35 conf)
topmost_page_children_alone__1 was topmostSubform[0].Page1[0].ChildrenNoAlone_cb[0] (0.39 conf)
topmost_subform_page_chid_care_provider_add_tel_cb was topmostSubform[0].Page1[0].ChidCareProviderAddTel_cb[0] (0.41 conf)
topmost_subform_page_child_care was topmostSubform[0].Page1[0].ChildCare_cb[0] (0.31 conf)
topmost_page_number_hour__1 was topmostSubform[0].Page1[0].NumberHour_no[0] (0.40 conf)
topmost_right_option_child_care was topmostSubform[0].Page1[0].Right1stOptionChildCare_cb[0] (0.31 conf)
topmost_subform_page_canceled_parent_time_cb was topmostSubform[0].Page1[0].CanceledParentTime_cb[0] (0.40 conf)
topmost_subform_page_children_tel_access_parent_cb was topmostSubform[0].Page1[0].ChildrenTelAccessParent_cb[0] (0.38 conf)
topmost_subform_page_parents_tel_access_children_cb was topmostSubform[0].Page1[0].ParentsTelAccessChildren_cb[0] (0.43 conf)
topmost_page_monitor_call_cb was topmostSubform[0].Page1[0].NoMonitorCall_cb[0] (0.37 conf)
topmost_scheduled_phone_contact was topmostSubform[0].Page1[0].ScheduledPhoneContact_cb[0] (0.33 conf)
topmost_page_phone_details was topmostSubform[0].Page1[0].PhoneContactDetails_ft[0] (0.32 conf)
topmost_phone_parent_children was topmostSubform[0].Page1[0].PhoneParentChildren_cb[0] (0.39 conf)
topmost_page_applies_petitioner was topmostSubform[0].Page1[0].AppliesToPetitioner_cb[0] (0.43 conf)
topmost_page_applies_respondent was topmostSubform[0].Page1[0].AppliesToRespondent_cb[0] (0.43 conf)
topmost_applies_parent_party was topmostSubform[0].Page1[0].AppliesToOtherParent_Party_cb[0] (0.41 conf)
topmost_subform_page_petitioner_cb__1 was topmostSubform[0].Page1[0].petitioner_cb[0] (0.40 conf)
topmost_subform_page_respondent_cb__1 was topmostSubform[0].Page1[0].Respondent_cb[0] (0.34 conf)
topmost_subform_page_respondent_cb__2 was topmostSubform[0].Page1[0].Respondent_cb[1] (0.34 conf)
topmost_subform_page_specify_attachment_tf was topmostSubform[0].Page1[0].SpecifyOtherAttachment_tf[0] (0.44 conf)
topmost_subform_page_otherspecify_cb was topmostSubform[0].Page1[0].Otherspecify_cb[0] (0.38 conf)
topmost_custody_order_judgment was topmostSubform[0].Page1[0].JuvenileCustodyOrder_Judgment_cb[0] (0.39 conf)
topmost_subform_page_caption_p_sf_case_number_ft__1 was topmostSubform[0].Page1[0].CaptionP1_sf[0].CaseNumber[0].CaseNumber_ft[0] (0.41 conf)
page_title_party_name_petitioner__1 was topmostSubform[0].Page1[0].CaptionP1_sf[0].TitlePartyName[0].Petitioner_ft[0] (0.37 conf)
page_title_party_name_respondent__1 was topmostSubform[0].Page1[0].CaptionP1_sf[0].TitlePartyName[0].Respondent_ft[0] (0.37 conf)
page_title_party_name_parent__1 was topmostSubform[0].Page1[0].CaptionP1_sf[0].TitlePartyName[0].OtherParentParty_ft[0] (0.36 conf)
persons_allowed_alone_children was topmostSubform[0].Page2[0].PersonsNotAllowedAloneWChildren_ft[0] (0.39 conf)
topmost_page_name_ft was topmostSubform[0].Page2[0].NameNocontact_ft[0] (0.39 conf)
topmost_page_children_contact was topmostSubform[0].Page2[0].ChildrenContactWith_cb[0] (0.38 conf)
topmost_page_children_alone__2 was topmostSubform[0].Page2[0].ChildrenNotAloneWith_cb[0] (0.38 conf)
topmost_subform_page_children_clothingand_belonging_cb was topmostSubform[0].Page2[0].ChildrenClothingandBelonging_cb[0] (0.34 conf)
topmost_page_party_contact was topmostSubform[0].Page2[0].ThirePartyContact_cb[0] (0.34 conf)
topmost_page_number_hour__2 was topmostSubform[0].Page2[0].NumberHour_no[0] (0.40 conf)
topmost_subform_page_alcohol_sub_abuse_cb was topmostSubform[0].Page2[0].AlcoholSubAbuse_cb[0] (0.35 conf)
topmost_subform_page_petitioner_cb__2 was topmostSubform[0].Page2[0].petitioner_cb[0] (0.40 conf)
topmost_subform_page_respondent_cb__3 was topmostSubform[0].Page2[0].Respondent_cb[0] (0.34 conf)
topmost_subform_page_permit_rd_party_cb was topmostSubform[0].Page2[0].NoPermit3rdParty_cb[0] (0.41 conf)
topmost_subform_page_respondent_cb__4 was topmostSubform[0].Page2[0].Respondent_cb[1] (0.34 conf)
topmost_subform_page_usechildren_messengers_cb was topmostSubform[0].Page2[0].NoUsechildrenMessengers_cb[0] (0.40 conf)
exposure_cigarette_smoke was topmostSubform[0].Page2[0].NoExposureToCigaretteMarijuanaSmoke_cb[0] (0.38 conf)
topmost_subform_page_interference_cb was topmostSubform[0].Page2[0].NoInterference_cb[0] (0.39 conf)
topmost_page_party_clothing was topmostSubform[0].Page2[0].EachPartyHasClothing_cb[0] (0.44 conf)
topmost_subform_page_children_return_clothing_belonging_cb was topmostSubform[0].Page2[0].ChildrenReturnWithTheirClothingBelonging_cb[0] (0.43 conf)
topmost_subform_page_log_book_cb was topmostSubform[0].Page2[0].LogBook_cb[0] (0.36 conf)
topmost_subform_page_terms_conditions_cb was topmostSubform[0].Page2[0].TermsConditions_cb[0] (0.39 conf)
topmost_subform_page_cb__3 was topmostSubform[0].Page2[0].Other_cb[0] (0.37 conf)
topmost_page_othe_provisions was topmostSubform[0].Page2[0].OtheProvisions_ft[0] (0.38 conf)
topmost_subform_page_negative_comment_cb was topmostSubform[0].Page2[0].NoNegativeComment_cb[0] (0.40 conf)
page_discussion_court was topmostSubform[0].Page2[0].DiscussionOfCourtProceedings_cb[0] (0.29 conf)
topmost_subform_page_caption_p_sf_case_number_ft__2 was topmostSubform[0].Page2[0].CaptionP1_sf[0].CaseNumber[0].CaseNumber_ft[0] (0.41 conf)
page_title_party_name_petitioner__2 was topmostSubform[0].Page2[0].CaptionP1_sf[0].TitlePartyName[0].Petitioner_ft[0] (0.37 conf)
page_title_party_name_parent__2 was topmostSubform[0].Page2[0].CaptionP1_sf[0].TitlePartyName[0].OtherParentParty_ft[0] (0.36 conf)
page_title_party_name_respondent__2 was topmostSubform[0].Page2[0].CaptionP1_sf[0].TitlePartyName[0].Respondent_ft[0] (0.37 conf)

We've done our best to group similar variables togther to avoid overwhelming the user.

Suggested Screen 0:

topmost_page_number_minutes
topmost_page_number_days_ft
topmost_page_number_days
topmost_page_number_hour__1
topmost_scheduled_phone_contact
topmost_page_phone_details
topmost_page_number_hour__2
topmost_page_othe_provisions

Suggested Screen 1:

page_custodial_parent_notice

Suggested Screen 2:

topmost_much_notice_possible
topmost_right_option_child_care
topmost_custody_order_judgment

Suggested Screen 3:

topmost_page_child_sick_ft
topmost_page_name_ft

Suggested Screen 4:

topmost_page_children_schools
topmost_page_children_alone__1
topmost_phone_parent_children
persons_allowed_alone_children
topmost_page_children_contact
topmost_page_children_alone__2
topmost_page_party_contact
topmost_page_party_clothing

Suggested Screen 5:

topmost_page_applies_petitioner
topmost_page_applies_respondent
topmost_applies_parent_party

Suggested Screen 6:

topmost_subform_page_noncustodial_parent_late_cb
topmost_subform_page_petition
topmost_subform_page_work_cb__1
topmost_subform_page_work_cb__2
topmost_subform_page_notification_move_child_cb
topmost_subform_page_chid_care_provider_add_tel_cb
topmost_subform_page_child_care
topmost_subform_page_canceled_parent_time_cb
topmost_subform_page_children_tel_access_parent_cb
topmost_subform_page_parents_tel_access_children_cb
topmost_page_monitor_call_cb
topmost_subform_page_petitioner_cb__1
topmost_subform_page_respondent_cb__1
topmost_subform_page_respondent_cb__2
topmost_subform_page_caption_p_sf_case_number_ft__1
topmost_subform_page_petitioner_cb__2
topmost_subform_page_respondent_cb__3
topmost_subform_page_respondent_cb__4
topmost_subform_page_children_return_clothing_belonging_cb
topmost_subform_page_caption_p_sf_case_number_ft__2

Suggested Screen 7:

topmost_subform_page_doctor_excuse_cb
topmost_subform_page_earliest_possibile_opportunity_cb
topmost_subform_page_cb__1
topmost_subform_page_cb__2
topmost_subform_page_u_nable_ft
topmost_subform_page_response_cb
topmost_subform_page_stip_ord_custody_visitation_cb
topmost_subform_page_findings_order_cb
topmost_subform_page_resp_decl_rf_cb
topmost_subform_page_request_order_cb
topmost_subform_page_residence_cb
topmost_subform_page_mailing_cb
topmost_subform_page_home_cb
topmost_subform_page_email_cb
topmost_subform_page_cellphone_cb
topmost_subform_page_notify_current_adress_cb
topmost_subform_page_specify_attachment_tf
topmost_subform_page_otherspecify_cb
topmost_subform_page_children_clothingand_belonging_cb
topmost_subform_page_alcohol_sub_abuse_cb
topmost_subform_page_permit_rd_party_cb
topmost_subform_page_usechildren_messengers_cb
topmost_subform_page_interference_cb
topmost_subform_page_log_book_cb
topmost_subform_page_terms_conditions_cb
topmost_subform_page_cb__3
topmost_subform_page_negative_comment_cb

Suggested Screen 8:

exposure_cigarette_smoke

Suggested Screen 9:

page_parent_unable_visit
page_title_party_name_petitioner__1
page_title_party_name_respondent__1
page_title_party_name_parent__1
page_discussion_court
page_title_party_name_petitioner__2
page_title_party_name_parent__2
page_title_party_name_respondent__2

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The Legal Innovation & Technology Lab's Form Explorer Beta @ Suffolk Law School Last updated 2023-04-02

Additional Provisions—Physical Custody Attachment

About This Form:

Identified Data Fields:

Create an Interactive Version of this Form:

The Legal Innovation & Technology Lab's Form Explorer ^Beta @ Suffolk Law School Last updated 2023-04-02