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Here is the text we could read:

ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address):

FOR COURT USE ONLY

FL-355

FAX NO. (Optional):

SUPERIOR COURT OF CALIFORNIA, COUNTY OF
STREET ADDRESS:

TELEPHONE NO.:

E-MAIL ADDRESS (Optional):

      ATTORNEY FOR (Name):

MAILING ADDRESS:

CITY AND ZIP CODE:

BRANCH NAME:

   PETITIONER:

RESPONDENT:

OTHER:

STIPULATION AND ORDER FOR CUSTODY 
AND/OR VISITATION OF CHILDREN

MODIFICATION

CASE NUMBER:

The parties signing this stipulation agree that:
1.  This court has jurisdiction over the minor children because California is the children's home state.
2.  The habitual residence of the children is the United States of America.
3.  The parties acknowledge they were advised that any violation of this order may result in civil or criminal penalties, or both.
4.  a. The parties stipulate that the attached document, dated
(specify):

and consisting of (number):

pages

is 

their custody and visitation agreement and request that it be made an order of the court, or

b. The parties stipulate that the attached forms

FL-341

FL-341(A)

FL-341(B)

FL-341(C)

FL-341(D)

FL-341(E)

are their agreement regarding custody and/or visitation of their children and request that they be made an order of the court.

Each party declares under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
Date:

(TYPE OR PRINT NAME)

(SIGNATURE OF PETITIONER)

Date:

Date:

Date:

Date:

Date:

(TYPE OR PRINT NAME)

(SIGNATURE OF RESPONDENT)

(TYPE OR PRINT NAME)

(SIGNATURE OF ATTORNEY FOR PETITIONER)

(TYPE OR PRINT NAME)

(SIGNATURE OF ATTORNEY FOR RESPONDENT)

(TYPE OR PRINT NAME)

(SIGNATURE OF OTHER)

(TYPE OR PRINT NAME)

(SIGNATURE OF ATTORNEY FOR OTHER)

FINDINGS AND ORDER

THE COURT FINDS:
1.  This court has jurisdiction over the minor children because California is the children's home state.
2.  The habitual residence of the children is the United States of America.
3.  Both parties have been advised that any violation of this order may result in civil or criminal penalties, or both.
THE COURT ORDERS:
1.  The agreement of the parties regarding custody and visitation

as set forth in the attached document dated(specify):

and consisting of (number):

pages or

set forth in the attached forms:

FL-341

FL-341(A)

FL-341(B)

FL-341(C)

FL-341(D)

FL-341(E)

is adopted as the order of the court and fully incorporated by reference herein.

Date:

Form Approved for Optional Use 
Judicial Council of California 
FL-355 [New January 1, 2004]

STIPULATION AND ORDER FOR CUSTODY 
AND/OR VISITATION OF CHILDREN

JUDICIAL OFFICER

Page 1 of 1

Stipulation and Order for Custody and/or Visitation of Children

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): 1
Fields(s): 45
Average fields per page: 45
Reading Level: Grade 6
LIST Grouping(s): Unknown

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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.

f_page_p_caption_case_number was FL-355[0].Page1[0].P1Caption[0].Subform[0].CaseNumber[0].CaseNumber[0] (0.58 conf)
f_page_p_party_info_text was FL-355[0].Page1[0].P1Caption[0].Subform[0].AttyPartyInfo[0].TextField1[0] (0.39 conf)
f_page_p_party_info_phone was FL-355[0].Page1[0].P1Caption[0].Subform[0].AttyPartyInfo[0].Phone[0] (0.42 conf)
f_l_page_p_party_info was FL-355[0].Page1[0].P1Caption[0].Subform[0].AttyPartyInfo[0].Fax[0] (0.42 conf)
f_page_p_party_info_email__1 was FL-355[0].Page1[0].P1Caption[0].Subform[0].AttyPartyInfo[0].Email[0] (0.42 conf)
f_page_p_party_info_email__2 was FL-355[0].Page1[0].P1Caption[0].Subform[0].AttyPartyInfo[0].Email1[0] (0.42 conf)
f_l_page_p_info_county was FL-355[0].Page1[0].P1Caption[0].CourtInfo[0].CrtCounty[0] (0.39 conf)
f_l_page_p_info_street was FL-355[0].Page1[0].P1Caption[0].CourtInfo[0].CrtStreet[0] (0.39 conf)
f_l_page_p_caption_info was FL-355[0].Page1[0].P1Caption[0].CourtInfo[0].CrtMailingAdd[0] (0.43 conf)
f_l_page_p_caption_court_info_crt_city_zip was FL-355[0].Page1[0].P1Caption[0].CourtInfo[0].CrtCityZip[0] (0.40 conf)
f_l_page_p_court_branch was FL-355[0].Page1[0].P1Caption[0].CourtInfo[0].CrtBranch[0] (0.39 conf)
f_page_p_title_party_name__1 was FL-355[0].Page1[0].P1Caption[0].TitlePartyName[0].Party1[0] (0.37 conf)
f_page_p_title_party_name__2 was FL-355[0].Page1[0].P1Caption[0].TitlePartyName[0].Party2[0] (0.37 conf)
f_page_p_title_party_name__3 was FL-355[0].Page1[0].P1Caption[0].TitlePartyName[0].Party3[0] (0.37 conf)
f_page_p_form_title_choice was FL-355[0].Page1[0].P1Caption[0].FormTitle[0].Choice1[0] (0.40 conf)
f_l_page_list_fill_text__1 was FL-355[0].Page1[0].List4[0].LI1[0].FillText1[0] (0.41 conf)
f_l_page_list_fill_text__2 was FL-355[0].Page1[0].List4[0].LI1[0].FillText3[0] (0.41 conf)
f_l_page_list_choice__1 was FL-355[0].Page1[0].List4[0].LI2[0].Choice1[0] (0.37 conf)
f_l_page_list_choice__2 was FL-355[0].Page1[0].List4[0].LI2[0].Choice2[0] (0.37 conf)
f_l_page_list_choice__3 was FL-355[0].Page1[0].List4[0].LI2[0].Choice3[0] (0.37 conf)
f_l_page_list_choice__4 was FL-355[0].Page1[0].List4[0].LI2[0].Choice4[0] (0.37 conf)
f_l_page_list_choice__5 was FL-355[0].Page1[0].List4[0].LI2[0].Choice5[0] (0.37 conf)
f_l_page_list_choice__6 was FL-355[0].Page1[0].List4[0].LI2[0].Choice6[0] (0.37 conf)
f_l_page_sub_form_sig_date__1 was FL-355[0].Page1[0].SubForm[0].SigDate[0] (0.36 conf)
f_l_page_sub_form_sig_name__1 was FL-355[0].Page1[0].SubForm[0].SigName[0] (0.36 conf)
f_l_page_sub_form_sig_date__2 was FL-355[0].Page1[0].SubForm[0].SigDate1[0] (0.36 conf)
f_l_page_sub_form_sig_name__2 was FL-355[0].Page1[0].SubForm[0].SigName1[0] (0.36 conf)
f_l_page_sub_form_sig_date__3 was FL-355[0].Page1[0].SubForm[0].SigDate2[0] (0.36 conf)
f_l_page_sub_form_sig_name__3 was FL-355[0].Page1[0].SubForm[0].SigName2[0] (0.36 conf)
f_l_page_sub_form_sig_date__4 was FL-355[0].Page1[0].SubForm[0].SigDate3[0] (0.36 conf)
f_l_page_sub_form_sig_name__4 was FL-355[0].Page1[0].SubForm[0].SigName3[0] (0.36 conf)
f_l_page_sub_form_sig_date__5 was FL-355[0].Page1[0].SubForm[0].SigDate4[0] (0.36 conf)
f_l_page_sub_form_sig_name__5 was FL-355[0].Page1[0].SubForm[0].SigName4[0] (0.36 conf)
f_l_page_sub_form_sig_date__6 was FL-355[0].Page1[0].SubForm[0].SigDate5[0] (0.36 conf)
f_l_page_sub_form_sig_name__6 was FL-355[0].Page1[0].SubForm[0].SigName5[0] (0.36 conf)
f_l_page_list_choice__7 was FL-355[0].Page1[0].List8[0].LI1[0].Choice1[0] (0.37 conf)
f_l_page_list_fill_text__3 was FL-355[0].Page1[0].List8[0].LI1[0].FillText1[0] (0.41 conf)
f_l_page_list_fill_text__4 was FL-355[0].Page1[0].List8[0].LI1[0].FillText2[0] (0.41 conf)
f_l_page_list_choice__8 was FL-355[0].Page1[0].List8[0].LI1[0].Choice2[0] (0.37 conf)
f_l_page_list_choice__9 was FL-355[0].Page1[0].List8[0].LI1[0].Choice3[0] (0.37 conf)
f_l_page_list_choice__10 was FL-355[0].Page1[0].List8[0].LI1[0].Choice4[0] (0.37 conf)
f_l_page_list_choice__11 was FL-355[0].Page1[0].List8[0].LI1[0].Choice5[0] (0.37 conf)
f_l_page_list_choice__12 was FL-355[0].Page1[0].List8[0].LI1[0].Choice6[0] (0.37 conf)
f_l_page_list_choice__13 was FL-355[0].Page1[0].List8[0].LI1[0].Choice7[0] (0.37 conf)
f_l_page_list_choice__14 was FL-355[0].Page1[0].List8[0].LI1[0].Choice8[0] (0.37 conf)

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

Stipulation and Order for Custody and/or Visitation of Children

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Identified Data Fields:

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