Downloadable Resource
Sample Custody Plan
ICWA-Compliant Template for Native American Families
Important: This is a sample template for informational purposes only. It is not a substitute for legal advice. Custody plans should be tailored to your specific circumstances and must comply with applicable tribal, state, and federal law. Consult with an attorney before using this template.
Parenting Plan and Custody Agreement
Section 1: Parties and Children
Mother: _________________________________ (Name)
Tribal Affiliation: _________________________________ (Tribe, Enrollment No.)
Address: _________________________________
Phone: _________________________________
Father: _________________________________ (Name)
Tribal Affiliation: _________________________________ (Tribe, Enrollment No.)
Address: _________________________________
Phone: _________________________________
Child(ren):
Name: _________________________________ DOB: ____________
Tribal Affiliation: _________________________________ (Enrolled / Eligible for Enrollment)
Name: _________________________________ DOB: ____________
Tribal Affiliation: _________________________________ (Enrolled / Eligible for Enrollment)
Section 2: Legal Custody
The parties shall have (check one):
[ ] Joint Legal Custody: Both parents shall share decision-making authority regarding the child(ren)'s education, healthcare, religious upbringing, and cultural activities.
[ ] Sole Legal Custody to Mother/Father: _____________ shall have sole decision-making authority.
Consultation Requirement: Before making major decisions, the custodial parent shall consult with the non-custodial parent and make good-faith efforts to reach agreement.
Section 3: Physical Custody and Parenting Time
The child(ren) shall reside primarily with: _________________________________
Regular Parenting Time Schedule:
Weekdays: _________________________________
Weekends: _________________________________
Summer: _________________________________
Holiday Schedule:
- Thanksgiving: Alternating years, beginning _____________ (Even/Odd years with Mother/Father)
- Christmas/Winter Break: _________________________________
- Spring Break: _________________________________
- Mother's Day: With Mother
- Father's Day: With Father
- Child's Birthday: _________________________________
Section 4: Tribal and Cultural Activities
ICWA Consideration: The parties recognize the importance of maintaining the child(ren)'s connection to their tribal heritage, culture, and community.
Tribal Events: Both parents shall support and facilitate the child(ren)'s participation in tribal ceremonies, feast days, cultural events, and community gatherings, including but not limited to:
- _________________________________
- _________________________________
- _________________________________
Language and Cultural Education: Both parents agree to support the child(ren)'s learning of:
- Native language: _________________________________
- Traditional skills and knowledge: _________________________________
- Tribal history and customs: _________________________________
Extended Family: Both parents recognize the importance of the child(ren)'s relationships with extended family members and clan relatives, and shall facilitate regular contact with:
- Maternal relatives: _________________________________
- Paternal relatives: _________________________________
- Clan relatives: _________________________________
Section 5: Transportation and Exchanges
Exchange Location: _________________________________
Transportation Responsibility: _________________________________
Notice for Schedule Changes: _________ hours/days advance notice required
Section 6: Communication
The child(ren) shall have reasonable phone/video contact with the non-custodial parent, including:
Frequency: _________________________________
Method: [ ] Phone [ ] Video call [ ] Text/Message
Times: _________________________________
Section 7: Relocation
Neither parent shall relocate the child(ren)'s residence more than _________ miles from the current residence without:
- Written consent of the other parent, OR
- Court approval after proper notice
Notice Requirement: _________ days written notice before proposed relocation
Section 8: Child Support
Child support shall be paid as follows:
Payor: _________________________________
Amount: $_________ per month
Due Date: _________ of each month
Method: _________________________________
Section 9: Health Insurance and Medical Expenses
Health Insurance Provider: _________________________________
Responsible Party: _________________________________
Uncovered Medical Expenses: Shall be divided _____% Mother / _____% Father
Section 10: Dispute Resolution
In the event of a dispute regarding this parenting plan, the parties agree to:
[ ] Attempt mediation before filing court action
[ ] Participate in tribal peacemaking: _________________________________
[ ] Seek guidance from: _________________________________
Section 11: Signatures
___________________________________ Date: _______________
Mother's Signature
___________________________________ Date: _______________
Father's Signature
___________________________________ Date: _______________
Witness (Optional)
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