You must use black ink to fill out this form.
IN THE SUPERIOR COURT FOR THE STATE OF ALASKA
) Your Case No.
) CUSTODY & VISITATION ORDER (Short)
The plaintiff defendant filed a motion and the opposing party did did not respond in writing. A hearing was was not held on ,which plaintiff and/or defendant attended.
After considering the motion and any opposition thereto, and good cause being found, the following custody and visitation IS HEREBY ORDERED for the following child(ren):
Child(ren)’s Name(s) Date(s) of Birth
1) Legal Custody shall be with the Mother Father or both parents.
2) Physical Custody shall be shared between the parents or primarily with
the Mother Father. The child(ren) shall reside with the Mother Father except for the following days and times when the child(ren) shall reside with or be with the other parent:
Dated at , Alaska this _____ day of , 20 .
I certify that on a copy
of the above was mailed to each of the following at
their addresses of record. (List names if not an agency)
Deputy Clerk / Secretary
Page 1 of 1
Order For Custody & Visitation (Short) SHC-1123 (4/05)