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DE FACTO PARENT STATEMENT FORM JV 296 INSTRUCTIONS Provide all information requested in sections 1-5 In section 6 you want to send the clear message that your relationship with this child must be protected o In section 6 c provide detailed information about your child s needs. Be specific about what your child s day to day needs look like i*e* eating peculiarities sleep habits fears or phobias. Be specific about the time skills and dedication you render to meet those needs. Be specific and attach additional pages if needed* Include information about your relationships with the professionals involved with your child i*e* medical doctors therapists teachers tutors etc* In section 7 be sure to date and sign* If filing as a couple include both signatures. Be specific about what your child s day to day needs look like i*e* eating peculiarities sleep habits fears or phobias. Be specific about the time skills and dedication you render to meet those needs. Be specific and attach additional pages if needed* Include information about your relationships with the professionals involved with your child i*e* medical doctors therapists teachers tutors etc* In section 7 be sure to date and sign* If filing as a couple include both signatures.

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