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The DCSS 0053 form, known as the Visitation Verification form, plays a vital role in the child support and custody process in California. Designed by the Department of Child Support Services, it serves to document the visitation history of a noncustodial parent with their child or children over the past 12 months. A user-friendly layout allows individuals to log the number of hours spent with the child each month, giving an accurate picture of engagement in the child's life. The form also addresses shared custody and regular visitation arrangements, allowing parents to specify details such as the days and times of visitation, any vacation plans, and holiday schedules. By filling this form out, a custodial party or noncustodial parent ensures that all aspects of visitation are recorded, fostering transparency between the parties involved. It is crucial to provide accurate information, as this form may be shared with the other parent and could require further documentation to support the details provided. Completing the DCSS 0053 is not merely a bureaucratic exercise; it is an essential step towards maintaining effective co-parenting and ensuring that children's best interests are upheld.

Dcss 0053 Example

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

DEPARTMENT OF CHILD SUPPORT SERVICES

VISITATION VERIFICATION

DCSS 0053 (08/21/2016)

CSE Case Number:

Name of person completing form:

I am the

Custodial Party

Noncustodial Parent

 

 

 

 

PART 1. ACTUAL VISITATION BY THE NONCUSTODIAL PARENT

INSTRUCTIONS:

Complete the visitation history by filling in the last 12 months and number of hours for each month the noncustodial parent visited with the child(ren). If visitation is different for each child(ren), please complete one form for each child.

Example: If the last 12 months are June 2014 through May of 2015, you will complete June through December on the left side of the chart below. You would put 2014 for the year. Then you would complete the right side of the chart with January through May and put 2015 for the year.

 

NUMBER OF HOURS

 

NUMBER OF HOURS

 

THE NONCUSTODIAL

 

THE NONCUSTODIAL

MONTH/YEAR

PARENT VISITED WITH

MONTH/YEAR

PARENT VISITED WITH

 

THE CHILD(REN) EACH

 

THE CHILD(REN) EACH

 

MONTH

 

MONTH

 

 

 

 

January/

 

January/

 

 

 

 

 

February/

 

February/

 

 

 

 

 

March/

 

March/

 

 

 

 

 

April/

 

April/

 

 

 

 

 

May/

 

May/

 

 

 

 

 

June/

 

June/

 

 

 

 

 

July/

 

July/

 

 

 

 

 

August/

 

August/

 

 

 

 

 

September/

 

September/

 

 

 

 

 

October/

 

October/

 

 

 

 

 

November/

 

November/

 

 

 

 

 

December/

 

December/

 

 

 

 

 

 

TOTAL:

 

TOTAL:

 

 

 

 

Page 1 of 2

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

DEPARTMENT OF CHILD SUPPORT SERVICES

VISITATION VERIFICATION

DCSS 0053 (08/21/2016)

PART 2. SHARED CUSTODY/VISITATION

CHECK ONE:

Shared Custody

Visitation Only

Neither

VISITATION HOURS:

Regular Visitation:

From (specify day of the week)

at (specify time)

To (specify day of the week)

at (specify time)

Vacation Visitation:

Yes

If Yes, please specify dates/times:

 

Summer Visitation:

Yes

If Yes, please specify dates/times:

 

Holiday Visitation:

Yes

If Yes, please specify dates/times:

 

Overnight Visitation:

Yes

If Yes, please specify dates/times:

 

(Circle one) a.m./p.m.

(Circle one) a.m./p.m.

No

No

No

No

Court-ordered custody/visitation arrangement:

Yes

No

Additional Information:

I declare to the best of my knowledge and belief that the above information is true and correct. I am aware that this information may be provided to the other parent for their verification and that either party may be required to provide documentation.

PRINT NAME

SIGNATURE

DATE

Page 2 of 2

Form Characteristics

Fact Name Description
Purpose of the Form The DCSS 0053 is used to verify visitation for noncustodial parents in California.
Governing Body This form is managed by the California Department of Child Support Services.
Time Frame The form requires detailing visitation over the last 12 months.
Custodial and Noncustodial Roles It identifies whether the person filling it out is the custodial party or noncustodial parent.
Shared Custody Option Users can indicate if there is shared custody, visitation only, or neither.
Regular and Vacation Visitation Details The form asks for specifics about regular and vacation visitation hours.
Signature Requirement It must be signed and dated, declaring that the information provided is accurate to the best of one’s knowledge.

Guidelines on Utilizing Dcss 0053

After completing the DCSS 0053 form, you will submit it to the Department of Child Support Services. This document plays a vital role in ensuring accurate communication regarding visitation schedules. Below are step-by-step instructions to help you fill out the form correctly.

  1. Begin by locating the section for the CSE Case Number at the top of the form. Enter the case number provided.
  2. Next, fill in your name in the space designated for the person completing the form.
  3. Indicate your role by checking the appropriate box for either the Custodial Party or Noncustodial Parent.
  4. Move to Part 1 to document Actual Visitation by the Noncustodial Parent. You will need to record the visitation history for the last 12 months.
  5. For each month, starting from the first month in the past year, fill in the number of hours the noncustodial parent visited with the child(ren). Complete both halves of the chart by keeping months aligned properly.
  6. Once all hours are entered, sum the total number of hours for the entire year and place this total in the designated area.
  7. Proceed to Part 2, where you will check one option under Shared Custody/Visitation. Select either Shared Custody, Visitation Only, or Neither.
  8. Next, fill out the visitation hours. Provide details on regular visitation, including the days and times, making sure to specify where needed.
  9. Answer the questions regarding vacation, summer, holiday, and overnight visitation by checking 'Yes' or 'No.' If 'Yes,' specify dates and times for each item.
  10. Indicate whether there is a court-ordered custody/visitation arrangement by checking 'Yes' or 'No.'
  11. At the bottom of the form, certify the information by printing your name, signing the document, and entering the date of completion.

What You Should Know About This Form

What is the purpose of the DCSS 0053 form?

The DCSS 0053 form, also known as the Visitation Verification form, is designed to document and verify visitation schedules between a noncustodial parent and their child or children. Child Support Services may require this information to ensure compliance with visitation orders and to help facilitate a comprehensive understanding of the parenting arrangements. It provides a structured way to report the number of hours the noncustodial parent has spent with the child over the past year, which is vital for establishing a clear record of visitation practices.

Who should complete the DCSS 0053 form?

This form must be completed by the custodial party or the noncustodial parent, depending on the specific circumstances. If you are the person who primarily takes care of the child, you would be the custodial party. If your visitation rights are being documented, you would complete it as the noncustodial parent. It is important that the person filling out the form does so accurately to reflect the true nature of the visitation schedule.

How is the visitation history recorded on the form?

To record the visitation history, fill in the last twelve months in the designated chart provided in the form. For each month, specify the number of hours the noncustodial parent spent with the child or children. If visitation varies for different children, a separate DCSS 0053 form should be completed for each child. Be diligent in logging each visit accurately to ensure clarity and consistency in the official record.

What information is required regarding shared custody or visitation?

The form allows for the indication of whether shared custody exists or if it is solely visitation. You will need to check one of the options provided. Additionally, you should detail regular visitation hours, and if applicable, include information about vacation, summer, holiday, and overnight visitations. This section is important for ensuring that all aspects of the visitation arrangement are captured accurately, reflecting any nuances in the custody agreement.

Is there a declaration required on the DCSS 0053 form?

Yes, the form includes a declaration where the individual completing the document affirms that all information provided is true and correct to the best of their knowledge. This section serves as a pledge of honesty, indicating that the person understands the potential consequences of providing misleading information. It is essential to sign and date the form to affirm this declaration, as it may be shared with the other parent for verification purposes.

Common mistakes

When completing the DCSS 0053 form for visitation verification, individuals may inadvertently make several common mistakes. Such errors can result in delays or complications in processing the form. It is essential to be aware of these pitfalls to ensure that the form is completed accurately.

One frequent mistake is failing to provide complete information in the visitation history section. This part requires the input of visitation hours for each month over the past twelve months. Omitting any month, whether due to oversight or misunderstanding, can lead to an incomplete submission. Each child must be accounted for separately if visitation varies, meaning individuals should be cautious not to mix information between different children.

Inaccurate tracking of visitation dates and hours is another issue. Some people may underestimate the actual number of visitation hours or incorrectly designate the months. It is crucial to record visits as they happen, rather than relying on memory long after the fact. Ensuring that hours are represented correctly can profoundly affect any related custody or support matters.

Omitting specific details in the shared custody or visitation section often occurs. This includes not marking the correct option, such as whether the arrangement is shared custody or visitation only. Failing to specify visitation hours, like the specific days and times for regular or vacation visitation, can lead to further confusion and may require resubmission.

Additionally, many individuals neglect to check the box indicating if there is a court-ordered custody or visitation arrangement. This is a critical oversight, as it may inform the context in which visitation is to be understood. Providing this context can help clarify any disputes related to visitation rights or custody divisions.

Another crucial area often overlooked is the declaration at the end of the form. Some people either forget to sign and date the form or do so without reading the declaration statement. This statement serves to affirm the truthfulness of the information provided. Incomplete signatures may cause administrative delays and further complications.

It is also important to be mindful about the additional information sections. Some submitters fail to provide relevant details that could facilitate the understanding of their visitation arrangements. This may include special circumstances or additional notes that could help clarify their situation.

Lastly, failing to review the form before submission can lead to easily fixable mistakes. Individuals should take a moment to cross-check all entries, ensuring that everything aligns with their records. By taking these steps, the chances of errors can be significantly reduced, leading to a smoother processing experience.

Documents used along the form

The DCSS 0053 form, which is used for visitation verification in California's child support services, often necessitates the submission of several related documents. These additional forms help in providing comprehensive information regarding custody and visitation arrangements. Below is a list of commonly associated documents.

  • Child Custody Order: This document outlines the legal arrangements regarding the care and custody of the child. It includes provisions about physical custody, legal custody, and visitation rights of each parent.
  • Child Support Order: This form details the financial obligations of the noncustodial parent in terms of child support. It indicates the amount and frequency of payments to aid in the child's upbringing.
  • Visitation Schedule: A detailed plan that specifies the times and conditions under which the noncustodial parent may visit the child. This schedule often includes regular, holiday, and vacation visitation times.
  • Parental Agreements: These are written documents that parents may create, outlining their mutual understanding and arrangements regarding custody, visitation, and support matters. They are often used in lieu of court orders when both parents are in agreement.
  • Evidence of Compliance: This may include logs or diaries that show the noncustodial parent’s adherence to the visitation schedule. Such documentation can support claims made in the DCSS 0053 form.

When processing custody and visitation cases, these documents play an essential role in ensuring that all parties involved understand their rights and responsibilities. By providing clear and concise information, these forms help facilitate a smoother transition for children between households.

Similar forms

  • DCSS 0054 - Visitation Modification Request: This form serves to request a change in existing visitation arrangements. Like the DCSS 0053 form, it emphasizes the importance of accurate visitation documentation, providing a structured format for modifications based on actual circumstances.
  • DCSS 0055 - Custody Verification: This document verifies custodial details pertinent to child support cases. Similar to the visitation verification, it highlights the role of factual reporting within child custody matters and ensures clarity of responsibilities.
  • DCSS 0056 - Parenting Plan Agreement: This form outlines a parenting plan between parties, addressing visitation and custody. It mirrors the DCSS 0053 in its essential focus on delineating parenting responsibilities and providing a framework for partnership in child-rearing.
  • DCSS 0057 - Child Support Payment Records: While this form focuses on financial obligations, it shares the requirement of precision in reporting details, just like the visitation history in DCSS 0053. Accurate records contribute to transparent case management.
  • DCSS 0058 - Parent-Child Contact Log: This log aids in tracking parent-child communication and visits, reinforcing the same goal found in the DCSS 0053 of establishing a clear timeline and record of interactions for reference.
  • DCSS 0059 - Child Welfare Report: This document reports on the child's wellbeing and any pertinent issues. It relates to the DCSS 0053 by focusing on factors that impact visitation and the overall parenting environment.
  • DCSS 0060 - Visitation Compliance Report: Aimed at documenting adherence to visitation schedules, this report parallels the visitation verification process, both serving as tools for monitoring participation in the child's life.
  • DCSS 0061 - Mediation Agreement: Created to formalize agreements reached in mediation sessions, this form shares a similar purpose of clarifying expectations regarding custody and visitation, just like the DCSS 0053.

Dos and Don'ts

When filling out the DCSS 0053 form, following these guidelines will help ensure accuracy and compliance.

  • Do use accurate dates for the visitation history, covering the last 12 months.
  • Do specify the number of hours the noncustodial parent visited with the child each month.
  • Do complete one form for each child if visitation differs among them.
  • Do review the form for any errors before submitting it.
  • Don’t leave any required sections blank—fill in all necessary information.
  • Don’t provide false information; being truthful is essential as it may be verified by the other parent.

Misconceptions

Many people have misunderstandings about the DCSS 0053 form. Let’s clear up some common misconceptions.

  • Misconception 1: The form is only for court use.
  • While the DCSS 0053 form is often linked to legal proceedings, it can also assist parents in documenting visitation for their own records. It helps track actual visitations, which can be valuable in communication between parents.

  • Misconception 2: You only need to fill it out once.
  • The form is not a one-time submission. Parents should regularly update the visitation history. This reflects changes over time, which can be helpful if custody or visitation disputes arise.

  • Misconception 3: The number of hours is optional.
  • The form requires parents to record the number of hours spent with the child each month. Providing this information is crucial for accurately depicting visitation trends and ensuring transparency between both parents.

  • Misconception 4: You don’t need to fill it out for multiple children.
  • If visitation schedules vary between children, separate forms must be completed for each child. This ensures that each child’s visitation records are clear and precise, reflecting their specific situation.

Key takeaways

Completing the DCSS 0053 form is an important step in documenting visitation. Here are ten key takeaways to consider:

  • Identify Your Role: Clearly indicate whether you are the custodial party or the noncustodial parent.
  • Document Accurately: Fill in the visitation history for the last 12 months to ensure all information is current and relevant.
  • Use Separate Forms: If visitation varies by child, use a separate form for each child to maintain clarity.
  • Specify Time Periods: Be precise with the month and year for each entry to avoid confusion.
  • Detail Visitation Types: Indicate regular, holiday, summer, and other types of visitation clearly.
  • Verify with Proof: Be prepared to provide documentation if required, as either party may ask for it.
  • Timeliness Matters: Submit the form promptly to ensure timely handling of visitation issues.
  • Be Thorough: Include every month’s visitation details without omitting any, even if it was minimal.
  • Check Your Work: Review the completed form for accuracy before submission to prevent any mistakes.
  • Sign and Date: Ensure your name, signature, and date are included to authenticate the information provided.

Completing this form accurately can help support your case regarding visitation rights. Take the time needed to fill it out carefully.