Free STATE OF MINNESOTA - Minnesota

State of Minnesota
County Judicial District: Court File Number: Case Type:

District Court

In Re the Custody of:

Born (mo/day/yr)

Born (mo/day/yr)

Notice of Motion and Motion To Establish Custody And Parenting Time

Petitioner and

Respondent

TO:
First Middle Last Street Address Apt. #

City

State

Zip Code

NOTICE
PLEASE TAKE NOTICE that on
(date)

,
(year)

, at
(time)

o'clock

m., before of the located at

(name of

Judge or Judicial Officer) in room

Minnesota, I will ask the Court for an Order granting me the following relief:

CHC104

State

ENG

Rev 05/08

www.mncourts.gov/forms

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MOTION
1. Granting legal custody of the child(ren) as follows: (check one)
(Legal custody identifies who will have a right to make decisions regarding the child's upbringing, including education, health care, and religious training).

a. Jointly to both me and the other parent
(Full Name)

b. Solely to (check one): Me The other parent (print full name) 2. Granting physical custody of the child(ren) as follows: (check one) (Physical custody identifies who will handle the routine daily care and control of the child and with
whom the child(ren) will live).

a. Jointly to both parents. b. Solely to (check one): Me The other parent (print full name) 3. Determining parenting time as follows: (select only one) granting parenting time to the Mother Father as provided in the schedules below granting parenting time to the Mother Father as provided in the schedules below, with transfer of the minor child(ren) at a safe place, preferably a parenting time exchange center (if one is available) granting supervised parenting time to Mother Father as provided in the schedules below denying parenting time to the Mother Father (Use the space provided below to clearly explain when each parent will have the child(ren). State the time (o'clock) when the child(ren) will transfer from one parent to the other. If you want the order to say who will pick up and drop off the child(ren), or where transfer of the child(ren) should take place, include that under "Other"). Regular schedule: Monday through Friday:

CHC104

State

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Rev 05/08

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Weekends:

Summer (if you want a different schedule in summer)

Telephone contact with the child(ren):

Unlimited

or

Only at certain times as follows:

(describe the days and times when the parent and child(ren) may have telephone contact)

Exceptions to the Regular Schedule: [You can have a different schedule for holidays, school release days, and birthdays. If you do not want a different schedule, leave it blank.] School Release days or breaks during the school year

Any school release day schedule will override the regular parenting schedule.

Birthdays (child's birthday, parent's birthday)

Holidays

Any holiday or birthday schedule will override the regular and school release parenting schedule.

CHC104

State

ENG

Rev 05/08

www.mncourts.gov/forms

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Other

4. If child support is requested in the Petition, establishing child support according to Minnesota child support guidelines. Child support includes basic support, medical support, and child care support. Under the above Schedule: The children are with Petitioner: less than 10% of the time 10-45% of the time 45.1-50% of the time more than 50% of the time 5. Granting additional relief as follows: The children are with Respondent: less than 10% of the time 10-45% of the time 45.1-50% of the time more than 50% of the time

6.

Granting such other and further relief as the Court may deem just and equitable.

VERIFICATION AND ACKNOWLEDGMENT
a) I have read this document. To the best of my knowledge, information and belief, the information contained in this document is well grounded in fact and is warranted by existing law. b) I have not been determined by any Court in Minnesota or in any other state to be a frivolous litigant and I am not the subject of an Order precluding me from serving or filing this document. c) I am not serving or filing this document for any improper purpose, such as to harass the other party to cause delay or needless increase in the cost of litigation or to commit a fraud on the Court. d) I understand that if I am not telling the truth or if I am misleading the Court or if I am serving or filing this document for an improper purpose, the Court can order me to pay money to the other party, including the reasonable expenses incurred by the other party because of the serving or filing of this document, court costs and reasonable attorney's fees.

NOTICE TO OTHER PARENT
After reading this Motion, if you disagree with anything that is being requested, or if you want the court to consider your facts and what you want, you must serve upon all parties and file with the court an Answer, Responsive Motion and Responsive Affidavit. These documents are available

CHC104

State

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Rev 05/08

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online at www.mncourts.gov under the link for "court forms," or you may pick up court forms from any county court administrator's office. Your Answer, Responsive Motion and Responsive Affidavit must be personally served on the other party at least five (5) days before the hearing or mailed to the other party at least eight (8) days before the hearing. Your responsive papers must be filed with the court administrator at least five (5) days before the hearing. If you want to raise new issues at the hearing the other party has scheduled, you must serve and file a CounterPetition, Responsive Motion and Affidavit, which must be personally served on the other party ten (10) days before the hearing or mailed to the other party at least thirteen (13) days before the hearing. Your papers raising new issues must be filed with the court administrator at least ten (10) days before the hearing. If you do not understand what the other party is requesting, you may want to ask a lawyer for help or contact other legal services provider for assistance.

DATE: Signature Street Address City/State/Zip Code ( ) Telephone Number

CHC104

State

ENG

Rev 05/08

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