District Court Denver Juvenile Court ________________________________ County, Colorado Court Address:
________________________________________________
In re: The Marriage of: Parental Responsibilities concerning: ______________________________________________________ Petitioner: __________________________________ and Co-Petitioner/Respondent: ______________________________ Attorney or Party Without Attorney (Name and Address):
COURT USE ONLY Case Number:__________________
Phone Number:___________________ E-mail: _________________ FAX Number:_____________________ Atty. Reg. #: _____________
Division ______ Courtroom ________
MOTION FOR AN EVALUATION AND REPORT PURSUANT TO §14-10-127, C.R.S.
Petitioner, Co-Petitioner/Respondent, Stipulation of the parties requests this Court to order an The evaluation and written report concerning the disputed issues relating to the allocation of parental responsibilities appoint a mental health professional or approve the of the child(ren) pursuant to §14-10-127, C.R.S. and appointment of the following evaluator _________________________________________________. I request this evaluation because: __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________
Date: __________________________
_____________________________________________ Petitioner or Co-Petitioner/Respondent
CERTIFICATE OF SERVICE
I certify that on __________________________ (Date) the original was filed with the Court; and, a true and accurate copy of the Motion for an Evaluation and Report Pursuant to §14-10-127, C.R.S. was served on the other party by: Hand Delivery E-filed Faxed to this number ___________________ or by placing it in the United States mail, postage pre-paid, and addressed to the following: To: ______________________________________ ______________________________________ ______________________________________ ______________________________________
(Your Signature)
JDF 1331
1/07
MOTION FOR AN EVALUATION AND REPORT PURSUANT TO §14-10-127, C.R.S.