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In Re the Marriage of:

Name of Petitioner

Affidavit in Response to Motion for Parenting Time Assistance

v.
Name of Respondent

STATE OF MINNESOTA

) ) S.S. COUNTY OF _____________________________ )

My true and correct name is following questions, I understand that I am under oath and I must tell the truth. 1.

.

In answering the

This Responsive Notice of Motion is NOT a request to establish parenting time rights because an Order establishing parenting time rights for (check one): me the other party has already

been issued in this case. Instead, this Responsive Notice of Motion and Motion is a request to resolve a parenting time dispute. 2. An Order for Protection involving me and the other party and/or the child(ren) (check one): a. IS NOT currently in effect in any state. b. IS in effect from and the court file number is 3. County in the State of .

A juvenile court (child protection, delinquency, or foster care) proceeding involving one or more of the children in this case (check one): a. IS NOT currently in effect in any state. b. IS in effect from and the court file number is County in the State of .

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4.

The following child(ren) are involved in this case (attach another sheet of paper if necessary): Name of Child Birth Date My Relationship to Child

5.

The child(ren) live in the State of (month, day) , who is related to them as address of the child(ren) is: City/State/Zip:

and have lived there since . The child(ren) live with . The , .

6.

I have a parenting time problem. It is: (list date, times, names of witnesses, and any other information helpful to understanding the problem)

For questions 7-20, check off only those that apply ­ the same as on your Responsive Notice of Motion and Motion form. 7. The other party was scheduled to have parenting time on the following date(s): at the following times I have not wrongfully denied the scheduled parenting time. The other party missed visits: YES NO. If YES, the other party missed visits because: .

8.

I agree that the other party can have makeup (compensatory) parenting time: YES NO. If YES, the makeup parenting time should take place on the following date(s): at the

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following time(s): because

. If NO, the other party should not have makeup time because

.

9.

I ask the Court to appoint a parenting time expeditor to help me and the other party resolve this parenting time problem and/or any future parenting time problems that may happen. I understand that the other party and I may be required by the Court to pay for the fees and costs of the parenting time expeditor. It is in the best interests of the child(ren) for the Court to appoint a parenting time expeditor because:

.

10.

I ask the Court for supervised parenting time:

YES

NO.

If YES, I believe that it is in

the best interests of the child(ren) that the existing Parenting Time Order be changed to require supervised parenting time because:

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11.

I ask the Court for unsupervised parenting time:

YES

NO. If YES, I believe it is in the

best interests of the child(ren) that the existing Parenting Time Order be changed to allow unsupervised parenting time because:

. 12. I ask that the existing Parenting Time Order be changed to provide for drop-offs and pick-ups of the child(ren) to occur at a parenting time exchange center, and for both parties to be ordered to follow all rules of the parenting time exchange center: YES NO. If YES, I ask this because:

If NO, the other party's request to exchange the child(ren) at a parenting time exchange center should be denied because:

. 13. I ask that the existing Parenting Time Order be changed to provide for the transportation of the child(ren) for parenting time: YES NO. If YES, the transportation of the child(ren)

for parenting time should be as follows:

because:

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If NO, the other party's request to change the transportation should be denied because:

14.

I ask that the Parenting Time Order be changed from "reasonable parenting time/visitation" to a specific schedule: YES NO. If YES, I believe that it is in the best interests of the

child(ren) that the existing order be changed from "reasonable parenting time/visitation" to the specific parenting time schedule stated in my Responsive Motion because:

If NO, I do not believe a specific parenting time schedule is in the best interests of the child(ren) because:

.

15.

I am asking the Court to change the existing specific schedule: YES NO. If YES, I believe that it is in the best interests of the child(ren) that the

existing parenting time schedule should be changed to the new specific schedule in my Responsive Motion because:

If NO, the existing schedule should not be changed because:

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16.

I ask that the other party be ordered to pay me for my Court fees and costs which total $ and consist of: (list each fee/cost, and the separate amount for each)

17.

I am asking the Court to order the other party to pay me for my other expenses which total: $ and include costs for (list each expense separately, the

reason for each expense and the amount of each expense):

because the other party wrongfully disobeyed the Parenting Time Order, or wrongfully disobeyed the Parenting Time Order, or wrongfully disobeyed an agreement made with or a decision made by a parenting time expeditor, and caused me to have these expenses that I would not have otherwise had.

18.

I have not wrongfully disobeyed the existing Parenting Time Order, or wrongfully failed to follow our agreement made with a parenting time expeditor or failed to follow the decision of a parenting time expeditor. I ask that the Court deny the other party's request for me to pay to the Court a civil penalty of up to $500.

19.

I have already paid a total of $ separately, and state the amount of each expense):

for

(list

each

expense

in connection with an upcoming scheduled parenting time. As allowed under Minnesota Statutes section 518.175, subdivision 6(d), I ask the Court to direct the other party to pay to the Court to be held in escrow account an amount of money equal to my prepaid expenses for
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the upcoming parenting time to help guarantee that the other party obeys the parenting time order. I also ask that if the other party denies my upcoming parenting time that the money be paid to me. 20. I believe the following additional information would be helpful to the Court in understanding this parenting time problem:

Dated:
Signature (Sign only in front of notary public or court administrator.)

Name: Subscribed and sworn to before me this day of , . Address: City/State/Zip: Telephone:
Notary Public \ Deputy Court Administrator

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