Fill and Sign the Co Grandparents Visitation Form

 District Court  Juvenile Court ______________________ County, Colorado Court Address: In re:  The Marriage of:  The Civil Union of:  Parental Responsibilities concerning: ______________________________________________ Petitioner: and Co-Petitioner/Respondent: and concerning:  Grandparent(s)  Great-Grandparent(s) Intervenor(s): COURT USE ONLY Attorney or Party Without Attorney (Name and Address) : Phone Number: E-mail: FAX Number: Atty. Reg. #: Case Number: Division Courtroom VERIFIED PLEADING AFFIDAVIT FOR  GRANDPARENT  GREAT-GRANDPARENT VISITATION PURSUANT TO §19-1-117, C.R.S. AND RULE 24 OF THE COLORADO RULES OF CIVIL PROCEDURE Note to Responding Party: If you disagree with this Pleading Affidavit, the Colorado Civil Rules of Procedure allow you to file a written response with the Court which must be filed within 21 days of the date this Pleading Affidavit was served on you or mailed to you. The intervenor(s), the  maternal  paternal  grandparent(s)  great-grandparent(s) of the minor child(ren), states the following for the purpose of establishing visitation between the  grandparent(s)  great-grandparent(s) and the child(ren), pursuant to §19-1-117, C.R.S. A Pleading Affidavit seeking an Order for grandparent/great-grandparent visitation  has  has not been filed in the last two years. If one has been filed, please identify the date filed _____________________________ and state in section 8 below, the reasons why you believe you have good cause to now file again for visitation. 1. Information about Intervenor (1): Check if in Military  Full Legal Name: Date of Birth: Current Mailing Address: City: State: _____ Zip Code: _________ Home Phone #: Email Address: Cell Phone #: Intervenor has the following relationship with the minor child(ren): JDF 1701 R8-2017 PLEADING AFFIDAVIT FOR GRANDPARENT/GREAT-GRANDPARENT VISITATION PURSUANT TO §19-1-117, C.R.S. © 2017 Colorado Judicial Department for use in the Courts of Colorado Page 1 of 5  child(ren)’s grandmother  child(ren)’s grandfather  child(ren)’s great-grandmother  child(ren)’s great-grandfather JDF 1701 R8-2017 PLEADING AFFIDAVIT FOR GRANDPARENT/GREAT-GRANDPARENT VISITATION PURSUANT TO §19-1-117, C.R.S. © 2017 Colorado Judicial Department for use in the Courts of Colorado Page 2 of 5 2. Information about Intervenor (2): Check if in Military  Full Legal Name: Date of Birth: Current Mailing Address: City: State: _____ Zip Code: _________ Home Phone #: Email Address: Cell Phone #: Intervenor has the following relationship with the minor child(ren):  child(ren)’s grandmother  child(ren)’s grandfather  child(ren)’s great-grandmother  child(ren)’s great-grandfather 3. Information about the Mother:  Petitioner  Respondent/Co-Petitioner Check if in Military  Full Legal Name: Current Mailing Address: City: State: _____ Zip Code: _________ Home Phone #: Email Address: Cell Phone #: 4. Information about the Father:  Petitioner  Respondent/Co-Petitioner Check if in Military  Full Legal Name: Current Mailing Address: City: State: _____ Zip Code: _________ Home Phone #: 5. The minor child(ren) is/are: Full Name of Child Present Address Sex Date of Birth 6. The parental rights of the parents of the minor child(ren) have been terminated.  Yes  No If Yes , please furnish the case number: __________________________________ 7. Visitation with the  grandparent(s)  great-grandparent(s) is in the child(ren)’s best interest for the following reasons: JDF 1701 R8-2017 PLEADING AFFIDAVIT FOR GRANDPARENT/GREAT-GRANDPARENT VISITATION PURSUANT TO §19-1-117, C.R.S. © 2017 Colorado Judicial Department for use in the Courts of Colorado Page 3 of 5 8. The  grandparent(s)  great-grandparents(s) wish(es) to have visitation with the minor child(ren) at the following times and under the following conditions: 9. Transportation of the child(ren) will be as follows: 10. Have any Temporary or Permanent Protection/Restraining Orders or any Criminal Mandatory Protection/Restraining Orders (MRO) or Emergency Protection Orders been issued against the grandparent(s)/great-grandparent(s) or any of the parties within two years prior to the filing of this Petition?  No  Yes If your answer was Yes , complete the following: The Protection/Restraining Order was  Temporary  Permanent  MRO and issued against _________________________________ in a  Municipal Court  County Court  District Court in the County of _____________________, State of _______________, in case number ________________ on ______________________ (date). What was the subject matter of the Protection/Restraining Order or Emergency Protection Order? I/We respectfully request that this Court enter an Order for visitation between the  intervenor(s)/grandparent(s)  Intervenor(s)/great-grandparent(s) and the minor child(ren) as set forth in this Pleading Affidavit and any other orders necessary to effectuate the best interests of the child(ren).  I/We respectfully request a hearing before the Court before an order is entered. (Optional) JDF 1701 R8-2017 PLEADING AFFIDAVIT FOR GRANDPARENT/GREAT-GRANDPARENT VISITATION PURSUANT TO §19-1-117, C.R.S. © 2017 Colorado Judicial Department for use in the Courts of Colorado Page 4 of 5  By checking this box, I am acknowledging I am filling in the blanks and not changing anything else on the form.  By checking this box, I am acknowledging that I have made a change to the original content of this form. (Checking this box requires you to remove JDF number and copyright at the bottom of the form) VERIFICATION AND ACKNOWLEDGEMENT I _______________________________(name) swear/affirm under oath, and under penalty of perjury, that I have read the foregoing Verified Pleading Affidavit for Grandparent/Great-Grandparent Visitation Pursuant to §19-1- 117, C.R.S. and Rule 24 of the Colorado Rules of Civil Procedure and that the statements set forth therein are true and correct to the best of my knowledge and belief. _____________________________________ __________________________________________ Signature of  Grandmother Date Signature of  Grandfather Date Signature of  Great-Grandmother Signature of  Great-Grandfather ______________________________________ __________________________________________ Attorney Signature, if any Attorney Signature, if any The foregoing instrument was subscribed and The foregoing instrument was subscribed and affirmed, or sworn before me in the County of affirmed, or sworn before me in the County of _____________________, State of Colorado, _____________________, State of Colorado, this _____ day of _________________, 20___ this _____ day of _________________, 20 ___ by __________________________________ by _____________________________________ My Commission Expires: ________________ My Commission Expires: ________________ ______________________________________ ______________________________________ Notary Public/Deputy Clerk Notary Public/Deputy Clerk CERTIFICATE OF SERVICE I certify that on ____________________ (date) a true and accurate copy of this Verified Pleading Affidavit for Grandparent/Great-Grandparent Visitation Pursuant to §19-1-117, C.R.S. and Rule 24 of the Colorado Rules of Civil Procedure 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: __________________________________ _____________________________________ _____________________________________ _____________________________________ _____________________________________ _____________________________________ _____________________________________ _____________________________________ ______________________________________ Signature JDF 1701 R8-2017 PLEADING AFFIDAVIT FOR GRANDPARENT/GREAT-GRANDPARENT VISITATION PURSUANT TO §19-1-117, C.R.S. © 2017 Colorado Judicial Department for use in the Courts of Colorado Page 5 of 5