Legal Custody Application

LEGAL CUSTODY APPLICATION

This Legal Custody Application is filed by Applicant Name: (Applicant) against Respondent Name: (Respondent) in the Family Court of County: . Case Number (if known): .

RECITALS

WHEREAS, the parties are the parents or legal guardians of the minor child(ren) described herein and seek a judicial determination of legal custody and related responsibilities; and

WHEREAS, the Applicant contends that a custody determination is necessary to protect the best interests, welfare, and stability of the minor child(ren); and

WHEREAS, the parties desire to present to the Court the facts, supporting documentation, and proposed orders set forth in this application.

NOW, THEREFORE, the Applicant petitions the Court to issue orders as requested below.

1. PARTIES AND CONTACT INFORMATION

2. JURISDICTION

The Applicant alleges that the Court has jurisdiction over this matter because the child(ren) reside in the county specified above and the Court has authority under applicable state family law to make custody determinations.

3. CHILD(REN) INFORMATION

4. RELIEF REQUESTED

The Applicant requests the Court enter orders as follows (select all that apply and provide supporting detail).

Sole legal custody to Applicant
Joint legal custody with delineated decision-making responsibilities
Primary physical residence with Applicant
Shared physical residence / specified parenting schedule

5. PROPOSED PARENTING PLAN

The Applicant proposes the following schedule and parental responsibilities to promote the best interests of the child(ren).

6. BEST INTERESTS FACTORS

The Applicant asserts the following factual matters relevant to the statutory best-interest factors.

Child's preference (if age-appropriate) — explanation:

Stability of home environment — explanation:

Physical or emotional needs of the child(ren) — explanation:

7. BACKGROUND FACTS AND HISTORY

8. TEMPORARY ORDERS / EMERGENCY RELIEF

Applicant requests temporary custody or protection orders pending final hearing.

9. DISCLOSURES

Has either parent been convicted of a crime involving domestic violence or child abuse?

Applicant: Yes No — Explanation:

Respondent: Yes No — Explanation:

10. ATTACHMENTS

The Applicant attaches the following documents in support of this application:

Child(ren) birth certificate(s)
Proof of residence or habitation
Affidavit of Applicant or witnesses
Other (describe):

11. NOTICE AND SERVICE

The Applicant requests that service of all notices and papers be made at the addresses provided above unless otherwise directed by the Court.

12. GOVERNING LAW; ENTIRE AGREEMENT; SEVERABILITY

This Application and any resulting orders shall be governed by the laws of the State in which the Court sits. This Application, together with attachments and any subsequent orders of the Court, constitutes the entire request for relief by the Applicant and supersedes any prior written or oral statements relating to the subject matter. If any provision of this Application is held invalid, such invalidity shall not affect the remaining provisions, which shall remain enforceable.

13. AMENDMENTS; WAIVER

This Application may be amended by the Applicant through subsequent filings with the Court. No waiver of any provision shall be effective unless in writing and signed by the party waiving such provision or by order of the Court.

14. REQUEST FOR HEARING

The Applicant requests a hearing date be set at the Court's earliest convenience. Proposed hearing date (if any):

15. CERTIFICATION

I certify under penalty of perjury under the laws of the State in which this Court sits that the information contained in this Application and its attachments is true and correct to the best of my knowledge.

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