Fill and Sign the Minnesota Complaint Form

STATE OF MINNESOTA DISTRICT COURT COUNTY OF             JUDICIAL DISTRICT FAMILY COURT DIVISION In Re the Marriage of: Court File No.             , Petitioner, COMPLAINT (parentage alleged AND by father)       , Respondent, * * * * * * * * * * * * * * * * * * ____________________ , being first duly sworn, alleges for his cause of action: The true and correct names, addresses, and social security numbers of Plaintiff and Defendant are: Plaintiff: _________________________ _________________________ _________________________ SSN: ____________________ Defendant: _________________________ _________________________ _________________________ SSN: ____________________ Plaintiff is being represented in these proceedings by _______________________________________ , Esquire, of - 1 - _______________________________________________________________ , (address) , (city) , (state) (zip code) . Plaintiff's date of birth is ________________ , 20 ____ , and he is ________________ ( ____ ) years of age. Defendant's date of birth is ________________ , 20 ____ , and she is ________________ ( ____ ) years of age. Plaintiff (and the minor child) reside(s) in the County of ________________ , State of Minnesota. Defendant (and the minor child) reside(s) in the County of ________________ , State of Minnesota. On or about the ____ day of ________________ , 20 ____ , in the City of ________________ , County of ________________ , and State of ________________ , Plaintiff, ________________ , and Defendant, ________________ , had sexual intercourse. By reason of said sexual intercourse, Defendant became pregnant with a (male)(female) child, ________________ , who was born (out of wedlock) in the City of ________________ on the ____ day of ________________ , 20 ____ . Blood tests indicate that there is a ____ percent likelihood that Plaintiff is the father of said minor child. (Plaintiff requests that he be adjudicated the father of said minor child.) (The parties have agreed that Plaintiff is the father of the minor child.) A (declaration)(recognition) of parentage, pursuant to Minn. Stat. §(257.34)(257.75) has (not) been signed by (Plaintiff) (Defendant) (the parties). Plaintiff is the father of said child, and (said child bears his surname) (his name appears on the birth certificate of the minor child). - 2 - (Plaintiff is a)(the parties are) fit and proper custodian(s) for said minor child, and the best interests of the child will be served if (Plaintiff is)(the parties are) awarded (sole)(joint) legal and (Plaintiff is awarded sole) physical custody. Defendant is capable of contributing to the support of said minor child. Plaintiff is employed as a ________________ by ________________ , located at ________________ . He has gross income of $ ________________ per ________________ and net income of $ ________________ per ________________ . Defendant is employed as a ________________ by ________________ , located at ________________ . She has gross income of $ ________________ per ________________ and net income of $ ________________ per ________________ . Plaintiff is dependent upon Defendant for a contribution to the support of the minor child(ren) of the parties. Neither party receives public assistance. WHEREFORE, Plaintiff prays for the Judgment and Decree of this Court as follows: ADJUDICATION 1. Adjudicating Plaintiff to be the father of the minor child, ________________ . CUSTODY/VISITATION 1. Granting ________________ the sole legal and physical custody of said minor child subject to ________________ 's right to (reasonable) (supervised) (reasonable and liberal) visitation. 2. Granting Plaintiff and Defendant the joint legal custody of said minor child, and designating ________________ as (his)(her) sole physical custodian subject to ________________ 's right to (reasonable) (supervised) (reasonable and liberal) visitation. 3. Granting Plaintiff and Defendant joint legal and physical custody of said minor child. 4. Ordering such custody, care and control of said minor child as the Court deems in (his)(her) best interest. - 3 - CHILD SUPPORT 1. Ordering such support for said minor child as the Court deems just, fair and equitable. 2. Ordering ________________ to pay to ________________ a reasonable sum of money for the support of said minor child. 3. Reserving the issue of support for said minor child. INCOME WITHHOLDING 1. Requiring that the child support payment by ________________ be made by income withholding pursuant to Minn. Stat. §518.613. INSURANCE 1. Requiring that ( ________________ )(both parties) provide medical (and dental) insurance for the benefit of said minor child (in a just and equitable manner). NAME CHANGE 1. Ordering that the minor child's name be changed from ________________ to ________________ . SUCH OTHER 1. For such other and further relief as the Court deems just, fair and equitable in the premises. Dated: ________________ _________________________ Firm By _________________________ _________________________ Printed Name _________________________ - 4 - _________________________ _________________________ Address _________________________ Telephone Attorney for ______________ VERIFICATION STATE OF MINNESOTA) )SS. COUNTY OF ______________ ) ______________ , being first duly sworn, upon oath deposes and says that he is the Plaintiff in the above - entitled action; that he has read the foregoing Complaint, knows the contents thereof and that the same is true and correct, except as to those matters therein stated on information and belief and as to those matters he believes them to be true. ______________________________ Name of Client Plaintiff Dated: _____________ _______________________ Petitioner/Respondent Subscribed and sworn to before me this _____ day of ____________ , 20 ___ . _______________________________ NOTARY PUBLIC - 5 - ACKNOWLEDGMENT STATE OF MINNESOTA ) ) SS. COUNTY OF ______________ ) __________________________ , the attorney for Plaintiff in the above-captioned matter, and __________________________ , Plaintiff herein, hereby acknowledge that pursuant to Minn. Stat. §549.21, costs, disbursements, witness fees and reasonable attorneys' fees may be awarded to Defendant in the event Plaintiff is found to be acting in bad faith and/or asserting a frivolous claim. _____________________________ Name of Client Plaintiff Subscribed and sworn to before me this _____ day of ______________ , 20 ___ . _____________________________ Notary Public _____________________________ Attorney for Plaintiff Subscribed and sworn to before me this _____ day of ______________ , 20 ___ . _____________________________ Notary Public - 6 -