Fill and Sign the Motion Family Access Form

IN THE ______ JUDICIAL CIRCUIT COURT, ________________________ , MISSOURI Judge or Division:       Case Number:       (Date File Stamp)Petitioner:             SSN (Last Four Digits)       vs. Petitioner's address:             Respondent:             SSN (Last Four Digits)       Respondent's address:             Motion for Family Access Order (Check each box that applies) A judgment of dissolution, legal separation or paternity was entered In       County, Missouri. The judgment of dissolution, legal separation or paternity was modified in       County, Missouri.       (name) has denied or interfered with custody, visitation or third party custody under the judgment of dissolution, legal separation, paternity or modification without good cause by the following acts: (please provide specific facts, including dates and times, which you claim are a violation of the court's judgment.)       I request that the court find that       (name) has denied or interfered with: (check the box that applies) Custody or visitation under the judgment. Third-party custody under the judgment. I further request that       be ordered to: (check each box that applies) Provide a period of visitation, custody or third-party custody not less than the period of time denied. Participate in counseling regarding the importance of providing the child(ren) with a continuing and meaningful relationship with both parents. Participate in Alternative Dispute Resolution to assist in resolving the problems which caused the filing of this motion. Pay a fine of up to $500. Post bond or security to ensure future compliance with the court's judgment. Pay the cost of counseling to re-establish the parent-child relationship. Pay reasonable expenses incurred as a result of the denial or interference with custody, visitation or third party custody, including attorney's fees and court costs of the proceedings to enforce custody, visitation or third party custody. Other (specify):       OSCA (07-13) FA10 Page 1 of 2 452.400 RsMO I swear/affirm under penalty of perjury that these facts are true according to my best knowledge and belief. Date Your Signature       Your Street Address       City State Zip       Your Telephone Number Notice of Alternative Dispute Resolution At the initial hearing, the Court may order Alternative Dispute Resolution to assist you and the person against whom your file this motion in resolving the problems which caused the filing of this motion. You and the person against whom you have filed this motion may be required to attend more than one session. Any costs of the Alternative Dispute Resolution will be paid by you and the person against whom your file this motion in the proportions determined by the Court. Notice to       (name) PURSUANT TO SECTION 452.400, RSM OH, YOU ARE REQUIRED TO RESPOND TO THE CIRCUIT CLERK WITHIN 10 DAYS OF THE DATE OF SERVICE. FAILURE TO RESPOND TO THE CIRCUIT COURT MAY RESULT IN THE FOLLOWING: 1. IN ORDER FOR A COMPENSATORY PERIOD OF CUSTODY, VISITATION OR THIRD-PARTY CUSTODY AT A TIME CONVENIENT FOR THE AGGRIEVED PARTY NOT LESS THAN THE PERIOD OF TIME DENIED; 2. PARTICIPATION BY THE VIOLATOR IN COUNSELING TO EDUCATE THE VIOLATOR ABOUT THE IMPORTANCE OF PROVIDING THE CHILD WITH A CONTINUING AND MEANINGFUL RELATIONSHIP WITH BOTH PARENTS; 3. ASSESSMENT OF A FINE OF UP TO FIVE HUNDRED DOLLARS AGAINST THE VIOLATOR; 4. REQUIRING THE VIOLATOR TO POST BOND OR SECURITY TO ENSURE FUTURE COMPLIANCE WITH THE COURT'S ORDERS; 5. ORDERING THE VIOLATOR TO PAY THE COST OF COUNSELING TO RE-ESTABLISH THE PARENT-CHILD RELATIONSHIP BETWEEN THE AGGRIEVED PARTY AND THE CHILD; AND 6. A JUDGMENT IN AN AMOUNT NOT LESS THAN THE REASONABLE EXPENSES, INCLUDING ATTORNEYS FEES AND COURT COSTS ACTUALLY INCURRED BY THE AGGRIEVED PARTY AS A RESULT OF THE DENIAL OF CUSTODY, VISITATION, OR THIRD-PARTY CUSTODY. A response to this motion must be filed in writing with the Circuit Clerk of the court named above. Please keep a copy of this Motion to bring with you to any scheduled hearing or alternative dispute resolution. OSCA (07-13) FA10 Page 2 of 2 452.400 RsMO