Fill and Sign the Order After Review of Petition for Visits Washington Form

Chapter 26.11 RCW (07/2018) FL Visits 476 Petition for Visits p. 1 of 9 Superior Court of Washington, County of In re visits with: Children: Petitioner/s (person/s who started this case) : Respondent/s (parent/s, legal custodian, and anyone with court -ordered residential time) : No. Petition for Visits (PTV) Clerk’s action required: 9 (link juv. case). Petition for Visits Use this form to ask for visits only if all these are true :  You are a relative of the child or a relative of the child’s parent. (See section 2, below.)  You have an ongoing and substantial relationship with the chil d.  The child is likely to suffer harm or substantial risk of harm if visits are denied.  You’ve never filed a petition for visits with the child before. You must prove your case by clear and convincing evidence. You may have to pay for Respondent’s costs and lawyer fees in advance. 1. Petitioner’s Information My name is: I live in (county and state only): I am related to the child in this way: If there is another Petitioner in this case, put the other Petitioner’s information below . My name is: Lives in (county and state only): I am related to the child in this way: This is the first Petition for Visits filed by Petitioner/s for these chil dren. Chapter 26.11 RCW (07/2018) FL Visits 476 Petition for Visits p. 2 of 9 2. Family Relationship I am related to the children or the children’s parent as follows (check all that apply, if more than one petitioner, specify each petitioner’s relationship ): “Parent” means a legal parent whose rights have not been terminat ed, relinquished, or declared not to exist. Blood relative, including those of half -blood, and including first cousins, second cousins, nephews or nieces, and persons of preceding generations as denoted by prefixes of grand, great, or great -great , or That person’s spouse, even after the marriage is terminated or One of those relatives of any half sibling of the child. Stepfather, stepmother, stepbrother, and stepsister, or That person’s spouse, even after the marri age is terminated or One of those relatives of any half sibling of the child. A person who legally adopts a child or the child's parent as well as the biological and other legally adopted children of such persons, and other relatives of the adoptive parents in accordance with state law, or Th at person’s spouse, even after the marriage is terminated or One of those relatives of any half sibling of the child. Extended family members, as defined by the law or custom of an Indian child's tribe or, in the absence of such law or custom, a person who has reached the age of eighteen and who is the Indian child's grandparent, aunt or uncle, brother or sister, br other-in - law or sister -in -law, niece or nephew, first or second cousin, or stepparent who provides care in the family abode on a twenty -four hour basis to an Indian child as defined in 25 U.S.C. Sec. 1903(4). 3. Children I ask the court for visits with th e following children. The children live in (county and state only): 4. Respondents’ Information List the children’s parents and anyone else with court -ordered residential time with the children. Respondent (name): Relationship to the children in this case: Lives in (county and state only): Other Respondent, if any (name): Child’s Name Age Child’s Name Age 1. 2. 3. 4. 5. 6. Chapter 26.11 RCW (07/2018) FL Visits 476 Petition for Visits p. 3 of 9 Relationship to the children in this case: Lives in (county and state only): Other Respondent, if any (name): Relationship to the children in this case: Lives in (county and state only): Warning! If a Respondent asks, the court must order Petitioner to pay reasonable costs and fees for Respondent’s lawyer before any hearing on this petition unless the court finds it to be unjust. The court will consider the parties’ financial resources before ordering fees. 5. Other people with a legal right to spend time with a child Do you know of anyone besides you and the Respondents who has or claims to have a legal right to spend time with any of these children? (Check one): No. (Skip to 7.) Yes. (Fill out below.) Name of person Children this person may have the right to spend time with All children (Name/s): All children (Name/s): All children (Name/s): 6. Children’s Home/s During the past 5 years have any of the children lived:  on an Indian reservation,  outside Washington state,  in a foreign country, or  with anyone other than Petitioner/s and/or Respondent/s? No. (Skip to 7.) Yes. (Fill out below to show where each child has lived during the last 5 years.) Dates Children Lived with In which state, Indian reservation, or foreign country From: To: All children (Name/s): Petitioner/s Resp. (name/s): Other (name): From: To: All children (Name/s): Petitioner/s Resp. (name/s): Other (name): Chapter 26.11 RCW (07/2018) FL Visits 476 Petition for Visits p. 4 of 9 From: To: All children (Name/s): Petitioner/s Resp. (name/s): Other (name): From: To: All children (Name/s): Petitioner/s Resp. (name/s): Other (name): 7. Other court cases involving a child Do you know of any court cases involving any of these children? (Check one): No. (Skip to 8.) Yes. (Fill out below.) Kind of case (Family Law, Criminal, Protection Order, Juvenile, Dependency, Other) County and State Case number and year Children All children (Name/s): All children (Name/s): All children (Name/s): All children (Name/s): 8. Jurisdiction over the children (RCW 26.27.201 – .221, .231, .261, .271; 13.04.030) This Court can decide this case for the children because (check all that apply; if a box applies to all of the children, you may write “the children” instead of listing names): Exclusive, continuing jurisdiction – A Washington court has already made a custody order or parenting plan for the children, and the court still has authority to make other orders for (children’s names): . Home state jurisdiction – Washington is the children’s home state because (check all that apply): (Children’s names): lived in Washington with a parent or someone acting as a parent for at least the 6 months just before this case was filed, or if the children are less than 6 months old, they have lived in Washington with a parent or someone acting as a parent since birth. Chapter 26.11 RCW (07/2018) FL Visits 476 Petition for Visits p. 5 of 9 There were times the children were not in Washington in the 6 months just before this case was filed (or since birth if they are less than 6 months old), but thos e were temporary absences. (Children’s names): do not live in Washington right now, but Washington was the children’s home state some time in the 6 months just before this case was filed, and a parent or someone acting as a parent of the children still lives in Washington. (Children’s names): do not have another home state. No home state or home state declined – No court of any other state (or tribe) has the jurisdiction to make decisions for (children’s names): or a court in the children’s home state (or tribe) decided it is better to have this case in Washington and:  The children and a parent or someone acting as a parent have ties to Washington beyond just living here; and  There is a lot of information (substantial evidence) about the children’s care, protection, education and relationships in this state. Other state declined – The courts in other states (or tribes) that might be (children’s names): ’s home state have refused to take this case because it is better to have this case in Washington . Other reason (specify): 9. County where this case should be heard I am filing this petition in this county because: T here is a juvenile court case involving child custody or out -of -home placement filed in this county under c ase number/s The children live most of the time in this county. T here is no juvenile court case involving child custody or out -of -home placement filed in any county. Other reason:  Petitioner’s Statement (Affidavit) If you need additional space for any section, below, use the Declaration FL All Family 135. 10. Ongoing and substantial relationship I had an ongoing and substantial relationship with the children for at least two years, or, if a child is under two, for at least half the child’s life and with a shared expectation of and desire for an ongoing relationship. (Describe how your relationship with the children was formed and sustained through interaction, companionship, and mutuality of interest and affection, without expectation o f financial compensation and with substantial continuity .) Chapter 26.11 RCW (07/2018) FL Visits 476 Petition for Visits p. 6 of 9 11. Risk of harm Warning! The court will presume that a fit parent’s decision to deny visit s is in the best interest of the children and does not create a likelihood of harm or a substantial risk of harm to the children. Petitioners must overcome this presumption by clear and convincing evidence . The children are likely to suffer harm or a substantial risk of harm if visits a re denied. (Explain why and how the children would be harmed.) 12. Best interest Warning! Petitioner must prove visit s are in the children’s best interest by clear and convincing evidence. Visits are in the children’s best interest considering these factors: a. Current relationship: Describe the love, affection, and strength of the current relationship between the child and Petitioner and how the relationship is beneficial to the child . (Describe): b. Prior relationship: Describe the length and quality of the prior relationship between the child and Petitioner before Respondent denied visits, including the role performed by Pet itioner and the emotional ties that existed between the child and Petitioner. (Describe): c. Relationship between parties: Describe the relationship between Petitioner /s and Respondent /s. (Describe): Chapter 26.11 RCW (07/2018) FL Visits 476 Petition for Visits p. 7 of 9 d. Resp ondent’s relationship: Describe the love, affection, and strength of the current relationship between the child and Respondent . (Describe): e. Objection: Describe t he nature and reason for Respondent's objection to granting P etitioner visit s. (Describe): f. Effect if granted: Describe the effect that granting visit s will have on the relationship between the child and Respondent . (Describe): g. Residential time: Describe the residential time -sharing arrangements between the parties having residential time with the child . (Describe): h. Good faith: Describe the good faith of Petitioner /s and Respondent /s. (Describe): i. Abuse or neglect: Describe any history of physical, emotional, or sexual abuse or neglect by Petitioner, or any history of physical, emotional, or sexual abuse or neglect by a person residing with Petitioner if visit s would involve contact be tween the child and the person with such history . (Describe): j. Child’s preference: Describe t he child's reasonable preference, if old enough to express a preference. (Describe): Chapter 26.11 RCW (07/2018) FL Visits 476 Petition for Visits p. 8 of 9 k. Other: Describe any other factor relevant to the child's best interest . (Describe): 13. Visits Requested (Specify frequency and lengths of visits you are requesting.) Petitioner fills out below: I declare under penalty of perjury under the laws of the state of Washington that the facts I have provided on this form are true. Signed at (city and state): Date: Petitioner signs here Print name Other Petitioner (if any) fills out below: I declare under penalty of perjury under the laws of the state of Washington that the facts I have provided on this form are true. Signed at (city and state): Date: Other Petitioner signs here Print name Petitioner’s lawyer (if any) fills out below: Petitioner’s lawyer signs here Print name and WSBA No. Date Warning! Documents filed with the court are available for anyone to see unless they are sealed. Financial, medical, and confidential reports, as described in General Rule 22, must be sealed so they can only be seen by the court, the other parties, and the lawyers in your case. Seal those docum ents by filing them separately, using a Sealed cover sheet (form FL All Family 011, 012, or 013). You may ask for an order to seal other documents. Chapter 26.11 RCW (07/2018) FL Visits 476 Petition for Visits p. 9 of 9 Respondent fills out below if s/he agrees to join this Petition: I, (name): , agree to join this Petition. I understand that if I fill out and sign below, the court may approve the requests listed in this Petition unless I file and serve a Response before the court signs final orders. (Check one): I do not need to be notified about the court’s hearings or decisions in this case. I ask the Petitioner to notify me about any hearings in this case. (List an address where you agree to accept legal documents. This may be a lawyer’s address o r any other address.) address city state zip (If this address changes before the case ends, you must notify all parties and the court clerk in writing. You may use the Notice of Address Change form (FL All Family 120 ). You must also update your Confidential Information Form (FL All Family 001) if this cas e involves parentage or child support.) Respondent signs here Print name Date Other Respondent fills out below if s/he agrees to join this Petition: I, (name): , agree to join this Petition. I understand that if I fill out and sign below, the court may approve the requests listed in this Petition unless I file and serve a Response before the court signs final orders. (Check one): I do not need to be notified about the court’s hearings or decisions in this case. I ask the Petitioner to notify me about any hearings in this case. (List an address where you agree to accept legal documents. This may be a lawyer’s address o r any other address.) address city state zip (If this address changes before the case ends, you must notify all parties and the court clerk in writing. You may use the Notice of Address Change form (FL All Family 120 ). You must also update your Confidential Information Form (FL All Family 001) if this cas e involves parentage or child support.) Other Respondent signs here Print name Date