Fill and Sign the Petition Paternity File Form

 District Court  Denver Juvenile Court ___________________ County, Colorado Court Address: In the Interest of: Petitioner: v. Respondent: COURT USE ONLY Attorney or Party Without Attorney (Name and Address) : Phone Number: E-mail: FAX Number: Atty. Reg. #: Case Number: Division Courtroom PETITION FOR PATERNITY I, _______________________________________ Petitioner, ask this Court to find  Petitioner or  Respondent to be the father of the child(ren) named in this Petition, and state that: 1. Information about the Petitioner:  Mother  Father Check if in Military  Date of Birth: _____________________ Length of Residence in Colorado: _________________________ Current Mailing Address: ______________________________________________________________________ City & Zip: _______________________________________________________________________________ Home Phone #: ____________________ Work Phone #: ___________________ Cell #: _________________ 2. Information about the Respondent:  Mother  Father Check if in Military  Date of Birth: _____________________ Length of Residence in Colorado: _________________________ Current Mailing Address: ___________________________________________________________________________ City & Zip: _______________________________________________________________________________ Home Phone #: ____________________ Work Phone #: ___________________ Cell #: _________________ 3. Respondent, is the other biological parent of the following child(ren): Full Name of Child Present Address Sex Date of Birth 4. The Court has jurisdiction over the Respondent. 5. The minor child(ren) live(s) in this County. 6. Each party has a continuing duty to inform the Court of any proceeding in this or any other state that could affect the current proceeding. JDF 1501 R8/17 PETITION FOR PATERNITY © 2017 Colorado Judicial Department for use in the Courts of Colorado Page 1 of 3 7. I have participated in the following proceeding(s) regarding the child(ren) as a party or a witness, or in any other capacity concerning the allocation of parental responsibilities including decision-making and parenting time with the child(ren). Identify name of court, case number, state, date, and type of proceeding if any. Name of Court Case Number State Date of Proceeding Type of Proceeding 8. I have knowledge of the following proceeding(s) that could affect the current proceeding including, but not limited to proceedings relating to domestic violence or domestic abuse, enforcement of Court orders, protection/restraining orders, termination of parental rights, and adoptions. Identify name of court, case number, state, date, and type of proceeding if any. Name of Court Case Number State Date of Proceeding Type of Proceeding 9. The following people are not parties in this matter, but have physical custody of the child(ren) or claim rights of parental responsibilities, legal custody or physical custody, or visitation/parenting time with the child(ren) Identify name and address of those persons, if any. Full Name of Person Address (Street, City/State, Zip Code) 10. Identify below the name and address of each person that the child(ren) has/have lived with over the past five years. Identify the relationship to the child(ren). Name of Person Address (City/Sate/Zip Code) Time Period (Month/Year) Type of Relationship to Child(ren) 11. I seek the following:  Determination that  Petitioner  Respondent is the father.  Order that the Birth Certificate(s) be changed to show  Petitioner  Respondent as the father.  Child support ordered.  Child support by income assignment to  Petitioner’s  Respondent’s employer.  Past child support including birthing expenses.  Medical support for the minor child(ren).  Allocation of parental responsibilities (decision-making and parenting time) be addressed.  Costs be addressed.  Other: JDF 1501 R8/17 PETITION FOR PATERNITY © 2017 Colorado Judicial Department for use in the Courts of Colorado Page 2 of 3 12. Required Notice of Prior Protection/Restraining Orders. Have any Temporary or Permanent Protection/Restraining Orders to prevent domestic abuse or any Criminal Mandatory Protection/Restraining Orders (MRO) or Emergency Protection Orders been issued against either party 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? Notice: Colorado Revised Statutes §19-4-105.5, provides that upon personal service of the Petition and Summons on the Respondent, or upon waiver and acceptance of service by the Respondent, an automatic temporary injunction shall be in effect against both parties for 120 days after its effective date, unless all parties consent to a modification of the temporary injunction. Either party may apply to the Court to modify the length of time the temporary injunction is in effect. 1. Both parties are enjoined from molesting or disturbing the peace of the other party; and 2. Both parties are restrained from removing the minor child(ren) from the state without the consent of all parties or an Order of the Court modifying the injunction; and 3. Both parties are restrained, without at least 14 days advance notification and the written consent of all other parties or an Order of the Court, from cancelling, modifying, terminating, or allowing to lapse for nonpayment of premiums, any policy of health insurance or life insurance that provides coverage to the minor child(ren) as a beneficiary of a policy. Petitioner acknowledges that he or she has read, and understands the terms of the automatic temporary injunction set forth in this Petition.  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 declare under penalty of perjury under the law of Colorado that the foregoing is true and correct. Executed on the ______ day of ________________, _______, at ______________________________________ (date) (month) (year) (city or other location, and state OR country ___________________________________ ___________________________________________ (printed name of Petitioner Father or Mother) Signature of Petitioner Father or Mother JDF 1501 R8/17 PETITION FOR PATERNITY © 2017 Colorado Judicial Department for use in the Courts of Colorado Page 3 of 3