Paternity Petition

District Court Denver Juvenile Court County, Colorado

Court Address:

In the Interest of:

Petitioner:

v.

Respondent:

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):

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.

7. Prior proceedings regarding the child(ren):

8. Knowledge of proceedings affecting this case:

9. Other persons with custody or parental rights:

10. People the child(ren) has/have lived with over the past five years:

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:

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 .

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.

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