Fill and Sign the To Modify Decision Making Responsibility Pursuant to 14 10 131 C Form

JDF 1415 R8 17 VERIFIED MOTION/STIPULATION TO MODIFY DECISION-MAKING RESPONSIBILITIES © 2017 Colorado Judicial Department for use in the Courts of Colorado Page 1 of 3District Court Denver Juvenile Court ___________________ County, ColoradoCourt Address:In re:The Marriage of:The Civil Union of:Parental Responsibilities concerning:______________________________________________________Petitioner: andCo-Petitioner/Respondent: COURT USE ONLY Attorney or Party Without Attorney (Name and Address): Phone Number: E-mail:FAX Number: Atty. Reg. #:Case Number:Division Courtroom  MOTION STIPULATION TO MODIFY DECISION-MAKING RESPONSIBILITY PURSUANT TO §14-10-131, C.R.S. Note to Responding Party:If you disagree with this Motion, the Colorado Civil Rules of Procedure allow you to file a written response with the Court which must be filed within 21 days of the date this Motion was served on you or mailed to you. The  Petit io ne r  Co-P etit io ner/R esp ondent  Both re quests th at th is C ourt m odif y Allocation of Parental Responsibilities previously entered in this case, pursuant to §14-10-131, C.R.S., and state the following:1. The last Order regarding allocation of parental responsibilities was entered by the Court on _____________________________ (date).2. A motion for a substantial modification of allocation of parental responsibilities has  has not been filed in the last two years. If one has been filed, please identify the date filed _____________________________. 3.Information about Petitioner: Date of Birth: Current Mailing Address: City, State & Zip Code: Home Phone #: Work Phone #: Cell #: 4.Information about Co-Petitioner/Respondent: Date of Birth: Current Mailing Address:City, State & Zip Code: Home Phone #: Work Phone #: Cell #: JDF 1415 R8 17 VERIFIED MOTION/STIPULATION TO MODIFY DECISION-MAKING RESPONSIBILITIES © 2017 Colorado Judicial Department for use in the Courts of Colorado Page 2 of 35. This Motion concerns the following child(ren) of the parties: Full NamePresent AddressSexDate of Birth6. Are there other child(ren) of the parties, who are not part of the motion? Yes No If Yes please identify: Full NamePresent AddressSexDate of Birth7. What new arrangements are you requesting? 8.Why are you requesting modification of allocation of parental responsibilities? See the requirements of §14- 10-131, C.R.S. Use additional paper, if necessary:9. Have you talked to the other party about this modification of allocation of parental responsibilities? Yes  No If Yes, what is her/his position? 10.Have any Temporary or Permanent Protection/Restraining Orders to prevent domestic abuse, any Criminal Protection/Restraining Orders or Emergency Protection Orders been issued against either party in any Court within two years prior to the filing of this motion? No  Yes If your answer was Yes, complete the following: JDF 1415 R8 17 VERIFIED MOTION/STIPULATION TO MODIFY DECISION-MAKING RESPONSIBILITIES © 2017 Colorado Judicial Department for use in the Courts of Colorado Page 3 of 3The Protection/Restraining Order was Temporary Permanent and issued against __________________________________________, in the County of ____________________, State of ___________________, in case number ___________________.What was the subject matter of the Protection/Restraining Order or Emergency Protection Order? 11.Is either party currently receiving Temporary Aid to Needy Families (TANF) or public assistance? Yes  No Not Sure 12.Does the other party live in another state? Yes No If Yes, what state? _______________________ 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 ACKNOWLEDGMENT 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) (printed name of Co-Petitioner/Respondent) ___________________________________________ __________________________________________________Signature of Petitioner Signature of Co-Petitioner/Respondent _____________________________________________ Petitioner’s Attorney Signature, if any Co-Petitioner/Respondent’s Attorney Signature, if any CERTIFICATE OF SERVICE I certify that on _________________________ (date) a true and accurate copy of the Verified Motion to Modify/Stipulation Decision-Making Responsibilities was served on the other party by:Hand Delivery E-filed Faxed to this number ___________________ orby placing it in the United States mail, postage pre-paid, and addressed to the following:To: ______________________________________ ______________________________________ ______________________________________ ______________________________________ (Your Signature)