Family Court Division (Page 2 of 5) in pdf

Family Court Division Page 2

Petitioner/Plaintiff currently resides at ________________________,

________________________________________________________________________ in

_________________________ County, _____________.

Respondent/Defendant currently resides at ___________________,

________________________________________________________________________ in

_________________________ County, _____________.

Petitioner’s

(Plaintiff’s)

social

security

number

_____________________.

Respondent’s

(Defendant’s)

social

security

number

_____________________.

Children: There (are/is) ______ unemancipated child(ren) of the

parties, to wit::

Name of Child

Date of Birth

Social Security No.

There is no other litigation pending in this or any other state concerning the

care and custody of the unemancipated child(ren) and there are no persons

other than myself and (Petitioner/Respondent) who have custody of the

child(ren) or claim to have any custody or visitation rights regarding the

child(ren) except: _____________________________________________.

The unemancipated child(ren) have been residents of the State of Missouri

for at least the six months period immediately prior to the filing of this action

and either continue to reside in the State of Missouri or have been residing

outside the State of Missouri for less than six months.

At least one of the parties hereto is represented by legal counsel.

10.

If the modification is regarding child support, custody, or

visitation, both parents have completed a court-approved parent education

program and have filed their certificates of completion with the Court.

11.

If the modification is regarding child support, custody, or

visitation, the required statutory language concerning a contemplated

relocation of the residence of the child(ren) or any party entitled to visitation

or custody of the child(ren) is included in the proposed judgment.

Family Court Division Page 2