Petition For Modification Of Custody And Child Support Form Page 6
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7THEREFORE, I request the following
:
[Check all that apply.]
☐ (a) That I be awarded legal custody and physical custody of the minor child(ren);
☐ (b) That the Respondent and I be awarded joint legal custody, and I be awarded
physical custody of the minor child(ren);
☐ (c) That the other custody arrangement is ordered as specified in Paragraph 11;
☐ (d) That the prior child support order be modified if the prior child custody
determination is modified;
☐ (e) That a Rule Nisi be scheduled by the Court to decide on the relief I have
requested;
☐ (f)
That the Court order the parties to participate in mediation to try to resolve this
matter;
☐ (g) That the Respondent be required to pay all costs of this action; and
☐ (h) That the Court order any and all other relief that the Court finds appropriate.
Dated:
Petitioner Pro se [signature]
Name:
Address:
City, State ZIP
Phone:
Email:
Petition for Modification of Custody and Support — Rev. May 2016
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Provided by the Gwinnett Family Law Clinic
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