General Form 40 - Petition For Modification Of An Order Of Custody/visitation
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F.C.A. § § 651, 652
General Form 40
Custody/Visitation- Mod.
12/2015
NCFC 5/2016
FAMILY COURT OF THE STATE OF NEW YORK
COUNTY OF NASSAU
.............................................................................................
In the Matter of a Proceeding for Custody/Visitation
PETITION for Modification of an
Under Article 6 of the Family Court Act
Order of Custody/Visitation
Made by
G NYS Family Court
Petitioner (1)
G NYS Supreme Court
First
M.I.
Last
Petitioner (2)
FILE #
First
M.I.
Last
DOCKET #(s)
-AGAINST-
Respondent (1)
(Court use only)
First
M.I.
Last
Respondent (2)
First
M.I.
Last
.............................................................................................
TO THE FAMILY COURT:
The undersigned petitioner respectfully alleges upon information and belief that:
1.
I(We) am(are) seeking to modify an order/judgment of custody/visitation/parenting time for the
following child(ren):
Name of Child (1):
G Male
G Female
Date of Birth:
Sex:
*Address:
Name of person(s) with whom child resides:
Name of Child (2), if applicable:
G Male
G Female
Date of Birth:
Sex:
*Address:
Name of person(s) with whom child resides:
Name of Child (3), if applicable:
G Male
G Female
Date of Birth:
Sex:
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