General Form 40 - Petition For Modification Of An Order Of Custody/visitation Page 2
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*Address:
Name of person(s) with whom child resides:
If there are 4 or more children, provide the same information on an additional sheet of paper.
* If address is not known to the respondent(s) and you are requesting that the address be kept
confidential from the respondent, print the word CONFIDENTIAL above and print the
child’s(ren’s) name(s), address(es) and the word CONFIDENTIAL on an additional sheet of
paper and attach it to the NCFC Information Sheet only.
2a.
Petitioner (1) - Information:
2b.
Petitioner (2) - Information, if applicable:
Name:
Name:
Date of Birth:
Date of Birth:
*Address:
*Address:
Relationship to the child(ren):
Relationship to the child(ren):
If the relationship is not the same for all children, please explain:
* If address is not known to the respondent(s) and you are requesting that the address be kept
confidential from the respondent, print the word CONFIDENTIAL above and print the child’s(ren’s)
name(s), address(es) and the word CONFIDENTIAL on an additional sheet of paper and attach it
to the NCFC Information Sheet only.
3a.
Respondent (1) - Information:
3b.
Respondent (2) - Information, If applicable:
Name:
Name:
Date of Birth:
Date of Birth:
Address:
Address:
Relationship to the child(ren):
Relationship to the child(ren):
If the relationship is not the same for all children, please explain:
4.
Is/Are either the petitioner parent(s) or respondent parent(s) activated, deployed or temporarily
G Yes
G No
assigned to military service?
Has/Have either the petitioner parent(s) or respondent parent(s) returned from active military
G Yes
G No
service, deployment or temporary assignment?
If yes to either question, complete and attach the 4a. Military Service Attachment.
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