Request For Child Custody Mediation Conference (Page 2 of 4) in pdf

Request For Child Custody Mediation Conference Page 2

Request for Child Custody Mediation Conference Instructions

FORM 5

This request shall be used for all types of custody matters when you are

requesting a Child Custody Mediation Conference.

_____

Print the name of the Plaintiff in the caption

_____

Print the name of the Defendant(s) in the caption

_____

Insert the case number that was assigned to your custody case

_____

Enter the date that you are serving the Prothonotary’s Office, the

Administrative Office of Fayette County Courts and opposing party

_____

Print the current address and phone number of the Plaintiff

_____

Print the name, address and phone number of the Plaintiff’s attorney

_____

Print the current address and phone number of the Defendant(s)

_____

Print the current name, address and phone number of the

Defendant’s attorney

_____

Circle how the Plaintiff served the Complaint for Custody FORM 1A or

FORM 1B on the Defendant(s)

_____

Circle how this request form was served on the opposing party/attorney.

You are required to serve a copy of the Request for Child Custody

Mediation Conference on the opposing party so they are aware that you

are requesting a Child Custody Mediation Conference. If the party has an

attorney, you are required to serve the attorney.

_____

Print and sign your name of the person presenting the request.

The following completed documents are to be filed in the Prothonotary’s

office:

1) Request for Child Custody Mediation Conference

2) Order of Court

3) Criminal Record/Abuse History Verification

4) Complaint for Custody or Petition for Modification or Petition for

Contempt

5) Order of Court (either FORM 3 or FORM 8)

Only the party requesting the mediation conference will pay the Prothonotary’s

Office the Child Custody Mediation Fee of $100.

You will receive a receipt that the fee was paid. A copy of this receipt is to be

attached to the Request for Child Custody Mediation Conference.

Request For Child Custody Mediation Conference Page 2

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