Petition For Modification Of Order Of
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4F.C.A. §§ 651, 652
General Form GF-40
(Petition for Modification of Order of
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Custody or Visitation –Family or Supreme Court)
12/2015
FAMILY COURT OF THE STATE OF NEW YORK
COUNTY OF
....................................................................................
In the Matter of a Proceeding for Custody/Visitation
Under Article 6 of the Family Court Act
Docket No.
Petitioner,
PETITION FOR
MODIFICATION OF ORDER OF
Custody
Visitation
-against-
MADE BY
FAMILY COURT
SUPREME COURT
Respondent
.......................................................................................
TO THE FAMILY COURT:
The undersigned Petitioner respectfully shows that:
1. I am [specify relationship to child(ren)]:
of [specify child(ren)’s
name(s)]:
I am seeking to modify an order of [check applicable box(es)]:
custody
visitation.
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2. The home addresses of the Petitioner and Respondent are as follows:
Petitioner:
Respondent:
3. Petitioner is
and was the
in an action filed in
Supreme Court of the State of New York,
County, Index No. [specify]:
Family Court of the State of New York,
County, Docket No. [specify]:
entitled
4. [Applicable when Petitioner and/or Respondent are on active duty or have recently returned from
active military service; DELETE if inapplicable]:
a. Petitioner [check applicable box]:
is on active duty, deployed or temporarily assigned to military service as follows [specify type of
service, military branch or National Guard unit, anticipated dates and location of duty and how duty is
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If the order was entered by a Court outside New York State or a tribal court, use Form UCCJEA-9.
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Unless ordered confidential, pursuant to Family Court Act §154-b, because disclosure would pose an
,
unreasonable risk to he health or safety of the party . See Forms GF-21 and 21a
available at
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