County, Colorado District Court



?District Court ?Denver Juvenile Court ___________________ County, ColoradoCourt Address:In re:?The Marriage of:?The Civil Union of:?Parental Responsibilities concerning:______________________________________________________Petitioner:andCo-Petitioner/Respondent:COURT USE ONLYAttorney or Party Without Attorney (Name and Address): Phone Number: E-mail:FAX Number: Atty. Reg. #:Case Number:Division CourtroomSTIPULATION REGARDING PARENTING TIME MODIFICATIONThe ________________________ (Petitioner) and _________________________ (Co-Petitioner/Respondent) stipulate and agree to the following Stipulation Regarding Parenting Time Modification:The parties have _____ minor child(ren):Full Name of ChildPresent AddressSexDate of BirthWe request the Court to change the current parenting time order to provide for the following new parenting plan schedule: (Attach additional documentation, if necessary.)We believe that the modification/restriction of the current parenting time order is in the best interests of the minor child(ren) for reason(s) which were unknown to the Court, or that have arisen since the last order. They are as follows:Other Information:We request that this Stipulation Regarding Parenting Time Modification be entered as an Order of this Court.??By checking this box, I am acknowledging I am filling in the blanks and not changing anything else on the form.??By checking this box, I am acknowledging that I have made a change to the original content of this form.VERIFICATION I declare under penalty of perjury under the law of Colorado that the foregoing is true and correct.Executed on the ____ day of ________________, _______, at ______________________________________ (date) (month) (year) (city or other location, and state OR country _______________________________________ _____________________________________________ (Printed name of Petitioner) Signature of Petitioner_________________________________________________________________________________________Address State Zip Code _________________________________________________________________________________________(Area Code) Telephone Number (home) (Area Code) Telephone Number (work)_______________________________________ Petitioner’s Attorney Signature, if anyI declare under penalty of perjury under the law of Colorado that the foregoing is true and correct.Executed on the ____ day of ________________, _______, at ______________________________________ (date) (month) (year) (city or other location, and state OR country _______________________________________ _____________________________________________ (Printed name of Co-Petitioner/Respondent) Signature of Co-Petitioner/Respondent_________________________________________________________________________________________Address State Zip Code _________________________________________________________________________________________(Area Code) Telephone Number (home) (Area Code) Telephone Number (work)___________________________________________ Co-Petitioner/Respondent’s Attorney Signature, if any ................
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