INSTRUCTIONS FOR FILING A PETITION FOR MODIFICATION …

[Pages:31]INSTRUCTIONS FOR FILING A PETITION FOR MODIFICATION OF CUSTODY ORDER

The following documents should be completed and filed with the filing fees, unless waived by the Court, in the Prothonotary's office. All information must be typewritten or neatly printed:

INTAKE

Complete this form in its entirety.

COVER SHEET

Fill in the top part of this form with your name and address and the respondent's name and address. You are the petitioner. The person you are filing against is the respondent. In the box titled "Statutory Basis for Cause of Action", you should write the word "custody". You must sign and date the form at the bottom.

ORDER OF COURT FOR CONFERENCE/HEARING

Insert your name on the first line on the left side of the top of the form (This is called the caption). Insert the respondent's name on the second line on the left side of the top of the form. The Court will complete the rest of the form.

ORDER OF COURT

Insert your name on the first line on the left side of the top of the form (This is called the caption). Insert the respondent's name on the second line on the left side of the top of the form. Please complete numbers 1, 5, 6 and 8 with your proposed recommendations for custody.

RELOCATION

No party may make a change in the residence of any child which significantly impairs the ability of the other party to exercise custodial rights without first complying with all of the applicable provisions of 23 Pa.C.S. ?5337 and Pa.R.C.P. No. 1915.17 regarding relocation.

PETITION FOR MODIFICATION OF A CUSTODY ORDER

If you already have a custody order from the court and you wish to change it, complete this form by inserting your name on the first line on the left side of the top of the form (This is called the caption). Insert the other person's name on the second line on the left side of the top of the form. You are the "Petitioner" and the other person is the "Respondent". Insert your case number from your current custody order on the

right hand side. Answer all the questions on the form completely. Sign the form in both places at the bottom above the word "Petitioner". (Current filing fees are $25.80 plus $150.00 for custody master. If you are filing an agreement, current filing fee is $25.80 only.) Complete the Criminal Record/Abuse History Verification regarding criminal offense(s) for all parties and members of the household.

PETITION FOR WAIVER OF COSTS (if applicable)

Complete this form ONLY if you cannot afford to pay the initial filling fees and costs. Insert your name on the first line on the left side of the top of the form (This is called the caption). Insert the respondent's name on the second line on the left side of the top of the form. Answer all the questions on the form completely. You must sign and date the form at the bottom. (Current filing fees are $25.80 plus $150.00 for custody master.)

ORDER OF COURT FOR WAIVING PAYMENT OF COSTS (if applicable)

If you complete the Petition for Waiver of Costs, insert your name on the first line on the left side of the top of the form (This is called the caption). Insert the respondent's name on the second line on the left side of the top of the form. The Court will complete the rest of the form.

PENNSYLVANIA RULE OF CIVIL PROCEDURE 1930.4 SERVICE OF ORIGINAL PROCESS IN DOMESTIC RELATIONS MATTERS

Proper service is required. Kindly review this rule which explains the proper procedure for effecting service.

CARBON COUNTY CUSTODY Intake: COMPLAINT/MODIFICATION/CONTEMPT

Docket Number: _______ ___________________ Petitioner (____Mother ____Father ____Other)

Name: _____________________________________ Date of Birth: ______________________ Address: __________________________________________ Apt: _____________________ City: ______________________________ State: ____________ Zip: _____________________ Home Phone: _______________________ Other Phone _______________________________ Petitioner's Attorney: _______________________ Attorney's Phone: ______________________

Respondent (____Mother ____Father ____Other)

Name: _____________________________________ Date of Birth: ______________________ Address: __________________________________________ Apt: ______________________ City: ______________________________ State: ____________ Zip: _____________________ Home Phone: _______________________ Other Phone _______________________________ Respondent's Attorney: ____________________ Attorney Phone: ________________________ Children

With whom does child(ren) reside? ___ Mother ___ Father ___ Other Has child(ren) and custodian resided in Carbon County for six months? ___Yes ___No Interpreter: Does either party need an Interpreter? ___ Yes ___ No If Yes, what language? _______________________ Mediation: Are there allegations of domestic violence or child abuse? ____ Yes ___ No Does either party live more than 75 miles from Courthouse? ____ Yes ___ No Incarceration: Is a party currently incarcerated? ____Yes ____No If yes, what is inmate's identification number, and facility address: _______________________________________________________________________

_____________________________________

(Attorney for Petitioner) (Petitioner)

DELIVER

THIS

FORM

WITH

_____________________________

Date

PLEADING

TO

PROTHONOTARY

Court of Common Pleas of Carbon County

Civil Cover Sheet

PETITIONER'S NAME: Enter names (last, first, middle initial) of petitioner. In the event there are more than two petitioners, list the additional parties on a separate sheet of paper. Husband and wife should be listed as separate parties.

For Prothonotary Use only (Docket Number)

RESPONDENT'S NAME: Enter names (last, first, middle initial) of respondent. In the event there are more than two respondents, list the additional parties on a separate sheet of paper. Husband and wife should be listed as separate parties.

PETITIONER'S ADDRESS & TELEPHONE NUMBER: RESPONDENT'S ADDRESS AND TELEPHONE NUMBER:

Enter the address and telephone numbers of the parties at the Enter the address and telephone numbers of the parties at the time of

time of filing of the action.

filing of the action.

ADDITIONAL PETITIONER'S NAME:

ADDITIONAL RESPONDENT'S NAME:

ADDITIONAL PETITIONER'S ADDRESS/TELEPHONE ADDITIONAL RESPONDENT'S ADDRESS /TELEPHONE NO: NO:

TOTAL NUMBER OF PETITIONERS: Indicate the total number of petitioners in the action.

TOTAL NUMBER OF RESPONDENTS: Indicate the total number of respondents in the action.

STATUTORY BASIS FOR CAUSE OF ACTION If the action is commenced pursuant to statutory authority ("Petition Action"), the specific statute must be cited

RELATED PENDING CASES: (All previously filed related cases must be identified by docket number. Indicated whether they have been consolidated by Court Order or Stipulation.)

TO THE PROTHONOTARY: Kindly enter my appearance on behalf of Petitioner. Papers may be served at the address set forth below.

NAME OF PETITIONER'S ATTORNEY: Unrepresented filers must provide their name, address, telephone number and signature.

ADDRESS

PHONE NUMBER

SUPREME COURT IDENTIFICATION NUMBER

E-MAIL ADDRESS:

__________________________________________________________ FAX NO. (OPTIONAL ? FOR SERVICE): Providing the fax number shall authorize the service of legal papers by facsimile transmission. See Pa.R.CP.440(d)

DATE: _____________________________

SIGNATURE: ________________________________________________

IN THE COURT OF COMMON PLEAS OF CARBON COUNTY, PENNSYLVANIA CIVIL ACTION - LAW

PETITIONER VS.

RESPONDENT

:

:

:

CUSTODY

:

NO.

:

:

You, ______________________________, respondent, have been sued in court

to MODIFY (shared legal custody) (sole legal custody) (partial physical custody)

(primary physical custody) (shared physical custody) (sole physical custody) (supervised

physical custody) of the child(ren):___________________________________________

_______________________________________________________________________

______________________________________________________________________.

You are ordered to appear in person at the First Floor or Third Floor Conference

Room, Carbon County Courthouse, Jim Thorpe, Pennsylvania, 18229, on

_______________________, 20___, at _______M., prevailing time, for

_____ a conciliation or mediation conference.

_____ a pretrial conference.

_____ a hearing before the court.

Any party to a custody action, who is incarcerated and cannot attend any scheduled proceeding and wishes to participate by electronic means, shall request permission from Court Administration seven (7) days before the scheduled event. Said party shall be responsible for making the arrangements with Court Administration and the Warden of said facility where the party is incarcerated.

If you fail to appear as provided by this order, an order for custody may be entered against you or the court may issue a warrant for your arrest.

You must file with the court a verification regarding any criminal record or abuse history regarding you and anyone living in your household on or before the initial in-person contact with the court (including, but not limited to, a conference with a

conference officer or judge or conciliation) but not later than 30 days after service of the petition.

No party may make a change in the residence of any child which significantly impairs the ability of the other party to exercise custodial rights without first complying with all of the applicable provisions of 23 Pa.C.S. ?5337 and Pa.R.C.P. No. 1915.17 regarding relocation.

YOU SHOULD TAKE THIS PAPER TO YOUR LAWYER AT ONCE. IF YOU DO NOT HAVE A LAWYER, GO TO OR TELEPHONE THE OFFICE SET FORTH BELOW. THIS OFFICE CAN PROVIDE YOU WITH INFORMATION ABOUT HIRING A LAWYER. IF YOU CANNOT AFFORD TO HIRE A LAWYER, THIS OFFICE MAY BE ABLE TO PROVIDE YOU WITH INFORMATION ABOUT AGENCIES THAT MAY OFFER LEGAL SERVICES TO ELIGIBLE PERSONS AT A REDUCED FEE OR NO FEE.

North Penn Legal Services 101 West Broad Street, Suite 713

Hazleton, PA 18201 (877) 953-4250 or

Carbon County Lawyer Referral 811 Blakeslee Blvd. Dr. East, Suite 130

Lehighton, PA 18235 Phone 1-610-379-4950

Fax (610) 379-4952

AMERICANS WITH DISABILITIES ACT OF 1990

The Court of Common Pleas of Carbon County is required by law to comply with the Americans with Disabilities Act of 1990. For information about accessible facilities and reasonable accommodations available to disabled individuals having business before the court, please contact the Office of the District Court Administrator at (570) 325-8556. All arrangements must be made at least seventy-two (72) hours prior to any hearing or business before the court. You must attend the scheduled conference or hearing.

BY THE COURT:

Date:

________________________________ J.

IN THE COURT OF COMMON PLEAS OF CARBON COUNTY, PENNSYLVANIA CIVIL ACTION - LAW

____________________________________, :

Petitioner

:

:

vs.

:

NO.

:

____________________________________, :

Respondent

:

_____________________________________ _____________________________________ -

Counsel for Petitioner Counsel for Respondent

ORDER OF COURT

AND NOW this day of

, 20 , it is hereby

ORDERED and DECREED as follows:

1. This Order of Court shall govern the custodial situation of the following children:

_______________________________________________________________________

_______________________________________________________________________

2. In accordance with the statutory laws of this Commonwealth, each party shall be provided all access to the medical, dental, religious and school records of the child(ren) involved. Absent an emergency situation, each party shall be informed in regard to the medical and dental needs of the child(ren) involved.

3. Jurisdiction of the child(ren) and this matter shall remain with the Court of Common Pleas of Carbon County, Pennsylvania, unless or until jurisdiction would change under the Uniform Child Custody Jurisdiction Act.

4. The welfare of the child(ren) shall be the primary consideration of the parties in any application of the terms of this Agreement. The parties shall exert every reasonable effort to foster a feeling of affection between the child(ren) of the other party. Neither party shall do anything to estrange the child(ren) from the other party, to injure the opinion of the child(ren) as to the other party, or to hamper the free and

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