Fillable Printable Petition for Child Custody - Missouri
Fillable Printable Petition for Child Custody - Missouri
Petition for Child Custody - Missouri
Petition for Child Cus tody – Page 1 of 5
Form CAFC201-7/1/2010 This form is available for free at www.selfrepresent.mo.gov
Form CAFC201 – Petition for Child Custody
In what Missouri county will this case
be filed?
In the Circuit Court of
MISSOURI
If this is an amended petition, what is
the case number of the pending case?
Case Number
Division Number
Answer all questions on this form completely.
Your
Information
1. My full name is: (You are the “Petitioner” in this case.)
__________________ ______________ _____________________________ ________
(First Name) (Middle Name) (Last Name) (Jr./Sr./III)
2. This is the first petition I have filed in this case. (Original Petition)
This is the second petition I have filed in this case.
This is the third petition I have filed in this case.
3. I am the Mother
I am the Father
4. The last four numbers of my Social Security Number are: XXX-XX-
_______________
5. My mailing address is:
___________________________________________________________________________________
(Street)
_____________________________________ ______________________ _______________
(City) (State) (Zip)
_________________________ ___________________________________________________
(Telephone Number) (E-Mail Address)
Other Party’s
Information
6. The full name of the other party is: (He or she is the “Respondent” in this case.)
__________________ ______________ _____________________________ ________
(First Name) (Middle Name) (Last Name) (Jr./Sr./III)
7. The last four numbers of the other party’s Social Security Number are:
XXX-XX-_______________
8. The other party’s mailing address is:
___________________________________________________________________________________
(Street)
_____________________________________ ______________________ _______________
(City) (State) (Zip)
_________________________ ___________________________________________________
(Telephone Number) (E-Mail Address)
Petition for Child Cus tody – Page 2 of 5
Form CAFC201-7/1/2010 This form is available for free at www.selfrepresent.mo.gov
Service
Information
9. The other party has signed a verified “Answer to Petition for Determination of
Custody” which is being filed with this motion. Therefore, do not issue a
summons.
The other party should be served at his or her residence.
___________________________________________________________________________________
(Street)
_____________________________________ ______________________ _______________
(City) (State) (Zip)
The other party should be served at his or her place of employment.
______________________________________________________ _______________________
(Employer’s Name - if applicable) (Hours of Employment)
___________________________________________________________________________________
(Street)
_____________________________________ ______________________ _______________
(City) (State) (Zip)
Service by publication. I don’t know where the other party is and I have no way
of locating him or her. Therefore, I am requesting that he or she be served by
publication. I have filed an Affidavit for Service by Publication and a Notice of
Publication.
Other method of service: ____________________________________________________
10. The parent receiving support is not receiving Temporary Assistance for Needy
Families (TANF).
The parent receiving support is receiving TANF and therefore the State of
Missouri must be served. Summons to issue to be served on:
Director, Family Support Division
615 Howerton Court
Jefferson City, Missouri 65102
Case
Information
11. I am entitled to ask for custody because:
Paternity was acknowledged by both parties and father’s name appears on the
birth certificate of each child listed in this petition. Copies of these birth
certificates are attached to this petition.
An administrative order was entered that determined paternity. A copy of this
administrative order is attached to this petition.
Father and Mother were married at the time of the birth of each child listed in
this petition and there are no existing custody judgments.
Other __________________________________________________________
(Explain)
Petition for Child Cus tody – Page 3 of 5
Form CAFC201-7/1/2010 This form is available for free at www.selfrepresent.mo.gov
Military
Information
12. The other party is NOT on active duty in the United States military.
The other party is on active duty in the United States military.
Employment
Information
13. I am self-employed
I am unemployed
I am employed at:
___________________________________________________________________________________
(Name of Employer)
___________________________________________________________________________________
(Street)
_____________________________________ ______________________ _______________
(City) (State) (Zip)
14. The other party is self-employed
The other party is unemployed
I don’t know the other party’s employment status
The other party is employed at:
___________________________________________________________________________________
(Name of Employer)
___________________________________________________________________________________
(Street)
_____________________________________ ______________________ _______________
(City) (State) (Zip)
Children’s
Information
15. There is/are ____________ child(ren) who is/are the subject of this proceeding as
listed below.
Child’s Full Name Child’s Age
Petition for Child Cus tody – Page 4 of 5
Form CAFC201-7/1/2010 This form is available for free at www.selfrepresent.mo.gov
Additional
Information
about the
Children
16. State all addresses at which the children have resided during the past six months
and the name of the person with whom said children resided.
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
17. Do you know of anyone other than you or the other parent that has physical
custody of any of the children or claims to have custody or visitation rights with respect
to any of the children?
Yes - State the name(s) and address(es) of these people in Paragraph 19.
No
18. Do you have any information of any other custody proceeding concerning any of
the children pending in a court of this or any other state?
Yes – Attach a copy of the petition or judgment from all other cases.
No
19. Have you participated in any other litigation concerning the custody of any of the
children in this or any other state?
Yes – Attach a copy of the petition or judgment from all other cases.
No
20. Have any of the child(ren) been a victim of abuse or neglect?
Yes
No
21. If you answered “Yes” to questions 17, 18, 19 or 20 please explain.
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Proposed
Parenting
Plan
22. The custody arrangement that is in the best interests of the minor children is set
forth in Part A of the attached parenting plan marked Exhibit 1. (You must attach a
completed copy of Parenting Plan Form CAFC501 to this petition.)
Request for
Relief
THEREFORE, I want the court to enter a judgment concerning custody as per Part A of
the attached parenting plan marked Exhibit 1.
I also request the following relief:
Child support should be set as set forth in Part B of the attached parenting plan
marked Exhibit 1.
I am without sufficient funds to pay for my attorney and I request that the other
party pay my attorney’s fees for this case.
Other (Please state the other requests)
_________________________________________________________________
Petition for Child Cus tody – Page 5 of 5
Form CAFC201-7/1/2010 This form is available for free at www.selfrepresent.mo.gov
Petitioner, being of lawful age and duly sworn on his or her oath, states that he or she is the petitioner named
above and that the facts stated in this Petition to Determine Child Custody are true according to his or her best
knowledge and belief.
►__________________________________ __________________________________
SIGN HERE PRINT YOUR NAME HERE
Subscribed and sworn to this ___________ day of __________________, 20____.
________________________
Notary Public
My Commission Expires:
_____________________
ATTORNEY INFORMATION
(To be completed by your attorney)
______________________________________________ ___________________
Attorney – SIGN HERE Missouri Bar Number
_____________________________________________________________________
Attorney for Movant – PRINT YOUR NAME HERE
______________________________________________________________________________
(Street)
______________________________________ ______________________ __________
(City) (State) (Zip)
__________________ _______________ _____________________________________
(Telephone Number) (Fax Number) (Email Address)
Do not enter any
information here if you are
filing this case without the
assistance of a lawyer.
This information should
be completed by your
attorney.
I have assisted
Petitioner in the preparation
of these pleadings, but I am
not entering my appearance
on behalf of Petitioner.
This should only be
completed if a lawyer
helped you with this
form
Sign this in front of a
Notary Public
