COURT OF COMMON PLEAS

DIVISION OF DOMESTIC RELATIONS

Name:
Address:
-vs/and-
Name:
Address:

HAMILTON COUNTY, OHIO

Date:
Case No.
File No.
CSEA No.
Judge
Magistrate

MOTION FOR CHANGE OF PARENTAL RIGHTS AND RESPONSIBILITIES (CUSTODY) AND AFFIDAVIT IN SUPPORT

1. I, (name), request this Court change the allocation of parental rights and responsibilities (custody) Order entered by this Court on (filed date) regarding the following minor child(ren):

Name of Child	Date of Birth

2. Select one:

(name) is currently designated as the residential parent and/or legal custodian of the child(ren) and resides in the School District. The non-residential parent currently resides in the School District.

The parents have a Shared Parenting Plan. Mediation was attempted: No Yes (date)

3. Describe any specific changes that have developed since the Court issued the existing Order:

4. Describe any changes or concerns regarding the health, behavior, education or extra-curricular activities of the child(ren) that have developed since the Court issued the existing Order:

5. Describe any relationship changes between the parties and the child(ren) or the child(ren) and other household members since the Court issued the existing Order:

6. Describe your current method of communication (ie: phone, text, email, etc.) with the other parent and whether it is effective. Additionally, explain any desired communication changes:

7. Explain the most concerning change of circumstance that has occurred since the Court issued the existing Order:

8. Explain how this change of circumstance has affected the child(ren):

9. Based upon your stated change of circumstances, explain your proposed changes to the existing Order:

10. Explain how your proposed changes to the existing Order would be in the best interest of the child(ren):

(Signature)

CERTIFICATE OF SERVICE

I hereby certify that a copy of the foregoing motion has been served by Certified Mail, Personal Service, or Ordinary U.S. Mail to:

Name

Address

City ,	State ,	Zip Code

On this date: