Provide Mother's information

Name:
Address:
City:    County:
State: Zip:

Provide Father's Information

Name:
Address:
City:    County:
State: Zip:

Indicate whether you are the mother or father:
Your phone number:
Email:


Provide Minor Children's Information

List the name and birth date of each child included in the custody order (Indicate M for male and F for female):



Provide Case Information

Indicate Case Number:

Indicate County where case originated:

Indicate assigned Judge:

Indicate the date of the divorce judgment or custody order:

Indicate whether this is the most recent order:Select OneYesNo

If no, indicate the date of the most recent order:

Indicate which parent has physical custody of the child(ren):Select OneMotherFatherJoint

Indicate which parent has legal custody of the child(ren):Select OneMotherFatherJoint

Indicate the type and why you are seeking a change of custody:

Indicate the substantial change in circumstances/good cause which establishes that it is not in the child(ren)'s best interest to remain in the custody of the other parent.  Give specific examples of conduct, including dates and other details, (i.e., the custodial parent is using drugs or failing to ensure that the child attends school on a regular basis):

Indicate why a change in custody will improve the quality of life of the child(ren) :


Indicate where you will reside with the child(ren) if the change of custody is granted:


Indicate who resides in your home and how they can assist you in providing a loving and stable home environment:

Indicate how you will foster the parent-child relationship between the child(ren) and the other parent if the change of custody is granted:


Indicate your proposed parenting time schedule for the other parent:

 ACKNOWLEDGMENT: Speedy Legal Docs did not provide me with any advice, explanation or representation about any legal rights, remedies, defenses or options.