SUPERIOR COURT OF THE DISTRICT OF COLUMBIA FAMILY COURT Domestic Relations Branch ________________________________________ PRINT PLAINTIFF’S NAME DR PLAINTIFF, ___________________ v. Judge ___________________ _________________________________ PRINT DEFENDANT’S NAME DEFENDANT. MOTION FOR TEMPORARY CUSTODY and/or ACCESS TO CHILDREN Does the Other Party Consent to this Motion? yes no I, _________________________________, am the PRINT YOUR NAME PLAINTIFF DEFENDANT in this case. 1. I believe it is in the best interests of the child(ren) for temporary custody to be as follows: [CHECK ONE] According to our written agreement. Joint legal custody & joint physical custody to me and the other party. Joint legal custody & sole physical custody. [Sole physical custody TO ME TO THE OTHER PARTY] Sole legal custody & joint physical custody. [Sole legal custody TO ME TO THE OTHER PARTY] Sole legal custody & sole physical custody. [Sole legal and physical custody TO ME TO THE OTHER PARTY] The presumption in favor of joint custody does not apply because there has been: DC Bar Pro Bono Program (revised 03.05) Motion for Temporary Custody and/or Access to Children Page 1 of 6 American LegalNet, Inc. www.FormsWorkFlow.com domestic violence. child abuse. child neglect. parental kidnapping. OR because joint custody is not in the best interest of the child(ren). 2. I believe it is in the best interests of the child(ren) for the other party to be with the child(ren) in this way: The other party and I will agree to a reasonable schedule. A specific schedule needs to be set. The other party’s access to the children needs to be supervised. The other party should have no access to the children at all. 3. My reasons for asking this Court to do this are ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ Request for Relief I RESPECTFULLY REQUEST that the Court award temporary custody of the child(ren) as requested above until the Court issues a final custody order in this case. I ALSO REQUEST that the Court award any other relief it considers fair and proper. I DO DO NOT request an oral hearing in front of the judge on this motion. DC Bar Pro Bono Program (revised 03.05) Motion for Temporary Custody and/or Access to Children Page 2 of 6 American LegalNet, Inc. www.FormsWorkFlow.com Respectfully Submitted, ____________________________________ SIGN YOUR NAME ___________________________________________ STREET ADDRESS ___________________________________________ CITY, STATE AND ZIP CODE ___________________________________________ TELEPHONE NUMBER SUBSTITUTE ADDRESS: CHECK BOX IF YOU HAVE WRITTEN SOMEONE ELSE’S ADDRESS BECAUSE YOU FEAR HARASSMENT OR HARM. If by consent: ___________________________________ ______________________________ OTHER PARTY’S SIGNATURE DATE I, _________________________________, solemnly swear or affirm under criminal penalties for the making of a false statement that I have read the foregoing Motion for Temporary Custody and/or Access to Children and that the factual statements made in it are true to the best of my personal knowledge, information and belief. ___________________________________ ______________________________ SIGN YOUR NAME DATE ___________________________________ PRINT YOUR NAME DC Bar Pro Bono Program (revised 03.05) Motion for Temporary Custody and/or Access to Children Page 3 of 6 American LegalNet, Inc. www.FormsWorkFlow.com POINTS AND AUTHORITIES IN SUPPORT OF MOTION FOR TEMPORARY CUSTODY and/or ACCESS TO CHILDREN In support of this Motion, I refer to: 1. Super. Ct. Dom. Rel. R. 7(b). 2. D.C. Code §§ 16-911(a)(5) and 16-914. 3. The record in this case. 4. The attached supporting document(s), if any. [LIST ANY DOCUMENTS THAT YOU ARE ATTACHING] __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ DC Bar Pro Bono Program (revised 03.05) Motion for Temporary Custody and/or Access to Children Page 4 of 6 American LegalNet, Inc. www.FormsWorkFlow.com SUPERIOR COURT OF THE DISTRICT OF COLUMBIA FAMILY COURT ________________________________________ PRINT PETITIONER’S/PLAINTIFF’S NAME Case No. ___________________ PETITIONER/PLAINTIFF, v. _________________________________ PRINT RESPONDENT’S/DEFENDANT’S NAME RESPONDENT/DEFENDANT. RULE 5 CERTIFICATE OF SERVICE IF YOU HAVE ALREADY SERVED THE OTHER PARTY, YOU CAN CERTIFICATE OF SERVICE ON THE SAME DAY YOU FILE YOUR PAPERS. FILL OUT AND FILE THIS IF YOU HAVE NOT ALREADY SERVED THE OTHER PARTY, YOU MUST FILL OUT AND FILE THIS CERTIFICATE OF SERVICE AFTER YOU SERVE THE OTHER PARTY. I certify that I served a copy of my Motion for Temporary Custody and/or Access to Children to the other party or the other party’s attorney on ____________________________. PRINT DATE OF SERVICE The papers were delivered [CHECK ONE] by handing it to the other party by first class mail to: ________________________________________________________________________ PRINT NAME OF PERSON SERVED WITH PAPERS ________________________________________________________________________ CITY, STATE AND ZIP CODE STREET ADDRESS DC Bar Pro Bono Program (revised 03.05) Motion for Temporary Custody and/or Access to Children Page 5 of 6 American LegalNet, Inc. www.FormsWorkFlow.com by fax to: ________________________________________________________________________ PRINT NAME OF PERSON SERVED WITH PAPERS ________________________________________________________________________ FAX NUMBER by leaving a copy at the other party’s workplace with a clerk or person in charge, or because there was no one in charge, by leaving it in a conspicuous place: ________________________________________________________________________ PRINT NAME OF PERSON SERVED WITH PAPERS ________________________________________________________________________ CITY, STATE AND ZIP CODE STREET ADDRESS by leaving a copy at the other party’s home with a person of suitable age and discretion who lives there: ________________________________________________________________________ PRINT NAME OF PERSON SERVED WITH PAPERS ________________________________________________________________________ CITY, STATE AND ZIP CODE STREET ADDRESS _____________________________ _____________________________ SIGN YOUR NAME DATE DC Bar Pro Bono Program (revised 03.05) Motion for Temporary Custody and/or Access to Children Page 6 of 6 American LegalNet, Inc. www.FormsWorkFlow.com