Person Filing: Address (if not protected): City, State, Zip Code: Telephone: Email Address: ATLAS Number: Lawyer222s Bar Number: Representing Self, without a Lawyer or Attorney for Petitioner OR Respondent SUPERIOR COURT OF ARIZONA IN MARICOPA COUNTY Regarding the Matter of : Case Number PETITION FOR GRANDPARENT VISITATION A.R.S 247 25 - 409 Name of Grandparent Requesting Visitation Name of Other Grandparent (if applicable) Name of Party A DECEASED (if applicable) Name of Party B DECEASED (if applicable) Name of Legal Guardian, if any There is an existing Family Department case in this county between the parents of the children for whom I want an order of visitation, and I have listed that case number above as required by Arizona law (A.R.S. 247 25-409). GENERAL INFORMATION: 1. Information about me (or us), the Grandparent(s): Name(s): Address: County of residence: Occupation(s): My / Our relationship to minor child(ren) for whom I want the VISITATION order: Grandparent on Party A222s side Great Grandparent on Party A222s side Grandparent on Party B222s side Great Grandparent on Party B222s side Other: (explain): For Clerk222s Use Only 251 Superior Court of Arizona in Maricopa County DRGV11f-030518 ALL RIGHTS RESERVED Page 1 of 7 American LegalNet, Inc. www.FormsWorkFlow.com Case No. 2. Information about Party A Name: Address: County of residence: Date of Birth: Occupation: Relationship to minor child(ren): 3. Information about the Party B Name: Address: County of residence: Date of Birth: Occupation: Relationship to minor child(ren): 4. Information about other legal guardians of minor child(ren), if any: Name: Address: County of residence: Date of Birth: Occupation: Relationship to minor child(ren): 5. Information about minor children for whom I / we want the visitation order: Name: Name: Birthdate: Birthdate: Current Address: Current Address: County of residence: County of residence: Name: Name: Birthdate: Birthdate: Current Address: Current Address: County of residence: County of residence: 251 Superior Court of Arizona in Maricopa County DRGV11f-030518 ALL RIGHTS RESERVED Page 2 of 7 American LegalNet, Inc. www.FormsWorkFlow.com Case No. 6. Legal Reason why I/we have a right to request a visitation order: (check whichever applies) A. Parents of minor child(ren) have been divorced for at least 3 months: Date of Divorce: Court case number: Name of Court: Court Address/Location: B. Child(ren) were born out of wedlock and parents aren222t currently married (List names of children born out of wedlock): C. Party A OR Party B has been dead for at least 3 months: Date of Death: D. Party A OR Party B has been missing for at least 3 months: Date parent discovered to be missing: Date reported to Law enforcement agency: Name, location of agency: E. If you are asking for visitation rights as PATERNAL grandparent(s), that is, you are the parent(s) or grandparent(s) of the father of the minor children, complete the information below: PATERNITY WAS ESTABLISHED BY: (check one box) A Court Order for Paternity* from this county or previously transferred to this county. (A.R.S. 247 25-502(c)) Filing an Acknowledgment of Paternity through the Hospital Paternity Program or other means allowed by law on or after July 21, 1996 (A.R.S. 247 25-812-814, or 247 36-334). Child Support Order*: An Order for Child Support has been issued which names my/our son/grandson as the father. (Supply information about the Order as requested below.) Marriage: Parties were legally married when child(ren) was (were) born, conceived or adopted. *Note: Documents mentioned above or giving proof of the above should already be in the case file or attached. 251 Superior Court of Arizona in Maricopa County DRGV11f-030518 ALL RIGHTS RESERVED Page 3 of 7 American LegalNet, Inc. www.FormsWorkFlow.com Case No. 7. Statements about your relationship with minor child(ren), and why you think it is best for the child(ren) that you have visitation with them: 8. Your plan for visitation with the minor child(ren): (be specific) TRANSPORTATION will be provided by (name): as follows: (explain) During WEEKENDS: (explain specifically) During the SUMMER MONTHS OR SCHOOL BREAKS: (explain specifically) FOR HOLIDAYS AND BIRTHDAYS: (explain specifically) FOR TELEPHONE CALLS: (explain specifically) OTHER: (explain specifically) 251 Superior Court of Arizona in Maricopa County DRGV11f-030518 ALL RIGHTS RESERVED Page 4 of 7 American LegalNet, Inc. www.FormsWorkFlow.com Case No. OTHER INFORMATION ABOUT THE CHILD(REN): 9. Where the child(ren) who is/are under 18 years of age have lived for the last 5 years. (Attach extra pages if necessary.) Child's Name: Dates: From To Lived with: Relationship to child: Street address: City, State Child's Name: Dates: From To Lived with: Relationship to child: Street address: City, State Child's Name: Dates: From To Lived with: Relationship to child: Street address: City, State 10. Court cases NOT involving legal decision-making, physical custody, parenting time or visitation related to the child(ren) under 18 years old. (check one box) I HAVE I HAVE NOT been a party or a witness in court in this state or in any other state regarding issues OTHER THAN legal decision-making, custody, parenting time or visitation of any of the child(ren) named above (If so, explain below, using extra pages if necessary. IF NOT, GO ON.) Name of each child: . Court state: Court location: Court case number: Current status: How the child is involved: Summary of any Court Order: 251 Superior Court of Arizona in Maricopa County DRGV11f-030518 ALL RIGHTS RESERVED Page 5 of 7 American LegalNet, Inc. www.FormsWorkFlow.com Case No. 11. Court cases INVOLVING legal decision-making, physical custody, parenting time or visitation cases related to child(ren) under 18 years old. (check one box) I DO HAVE I DO NOT HAVE information about a legal decision-making, custody, parenting time or visitation court case relating to any of the children named above that is pending in this state or in any other state (If so, explain below, using extra pages if necessary. IF NOT, GO ON). Name of each child: . Court state: Court location: Court case number: Current status: How the child is involved: Summary of any Court Order: 12. Legal decision-making, custody, parenting time or visitation claims of any person. (check one box) I DO KNOW I DO NOT KNOW a person other than Party A or Party B with whom the children are now living or who claims legal decision-making authority, physical custody, parenting time or visitation rights to any of the children named above. If so, explain below. Use extra pages if necessary. IF NOT, GO ON). Name of each child: Name of person with the claim: Address of person with the claim: Nature of the claim: 13. VENUE: This is the proper court to bring this lawsuit under Arizona law because it is the county of residence of the child(ren). 14. OTHER Statements to the Court: 251 Superior Court of Arizona in Maricopa County DRGV11f-030518 ALL RIGHTS RESERVED Page 6 of 7 American LegalNet, Inc. www.FormsWorkFlow.com Case No. REQUEST MADE TO COURT: (1) For a court order for visitation with the minor children as described above, and (2) For such other orders as this Court considers just and fair. UNDER OATH OR AFFIRMATION I swear or affirm under penalty of perjury that the contents of this document are true and correct to the best of my knowledge and belief. Date Signature STATE OF COUNTY OF Subscribed and sworn to or affirmed before me this: (date) By . (notary seal) Deputy Clerk or Notary Public (only fill out second notary and signature line if more than one party filling out this Petition) UNDER OATH OR AFFIRMATION I swear or affirm under penalty of perjury that the contents of this document are true and correct to the best of my knowledge and belief. Date Signature STATE OF COUNTY OF Subscribed and sworn to or affirmed before me this: (date) By . (notary seal) Deputy Clerk or Notary Public 251 Superior Court of Arizona in Maricopa County DRGV11f-030518 ALL RIGHTS RESERVED Page 7 of 7 American LegalNet, Inc. www.FormsWorkFlow.com