JDF 1319 R 5 - 1 8 MOTION FOR APPOINTMENT OF LEGAL REPRESENTATIVE OF THE CHILD PURSUANT TO 247 14 - 10 - 116, C.R.S. District Court Denver Juvenile Court County, Colorado Court Address: In re: The Marriage of: The Civil Union of: Parental Responsibilities concerning: Petitioner: and Co - Petitioner/Respondent: COURT USE ONLY Attorney or Party Without Attorney (Name and Address): Phone Number: E - mail: FAX Number: Atty. Reg.#: Case Number: Division Courtroom MOTION FOR APPOINTMENT OF L EGAL REPRESENTATIVE OF THE CHILD PURSUANT TO 247 14 - 10 - 116, C.R.S. The Petitioner Co - Petitioner/Respondent r equest s that a Legal Representative of the Child (CLR) be appointed to represent the best interest of the minor child (ren) identified below : Full Name of Child Date of Birth The CLR shall represent the best interest of the child (ren) with respect to: allocation of parental responsibilities (parenting time and decision - making responsibilities) support for the child other The Court authorized the filing of this motion on (date). The Petitioner Co - Petitioner/Resp ondent requests that the fees of the CLR be paid % by the Petitioner % by the Co - Petitioner/Respondent. If applicable, the Petitioner Co - Petitioner/Respondent attaches JDF 208 and requests a finding of indigency and that % of the CLR fees be paid by the State. Date: Petitioner or Co - Petitioner/Res pondent By checking this box, I am acknowledging I am filling in the blanks and not changing anything else on the form. By checking this box, I am acknowledging that I have made a change to the original content of this form. CERTIFICATE OF SERVICE I certify that on (date) the original was filed with the Court; and, a true and accurate copy of the Motion for Appointment of Legal Representative of the Child Pursuant to 24714 - 10 - 116, C.R.S. was served on the other party by: Hand Delivery E - filed Faxed to this number or by placing it in the United States mail, postage pre - paid, and addressed to the following: To: Your Signature American LegalNet, Inc. www.FormsWorkFlow.com