JDF 1406 R 3 - 1 8 VERIFIED MOTION TO MODIFY/RESTRICT PARENTING TIME Page 1 of 4 District Court Denver Juvenile Court County, Colorado Court Address: In re: The Marriage of: The Civil Union of: Parental Responsibilities concerning: Petiti oner: 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 TO : MODIFY PARENTING TIME , Pursuant to 24714 - 10 - 129, C.R.S. R ESTRICT PARENTING TIME , Pursuant to 24714 - 10 - 129 ( 4 ) , C.R.S NOTE: T o Party responding to a Motion to Modify Parenting Time : If you disagree with this M otion, Colorado Rules of Civil Procedure allow you to file a written response with the Court that must be filed within 21 days of the date this M otion was served on you or mailed to you. The Court will NOT address the motion until the 21 days have passed. NOTE: If this is a Motion to Restrict Parenti ng Time , a response can be filed on or before the emergency hearing or made at the hearing. If granted, a hearing will be set no later than 14 days from the filing of the motion. The Petitioner Co - Petitioner/Respondent states the following for the purpose of modifying /restricting parenting time. 1. The last Order regarding parenting time was entered by the Court on (date). 2. A motion for a substantial modification of parenting time which also changes the party with whom the child resides a majority of the time has has not been filed in the last two years. If one has been filed, please identify the date filed . 3. (Check only if this Motion is to Restrict Parenting Time or Par ental Contact pursuant to 247 14 - 10 - 129(4), C.R.S. ) The child(ren) is/are in imminent physical or emotional dan ger due to the current parenting time or parental contact of a parent and the Petitioner Co - Petitioner/Respondent request s the Court Order that: This hearing shall be held on an emergency basis within fourteen days of the filing of this Motion and p arenting time shall be supervised until the hearing by an unrelated third party deemed suitable by the Court or by a licensed mental health profession al. 4. Information about Petitioner: Date of Birth: Current Mailing Address: American LegalNet, Inc. www.FormsWorkFlow.com JDF 1406 R 3 - 1 8 VERIFIED MOTION TO MODIFY/RESTRICT PARENTING TIME Page 2 of 4 City , State & Zip Code : Home Phone #: Work Phone #: Cell #: 5. Information about Co - Petitioner/Respondent: Date of Birth: Current Mailing Address: City , State & Zip Code : Home Phone #: Work Phone #: Cell #: 6. The parties have minor child(ren): Full Name of Child Present Address Sex Date of Birth 7. (Check only if applicable.) (name of party) has been convicted of a crime set forth in 247 14 - 10 - 129(3)(a), C.R.S. in the County of , State of , in case number on (date) that constitutes a potential threat or endangerment to the child(ren) . 8. The Petitioner Co - Petitioner /Respondent now has parenting time with the minor child(ren) under the following parenting plan and und er the following conditions (if any): 9. R equired Notice of Prior Protection/Restraining Orders. Have any Temporary or Permanent Protection/Restraining Orders to prevent domestic abuse or any Criminal Protection/Restraining Orders or Emergency Protection Orders been issued against either party by any Court within two years prior to the filing of this M otion? No Yes If your answer was Yes , complete the following: The Protection/Restraining Order was Temporary Permanent and issued against , in the County of , State of , in ca se number on (date) . What was the subject matter of the Civil Protection/Restraining Order or Emergency Protection Order? American LegalNet, Inc. www.FormsWorkFlow.com JDF 1406 R 3 - 1 8 VERIFIED MOTION TO MODIFY/RESTRICT PARENTING TIME Page 3 of 4 I request that this Court enter an order modi fying /restricting the parenting time for the Petitioner Co - Petitioner/Respondent as described below . Complete number 10 if requesting to modify parenting time and number 11 if requesting to restrict parenting time. 10. a. I request the Court to modify the current parenting time order to provide for the following new parenting plan schedule and this plan is in the best interests of the minor child(ren) for the following reasons : (Attach additional documentation, if necessary.) b. The above new parenting plan is in the best interests of the minor child(ren) as follows: 11. a . I allege that the minor child(ren) is/are in imminent physical or emotional danger due to the current parenting time as follows: b. I request that the parenting time plan be restricted as follows: 12. (initial) I understand that the Court will NOT address a modification of child support unless I also file a Verified Motion to Modify Child Support Pursuant to C.R.S. 247 14 - 10 - 122, JDF 1403. 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. American LegalNet, Inc. www.FormsWorkFlow.com JDF 1406 R 3 - 1 8 VERIFIED MOTION TO MODIFY/RESTRICT PARENTING TIME Page 4 of 4 VERIFICATION I declare under penalty of perjury under the law of Colorado that the foregoing is true and correct. Executed on the day of , , at (date) (month) (year) (city or other location, and state OR country ( P rinted name of Petitioner) Signature of Petitioner) Address City State Zip Code (Area Code) Telephone Number (home) (Area Code) Telephone Number ( work ) V ERIFICATION I declare under penalty of perjury under the law of Colorado that the foregoing is true and corr ect. Executed on the day of , , at (date) (month) (year) (city or other location, and state OR country ( P rinted name of Co - Petitioner) Signature of Co - Petitioner) Address City State Zip Code (Area Code) Telephone Number (home) (Area Code) Telephone Number ( work ) Co - CERTIFICATE OF SERVICE I certify that on (date) a true and accurate cop y of the Motion to M odify R estrict Parenting Time 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 If the Child Support Enforcement Unit is involved in the c ase ; you must provide them a copy of this Motion. American LegalNet, Inc. www.FormsWorkFlow.com