JDF 1415 R 2 /1 8 MOTION/STIPULATION TO MODIFY DECISION - MAKING RESPONSIBILITY 24714 - 10 - 131, C.R.S Page 1 of 4 District Court County, Colorado Court Address: In re: The Marriage of: The Civil Union of: Parental Responsibilities concerning: Petitioner: and Co - Petitioner/Responden t: COURT USE ONLY Attorney or Party Without Attorney (Name and Address) : Phone Number: E - mail: FAX Number: Atty. Reg. #: Case Number: Division Courtroom MOTION STIPULATION TO MODIFY D ECISION - MAKING RESPO NSIBILITY PURSUANT TO 24714 - 10 - 1 31 , C.R.S. Note: T o Responding Party: If you disagree with this Motion, the Colorado Civil Rules of Procedure allow you to file a written response with the Court which must be filed within 2 1 days of the date this Motion was served on you or mailed to you. Note: The Court will NOT address the motion until the 21 days to respond have passed. The Petitioner Co - Petitioner/Respondent Both requests that this Court modify Allocation of Parental Responsibilities previously entered in this case, pursuant to 24714 - 10 - 131, C.R.S., and state the following: 1. The last Order regarding decision - making was ent ered by the Court on (date). 2. A motion for a substantial modification of decision - making has has not been filed in the last two years. If one has been filed, please identify the date filed . 3. Information about Petitioner: D ate of Birth: Current Mailing Address: City , State & Zip Code : Home Phone #: Work Phone #: Cell #: 4. Information about Co - Petitioner/Respondent: Date of Birth: Current Mail ing Address: City , State & Zip Code : Home Phone #: Work Phone #: Cell #: American LegalNet, Inc. www.FormsWorkFlow.com JDF 1415 R 2 /1 8 MOTION/STIPULATION TO MODIFY DECISION - MAKING RESPONSIBILITY 24714 - 10 - 131, C.R.S Page 2 of 4 5. This M otion concerns the following child(ren) of the parties: Full Name Present Address Sex Date of Birth 6. Are there other c hild(ren) of the parties, who are not part of the motion? Yes No If Yes please identify: Full Name Present Address Sex Date of Birth 7. What new arrangements are you requesting? 8. Why are you requesting modification of decision - making ? See the requirements of 24714 - 10 - 131, C.R.S. Use additional paper, if necessary : 9. Have you talked to the other party about this modification of allocation of decision - making ? Yes No If Yes , what is her/his position? American LegalNet, Inc. www.FormsWorkFlow.com JDF 1415 R 2 /1 8 MOTION/STIPULATION TO MODIFY DECISION - MAKING RESPONSIBILITY 24714 - 10 - 131, C.R.S Page 3 of 4 10. Have any Temporary or Permanent Protection/Restraining Orders to prevent domestic abuse, any Criminal Protection/Restraining Ord ers or Emergency Protection Orders been issued against either party in any Court within two years prior to the filing of this motion? 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 case number . What was the subject matter of the Protection/Restraining Order or Emergency Protection Ord er? 11. Does the other party live in another state? Yes No If Yes , what state? 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 origina l content of this form. 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 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 Co - Petitioner /Respondent ) ( Signature of Co - Petitioner/Respondent) American LegalNet, Inc. www.FormsWorkFlow.com JDF 1415 R 2 /1 8 MOTION/STIPULATION TO MODIFY DECISION - MAKING RESPONSIBILITY 24714 - 10 - 131, C.R.S Page 4 of 4 CERTIFICATE OF SERVICE I certify that on (da te) a true and accurate copy of the Motion /Stipulation to Modify Decision - Making Respons ibility Pursuant to 24714 - 10 - 131, C.R.S ., was served on the other party by: Hand Delivery E - filed Faxed to this number or by placi ng it in the United States mail, postage pre - paid, and addressed to the following: To: (Your Signature) American LegalNet, Inc. www.FormsWorkFlow.com