Circuit Court for City or County Name Name Case No. VS. Street Address Apt. # Street Address Apt. # ( City State Zip Code Area Code ) Telephone City State Zip Code ( Area Code ) Telephone Plaintiff Name Street Address Defendant No. 1 Apt. # ( City State Zip Code ) Area Code Telephone Defendant No. 2 PETITION/MOTION TO MODIFY õ CUSTODY õ VISITATION (DR 7) I, My name , representing myself, state that: I am the mother/ father or Relationship (for example, aunt, grandfather, guardian, etc) date of birth name of child date of birth 1. of : name of child name of child date of birth name of child date of birth name of child name of child date of birth date of birth name of child name of child date of birth date of birth 2. On the Circuit Court for City or County issued , granting custody of the child(ren) to an order in case number and visitation to 3. . Since the order, circumstances have changed and the Order is no longer in the best interest of the child(ren) because: American LegalNet, Inc. www.FormsWorkFlow.com Page 1 of 2 DR 7 - Revised 10/2015 4. I know of the following additional cases concerning the child(ren) (such as domestic violence (protective order), paternity, divorce of the child(ren)'s parents, custody, visitation, or juvenile court cases): Court Case No. Kind of Case Year Filed Results or Status (if you know) FOR THESE REASONS, I request the Court change custody and/or visitation as follows: State the changes that you are requesting and order any other appropriate relief. [ ] I am also requesting a change in the current child support order. I solemnly affirm under the penalties of perjury that the contents of the foregoing paper are true to the best of my knowledge, information, and belief. Date Signature American LegalNet, Inc. www.FormsWorkFlow.com Page 2 of 2 DR 7 - Revised 10/2015