INSTRUCTIONS FOR FILING A PETITION CHECKLIST. DID YOU INCLUDE THE FOLLOWING? 1. Case Number (the number that appears on your court documents)? 2. Names and most recent addresses and phone numbers of both the Plaintiff & Defendant? 3. Did you sign the petition and date it? 4. Have you checked AND described the specific items and the reasons you are requesting the change? (The law requires the Referee or Judge to address only the items that have been requested on the petition). 5. A check or money order payable to the TUSCOLA COUNTY CLERK for the proper amount of fees? (See schedule below). Upon completion of the above five items, send or deliver the ORIGINAL to the: TUSCOLA COUNTY CLERK COURTHOUSE (MAIN FLOOR) 440 N STATE ST CARO MI 48723 (It is not necessary to make copies) After filing by the clerk, a hearing will be scheduled by the Referee Division. Both parties will receive written notice with the date and time that the hearing will be held. Current schedule of fees** to be paid upon the filing of the petition or motion: Custody, Parenting Time or Change of Domicile $100.00 Support (Support means child support; medical, dental or other health care; education; child care or surcharge) Combination of custody or parenting time and support $60.00 $100.00 Alimony or spousal support through the FOC $20.00 Issues other than custody, parenting time or support $20.00 **You may request that the Court order reimbursement of fees by the other party. See petition form. JLP 10/15/2009 American LegalNet, Inc. www.FormsWorkFlow.com State of Michigan 54th Judicial Circuit Family Division Tuscola County Case Number PETITION TO CHANGE ORDER County Clerk: 440 N STATE STREET, CARO, MI 48723 (989) 672-3780 All Petitions must be typewritten or printed in ink. Please complete all areas that apply. If an area does not apply please enter N/A (not applicable). PLAINTIFF’S NAME, ADDRESS, AND TELEPHONE NUMBER I, _____________________________state: (Name of Party Filing Petition) State that the conditions have changed regarding: [ ] custody [ ] parenting time [ ] domicile [ ] support (child support, education, child care, surcharge, medical, dental or other health care) [ } other: ___________________________ DEFENDANT’S NAME, ADDRESS, AND TELEPHONE NUMBER of the minor child(ren), namely: (Please list child(ren)’s names and dates of birth): ___________________________ ___________________________ ___________________________ Circumstances have changed since the last order(s) as follows: (Briefly state changes in box below that have occurred since the last court order. If you need additional space, please use a separate sheet of paper and attach to the petition). *THIS SECTION MUST BE COMPLETED OR YOUR REQUEST MAY BE DENIED* WHEREFORE PETITIONER PRAYS: Items a.-f.: Place an X in the box, which indicates your request regarding the current order(s). a. That the Court award custody of the minor child(ren) in this matter as follows: (CHECK ONE) ( ) Joint legal and physical custody to both parties. ( ) Joint legal custody, physical custody to the: ( ) Plaintiff ( ) Defendant. ( ) Sole custody to the: ( ) Plaintiff ( ) Defendant. ( ) Other: _______________________________________________________________ SEE REVERSE SIDE OF THIS PAGE American LegalNet, Inc. www.FormsWorkFlow.com Always complete section b when requesting a change of custody. b. That the Court grant parenting time to the _____________________________: Plaintiff/Defendant) ( ) Pursuant to the Tuscola County Friend of the Court Parenting Guidelines. ( ) Other (as follows):________________________________________________ c. That the domicile (permanent residence) of the child be changed to the State of: ________________________. d. That the Court order support to be paid by the _________________________, as follows: (Plaintiff/Defendant) ( ) Pursuant to the Michigan Child Support Formula. ( ) In the amount of $___________ per __________. e. That the health care provision be changed as follows: ( ) Both parties shall obtain or maintain any health care coverage that is available to them as a benefit of employment or at a reasonable cost. ( ) Other (as follows):______________________________________________ f. Miscellaneous request(s): ___________________________________________ ________________________________________________________________ NOTICE You have chosen to represent yourself. These forms are provided to give you access to the Courts. You are held to the same standards in the court process as a client who is represented by counsel. You will be expected to present evidence and testimony according to the statutes and court rules of the State of Michigan. The Friend of the Court does not represent either party. You may wish to seek legal advice. I hereby declare that the statements above are true to the best of my information, knowledge, and belief. Dated: _____________ ________________________________ Sign your name and date the form. JLP O1/08/07 American LegalNet, Inc. www.FormsWorkFlow.com