CHC104 State ENG Rev 9/18-D www.mncourts.gov/forms Page 1 of 6 State of Minnesota District Court County Judicial District: Court File Number: Case Type: In Re the Custody of: Born (mo/day/yr) Notice of Motion and Motion Born (mo/day/yr) To Establish Custody And Parenting Time Petitioner and Respondent TO: First Middle Last Street Address Apt. # City State Zip Code NOTICE PLEASE TAKE NOTICE that on , , at (date) (year) (time) o222clock m., before (name of Judge or Judicial Officer) in room of the located at Minnesota, I will ask the court for an Order granting me the following relief: American LegalNet, Inc. www.FormsWorkFlow.com CHC104 State ENG Rev 9/18-D www.mncourts.gov/forms Page 2 of 6 MOTION 1. Granting legal custody of the children as follows: (check one) (Legal custody identifies who will have a right to make decisions regarding the child222s upbringing, including education, health care, and religious training). a. Jointly to both parents. b. Solely to (check one): Me The other parent (print full name) 2. Granting physical custody of the children as follows: (check one) (Physical custody identifies who will handle the routine daily care and control of the child and with whom the children will live). a. Jointly to both parents. b. Solely to (check one): Me The other parent (print full name) 3. Determining parenting time as follows: For the Petitioner: Granting parenting time to the Petitioner as provided in the schedules below; Granting parenting time to the Petitioner provided in the schedules below, with transfer of the minor children at a safe place, preferably a visitation exchange center (if one is available); Granting supervised parenting time to the Petitioner as provided in the schedules below; or Denying parenting time to the Petitioner. For the Respondent: Granting parenting time to the Respondent as provided in the schedules below; American LegalNet, Inc. www.FormsWorkFlow.com CHC104 State ENG Rev 9/18-D www.mncourts.gov/forms Page 3 of 6 Granting parenting time to the Respondent provided in the schedules below, with transfer of the minor children at a safe place, preferably a visitation exchange center (if one is available); Granting supervised parenting time to the Respondent as provided in the schedules below; or Denying parenting time to the Respondent. PARENTING TIME SCHEDULES (Use the space provided below to clearly explain when each parent will have the children. State the time (o222clock) when the children will transfer from one parent to the other. If you want the order to say who will pick up and drop off the children, or where transfer of the children should take place, include that under 223Other224). Regular schedule: Monday through Friday: Weekends: Summer (if you want a different schedule in summer) Telephone contact with the children: Unlimited or Only at certain times as follows: (describe the days and times when the parent and children may have telephone contact) American LegalNet, Inc. www.FormsWorkFlow.com CHC104 State ENG Rev 9/18-D www.mncourts.gov/forms Page 4 of 6 Exceptions to the Regular Schedule: [You can have a different schedule for holidays, school release days, and birthdays.] Do you want a different schedule for school release days or breaks during the school year? Yes No School Release days or breaks during the school year Any school release day schedule will override the regular parenting schedule. Do you want a different schedule for children222s or parents222 birthdays? Yes No Birthdays (child's birthday, parent's birthday) Do you want a different schedule for holidays? Yes No State the specific holiday and schedule: Any holiday or birthday schedule will override the regular and school release parenting schedule. Do you have any other requests for a different parenting time schedule? Yes No Other American LegalNet, Inc. www.FormsWorkFlow.com CHC104 State ENG Rev 9/18-D www.mncourts.gov/forms Page 5 of 6 4. Under the above Schedule: What is the annual number of overnights the children will spend with each parent? Note: if parenting time is equal, use 182.5 overnights for each parent. Number of overnights with Petitioner: Number of overnights with Respondent: 5. Establishing child support according to Minnesota child support guidelines. Child support includes basic support, medical support, and child care support. 6. Granting additional relief as follows: 7. Granting such other and further relief as the court may deem just and equitable. NOTICE TO OTHER PARENT After reading this Motion, if you disagree with anything that is being requested, or if you want the court to consider your facts and what you want, you must serve upon all parties and file with the court a Responsive Motion and Responsive Affidavit. These documents are available online at www.mncourts.gov under the link for 223court forms,224 or you may pick up court forms from any county court administrator222s office. Your Responsive Motion and Responsive Affidavit must be personally served on the other party at least five (5) days before the hearing or mailed to the other party at least eight (8) days before the hearing. Your responsive papers must be filed with the court administrator at least five (5) days before the hearing. If you want to raise new issues at the hearing the other party has scheduled, you must serve and file a Responsive Motion and Affidavit, which must be personally served on the other party ten (10) days before the hearing or mailed to the other party at least thirteen (13) days before the hearing. Your papers raising new issues must be filed with the court administrator at least ten (10) days before the hearing. If you do not understand what the other party is requesting, you may want to ask a lawyer for help or contact other legal services provider for assistance. American LegalNet, Inc. www.FormsWorkFlow.com CHC104 State ENG Rev 9/18-D www.mncourts.gov/forms Page 6 of 6 VERIFICATION AND ACKNOWLEDGMENT a) I have read this document. To the best of my knowledge, information and belief, the information contained in this document is well grounded in fact and is warranted by existing law. b) I have not been determined by any court in Minnesota or in any other state to be a frivolous litigant and I am not the subject of an Order precluding me from serving or filing this document. c) I am not serving or filing this document for any improper purpose, such as to harass the other party to cause delay or needless increase in the cost of litigation or to commit a fraud on the court. d) I understand that if I am not telling the truth or if I am misleading the court or if I am serving or filing this document for an improper purpose, the court can order me to pay money to the other party, including the reasonable expenses incurred by the other party because of the serving or filing of this document, court costs and reasonable attorney's fees. DATE: Signature Street Address City/State/Zip Code ( ) Telephone Number E-mail address American LegalNet, Inc. www.FormsWorkFlow.com