DR-202 Page 1 of 4 Rev. 4/18 COURT OF COMMON PLEAS DOMESTIC RELATIONS DIVISION CLERMONT COUNTY, OHIO Case Number: Plaintiff vs. Defendant MOTION AND AFFIDAVIT OR COUNTER AFFIDAVIT FOR TEMPORARY ORDERS WITHOUT ORAL HEARING Check one box below to show whether you are filing a (1) Motion and Affidavit or (2) Counter Affidavit. (1) Motion and Affidavit (Print Your Name) files this Motion and Affidavit under Rule 75(N) of the Ohio Rules of Civil Procedure to request the temporary orders checked here. Check only those that apply. Residential parenting rights (custody) Parenting time (visitation) Child support Spousal support (alimony) Payment of debts and/or expenses THE OTHER PARTY HAS 14 DAYS FROM THE DATE ON WHICH THIS MOTION IS SERVED TO FILE A COUNTER AFFIDAVIT AND SERVE UPON THE PARTY WHO FILED THE MOTION. (See below.) (2) Counter Affidavit (Print Your Name) files this Counter Affidavit in response to a Motion and Affidavit. Instructions : This form is used to request temporary orders in your divorce or legal separation case. After a party serves a Motion and Affidavit, the other party has 14 days to file a Counter Affidavit and serve it on the party who filed the motion. If more space is needed, add additional pages. American LegalNet, Inc. www.FormsWorkFlow.com DR-202 Page 2 of 4 Rev. 4/18 Complete the following information, whether filing Motion and Affidavit or Counter Affidavit. Check all that apply. 1. My spouse and I are living separately. Date of separation is . My spouse and I are living together. We have no minor children. (Skip to number 5.) There is/are minor child /ren who is/are adopted or born of this marriage. Name Date of Birth Living with In addition to the above child/ren there is/are in my household: adult(s) other minor and/or dependent child /ren 2. My child/ren attend(s) school in: My school district My spouse222s school district Open enrollment Other (Explain) The child / ren do not attend school in the same district. (Explain) 3. I request to be named the temporary residential parent and l egal custodian of the child/ren . (Specify child/ren if request is not for all children.) My spouse be named the temporary resi dential parent and legal custodian of the child/ren . I request the following parenting time order: The Court222s guideline parenting s chedule (See county222s local rules of court) A specific parenting time order as foll ows: I have reached an agreement regarding parenting time with my spouse as follows: I request that my spou se222s parenting time be supervised. (Explain 226 Supervised parenting time will NOT be granted if the reasons are not explained. ) Name of appropriate supervisor American LegalNet, Inc. www.FormsWorkFlow.com DR-202 Page 3 of 4 Rev. 4/18 4. A court or agency has made a child support order concerning the child/ren . Name of Court/Agency Date of Order SETS Number 5. I request the Court to order my spouse to pay: $ child support per month $ spousal support per month $ attorney fees, expert fees, court costs The following debts and/or expenses: Other: 6. I am willing to attend mediation. I am not willing to attend mediation. OATH [Do not sign until notary is present.] I, (print name) , swear or affirm that I have read this document and, to the best of my knowledge and belief, the facts and information stated in this document are true, accurate and complete. I understand that if I do not tell the truth, I may be subject to penalties for perjury. Your Signature Sworn before me and signed in my presence this day of , . Notary Public My commission expires: American LegalNet, Inc. www.FormsWorkFlow.com DR-202 Page 4 of 4 Rev. 4/18 CERTIFICATE OF SERVICE Check the boxes that apply. I delivered a copy of my: Motion and Affidavit or Counter Affidavit On: (Date) , To: (Print name of other party222s attorney or, if there is no attorney, print name of party.) At: (Print address or fax number.) By: U.S. Mai l Email Fax P ersonal Delivery Clerk of Courts (if address is unknown) Your signature American LegalNet, Inc. www.FormsWorkFlow.com