STATE OF SOUTH DAKOTA COUNTY OF ______________ __________________________ Plaintiff, v. __________________________ Defendant. ) IN CIRCUIT COURT )SS. ) __________ JUDICIAL CIRCUIT ) No. _________ ) ) ) PETITION FOR ORDER ) IMPLEMENTING SOUTH DAKOTA ) PARENTING TIME GUIDELINES ) ) ) COMES NOW, __________________________, (person filing Petition) and petitions this Court for an order to include the South Dakota Parenting Time Guidelines into the court order establishing visitation / child custody / child support (circle one) regarding my minor child(ren). In support of my request I state as follows: 1. That I am the Plaintiff/Defendant (circle one) in the above-entitled action which was an action establishing visitation / child custody / child support (circle one) regarding my minor child(ren). 2. 3. I have attached a copy of the prior Court Order to this Petition. Child(ren)'s name (list all involved minor children) DOB ________________ DOB ________________ DOB ________________ 1. __________________________________________ 2. __________________________________________ 3. __________________________________________ 4. Current address of minor child(ren): __________________________________________ City:_______________________ State: ___________________ Zip: _________ 5. The addresses of minor child(ren) for the past five years: (attach additional pages if necessary): ____________________________________________________________ American LegalNet, Inc. www.FormsWorkFlow.com Form UJS-366 Rev. 09/2010 ________________________________________________________________________ 6. Names and addresses of all persons with whom the child(ren) has lived during the past five years: _______________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ 7. I have/have not (circle one) participated in any capacity in any other legal proceeding that concerns the visitation / child custody /child support (circle one) with the child? If so, please explain: _______________________________________________________ ________________________________________________________________________ 8. I know/do not know (circle one) of any proceeding (Protection Order, adoption, termination of parental rights, etc) which could effect this proceeding? If so, please explain: _______________________________________________________ ________________________________________________________________________ 9. Names and addresses of any person not a party to this proceeding who has the physical custody of the child or claim rights to the legal and/or physical custody of or visitation with the child. ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ 10. I will serve a copy of this Petition, the South Dakota Parenting Time Guidelines and the Notice of Petition for Order Implementing Parenting Time Guidelines on the opposing party. American LegalNet, Inc. www.FormsWorkFlow.com Form UJS-366 Rev. 09/2010 I ask the Court that if the opposing party objects to the implementation of the standard guidelines within ten days of Service, the Court will set an expedited hearing on the matter. The Clerk will send separate Notices of Hearing to both parties. If the opposing party does not object within ten days, I will provide the Court with an Order to implement the South Dakota Parenting Time Guidelines. I further request whatever other relief the Court believes justified. My current address is: _____________________________________________________ City:_______________________ State: ___________________ Zip: _________. The opposing parties current address is: __________________________ City:_______________________ State: ___________________ Zip: _________. Dated this _______ day of ________________, 20___. ______________________________________________ Signature (person filing Petition) ) )ss. County of ______________ ) On this _______ day of ________________, 20___, I swear under oath that the allegations set forth in this Verified Petition are true and correct to the best of my knowledge, and that I believe that I am entitled to the relief requested for, and that this legal action is not filed for harassment, abuse of process, or delay. ______________________________________________ Signature (person filing Petition) Signed and sworn to before me this _______ day of _________________, 20___. ______________________________________________ Notary Public Commission Expires: State of South Dakota (SEAL) American LegalNet, Inc. www.FormsWorkFlow.com Form UJS-366 Rev. 09/2010