SUPERIOR COURT Unit Plaintiff Name STATE OF VERMONT FAMILY DIVISION Docket No. Defendant Name v. MOTION FOR GENETIC TESTING 1. In this case, I am the Plaintiff Defendant 2 The children who are the subject of this are: Name of Child(ren) Date of Birth 3. Basis for Request for Genetic Testing: I am requesting genetic testing because: (check appropriate box) There is no legal presumption of parentage in this case. The other party and I were not married at the time and the child(ren) was/were born and we have not signed a Voluntary Acknowledgment of Parentage. I signed a Voluntary Acknowledgment of Parentage for ___________________________________, but I have evidence to present to the Court that will demonstrate that one of the parties is not the parent of the child/these children because: (describe facts that indicate that you are not the parent) ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ The other party and I were married when ______________________________________________ Was/were born, but I have reason to believe that one of the parties is not the parent of the child(ren) because: ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ 400-00869 � Motion for Genetic Testing (08/2015) American LegalNet, Inc. www.FormsWorkFlow.com Page 1 of 2 REQUEST TO THE COURT I request that the Court: Order the parties to participate in Genetic Testing to determine whether they are the parents of the above name child(ren) Order that the cost of Genetic Testing be paid for as follows: _______________________________________________________________________________ _______________________________________________________________________________ I hereby swear or affirm that the information above is true to the best of my knowledge and belief. Dated Signature of Party Filing Motion Printed Name Subscribed and sworn before me on: My commission expires on: Signature of Notary Public Printed Name 400-00869 � Motion for Genetic Testing (08/2015) American LegalNet, Inc. www.FormsWorkFlow.com Page 2 of 2