To file a claim for a case in the State of Connecticut, complete proof of claim form.
Text version of this Form
Form PS–05
Page 1 of 2 Rev. 8/08
First Petition for Child Custody
Case Number (the clerk will fill this in)
In the Court of (county): County, Alabama
v.
Your Name
(Plaintiff in this case)
Defendant’s First and Last Name
(the other parent)
(Type District if in District Court, Circuit if in Circuit Court)
(Type name of county)
(Type your first and last name – you are the Plaintiff)
(Type the other parent’s first and last name)
Use this form only if this is the first custody order for these children. To change an order, use form PS-07.
Do not use this form in a child support case filed by Alabama DHR.
Important! You must file this form in the same county where the child/ren live.
Print your answers.
q Mother’s information
Name: Age:
first middle last•
Address:
street address city state zip•
Phone #: ( )
Is the mother of these children married to the father of these children? ..Yes ..No •
w Father’s information
Name: Age:
first middle last•
Address:
street address city state zip•
Phone #: ( )
e If the person asking for custody is NOT the mother or father of the children above, fill out below:
Name: Age:
first middle last•
Address:
street address city state zip•
Phone #: ( ) Your relationship to the children (explain):
r Information about the children
Names and dates of birth of the child/ren under 19 involved in this case (print):
Name: Date of birth:
Name: Date of birth:
Name: Date of birth:
Name: Date of birth:
Who do the child/ren live with now? •
Mother .. Father .. Other (name and relationship):
Current Address:
street address city county state zip•
How long have the child/ren been at this address?
If less than 6 months, where else have the child/ren lived during the last 12 months?
Previous addresses:
street address city county state zip
street address city county state zip
street address city county state zip•
(Type the Mother’s first name)
(Type the Mother’s middle name)
(Type the Mother’s last name)
(Type the Mother’s age)
(Type the Mother’s street address)
(Type the Mother’s city)
(Type the Mother’s state)
(Type the Mother’s zip code)
(Type the Mother’s area code)
(Type the Mother’s phone number)
(Click or hit spacebar to check this box) Unchecked
(Click or hit spacebar to check this box) Unchecked
(Type the Father’s first name)
(Type the Father’s middle name)
(Type the Father’s last name)
(Type the Father’s age)
(Type Father’s street address)
(Type Father’s city)
(Type Father’s state)
(Type Father’s zip code)
(Type father’s area code)
(Type Father’s phone number)
(Type first name of other person)
(Type the other person’s middle name)
(Type the last name of the other person)
(Type the other person’s age)
(Type the other person’s street address)
(Type the other person’s city)
(Type the other person’s state)
(Type the other person’s zip code)
(Type the other person’s area code)
(Type the other person’s phone number)
(Type the other person’s relationship to the children (explain))
(Type the first child’s name)
(First child’s date of birth)
(Type the second child’s name)
(Second child’s date of birth)
(Type the third child’s name)
(Third child’s date of birth)
(Type the fourth child’s name)
(Fourth child’s date of birth)
(Click or hit spacebar to check this box) Unchecked
(Click or hit spacebar to check this box) Unchecked
(Click or hit spacebar to check this box) Unchecked
(Who do the child/ren live with now? (name and relationship))
(Who do the child/ren live with now? (name and relationship) continued)
(Type children’s current address)
(Type children’s current city)
(Type county where children live now)
(Type children’s current state abbreviation)
(Type children’s current zip code)
(Type how long children have lived at this address)
(Type children’s first previous address)
(Previous city 1)
(Previous county 1)
(Previous state abbreviation 1)
(Previous zip code 1)
(Type children’s second previous address)
(Previous city 2)
(Previous county 2)
(Previous state abbreviation 2)
(Previous zip code 2)
(Type children’s third previous address)
(Previous city 3)
(Previous county 3)
(Previous state abbreviation 3)
(Previous zip code 3)Rev. 10/08 © 2008 Alabama State Bar
Form PS–05
Page 2 of 2 Rev. 8/08 First Petition for Child Custody Case Number (the clerk will fill this in)
t
Other cases involving these child/ren
Have there been any other court cases, like child support, juvenile, or DHR
about this child/ren? .. Yes* .. No
*If Yes, fill out below:
When and where were the orders made? What kind of orders did the court make?
Date County State
y
Best person to take care of the children
Explain why you believe giving you full custody would be best for the child/ren.
u
The person asking for custody must read and sign below:
•
I believe that giving me full custody is best for the child/ren.
•
I certify that I am able to take care of the child/ren listed above. I am a fit and proper person.
•
I ask the Court to give me full legal and physical custody of the child/ren listed above, and to make
any other orders I may be entitled to, including child support, and unpaid support, if owed.
Sign here in front of a notary: Date :
Notary fills out below—
Sworn to and subscribed before me, the undersigned authority,
By (Print name of notary/clerk):
On this date:
Notary signs here
(Notary’s seal here)
(Click or hit spacebar to check this box) Unchecked
(Click or hit spacebar to check this box) Unchecked
(Date of first court order)
(County where first order was made)
(State where first order was made)
(What kind of orders did the court make?)
(Date of second court order)
(County where second order was made)
(State where second order was made)
(What kind of orders did the court make?)
(Date of third court order)
(County where third order was made)
(State where third order was made)
(What kind of orders did the court make?)
(Explain why you believe giving you full custody would be best for the children)
(Explain why you believe giving you full custody would be best for the children (continued))
(Explain why you believe giving you full custody would be best for the children (continued))
(Explain why you believe giving you full custody would be best for the children (continued))Rev. 10/08 © 2008 Alabama State Bar