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DEPARTMENT FOR USE IN THE COURTS OF COLORADO Page 1 of 4

District Court Denver Juvenile Court

___________________________ County, Colorado

Court Address:

In re:

The Marriage of:

The Civil Union of:

Parental Responsibilities concerning:

______________________________________________________

Petitioner:

and

Co-Petitioner/Respondent:

COURT USE ONLY

Case Number:

Division Courtroom

ORDER RE: ABDUCTION PREVENTION MEASURES

PURSUANT TO §14-13.5-101, C.R.S

This matter comes before the Court on the Petition/Motion for Abduction Prevention Measures Pursuant to §14-

13.5-101, C.R.S. of the Petitioner Co-Petitioner/Respondent. Following review of the Petition/Motion and

Response, if applicable, or hearing on _______________________________ (date), the Court finds the following:

1. The Court has jurisdiction over the Petitioner and the minor child(ren).

2. The Court states the following regarding personal jurisdiction over the Co-Petitioner/Respondent.

 The Respondent was served in _____________________ (name of state) on ________________ (date).

 The Respondent signed an Acceptance and Waiver of Service on _________________________ (date).

 The Respondent was given notice of these proceedings on ________________ (date) at _______ (time).

 Other jurisdiction/notice: _______________________________________________________________.

3. The Petitioner is the biological Mother Father Grandparent Other __________________________

of the minor children.

4. The Co-Petitioner/Respondent is the biological Mother Father Grandparent Other

______________________ of the minor child(ren).

5. The following minor child(ren) who is/are subject to this Order is/are:

Full Name of Child

Present Address

Sex

Date of Birth

Age

DEPARTMENT FOR USE IN THE COURTS OF COLORADO Page 2 of 4

6. The child(ren)’s country of habitual residence at the time of this Order is as follows:

_______________________________

7. Below is a detailed description of each party’s current allocation of parental responsibility or custody and

visitation rights, and residential arrangements for the child(ren), and any allocation of parental responsibility or

custody determinations in effect:

_______________________________________________________________________________________

8. The Court has considered the allocation of parental responsibilities of the parties or custody and visitation

rights of the parties and the child-custody determination currently in effect at the time of the filing of the

petition. The Court has considered the age of the child(ren), the potential harm to the child(ren) from an

abduction, the legal and practical difficulties of returning the child to the jurisdiction if abducted, and the

reasons for the potential abduction, including evidence of domestic violence, domestic abuse, stalking, or

child abuse or neglect. The Court finds a credible risk of abduction of the child(ren) and finding that it is in the

best interest of the child(ren) to enter the following Orders in order to prevent abduction of the child(ren):

 An imposition of travel restrictions that require that a party traveling with the child(ren) outside a

designated geographical area provide the other party with the following;

 The travel itinerary of the child(ren);

 A list of physical addresses and telephone numbers at which the child(ren) can be reached at

specified times; and

 Copies of all travel documents.

 A prohibition of the Petitioner or Co-Petitioner/Respondent directly or indirectly from:

 removing the child(ren) from this State, the United States, or another geographic area without

permission of the court or the other party’s written consent;

 removing or retaining the child in violation of a child-custody or allocation of parental responsibility

determination;

 removing the child(ren) from school or a child-care or similar facility; or

 approaching the child(ren) at any location other than a site designated for supervised visitation,

supervised parenting time, or supervised exchange.

 Petitioner or Co-Petitioner/Respondent is registering this Order in _____________________ (name

of State) as a prerequisite allowing the child(ren) to travel to that State.

 The Court enters the following orders with regard to the child(ren)’s passport:

 Petitioner Co-Petitioner/Respondent place the child’s name in the United States Department of

State’s child passport issuance alert program;

 A requirement that the Petitioner Co-Petitioner/Respondent surrender to the Court or to the

party’s attorney any United States or foreign passport issued in the child’s name, including a passport

issued in the name of both the parent and the child(ren); and

DEPARTMENT FOR USE IN THE COURTS OF COLORADO Page 3 of 4

 A prohibition upon the Petitioner Co-Petitioner/Respondent from applying on behalf of the

child(ren) for a new or replacement passport or visa.

 As a prerequisite to exercising custody, parental responsibilities, or visitation or parenting time, a

requirement that the Petitioner Co-Petitioner/Respondent, provide;

 To the United States Department of State Office of Children’s Issues and the Relevant Foreign

Consulate or Embassy, an authenticated copy of the Order detailing passport and travel restrictions

for the child(ren).

 To the Court:

 Proof that the Petitioner Co-Petitioner/Respondent has provided the authenticated copy of

the Order detailing passport and travel restrictions for the child(ren) to the Department of State

Office of Children’s Issues and the Relevant Foreign Consulate or Embassy; and

 An acknowledgment in a record from the Relevant Foreign Consulate or Embassy that no

passport application has been made, or passport issued, on behalf of the child(ren).

 To the Petitioner Co-Petitioner/Respondent proof of registration with the United States Embassy

or other United States Diplomatic Presence in the Destination Country and with the Central Authority

for the “Hague Convention on the Civil Aspects of International Child Abduction”, if that convention is

in effect between the United States and the destination country, unless one of the parties objects; and

 A written waiver under the Federal “Privacy Act of 1974”, 5 U.S.C. Section 552a, with respect to any

document, application, or other information pertaining to the child(ren) authorizing its disclosure to the

Court and the other parties.

 Upon a party’s request, a requirement that the other party obtain an order from the relevant foreign

country containing the terms identical to the child-custody or allocation of parental responsibility

determination issued in the United States.

The Court imposes the following conditions on the exercise of allocation of parental responsibilities,

child custody or visitation:

 The following limitations:

____________________________________________________________________________________

 Parenting time to be supervised as follows:

____________________________________________________________________________________

 Petitioner Co-Petitioner/Respondent, is required to post bond or provide other security in an amount

sufficient to serve as a financial deterrent to abduction as follows:

____________________________________________________________________________________

DEPARTMENT FOR USE IN THE COURTS OF COLORADO Page 4 of 4

____________________________________________________________________________________

Note: The proceeds of the bond or other security may be used to pay for the reasonable expense of the

child, including reasonable attorney’s fees and costs if there is an abduction.

 Petitioner Co-Petitioner/Respondent, is required to obtain education on the potentially harmful effects

to the child(ren) from abduction as follows:

____________________________________________________________________________________

 The Court issues a warrant/writ of aid in enforcement to take physical custody of the child pursuant to

§14-13.5-109, C.R.S.

 The Court directs law enforcement to take the following actions:

____________________________________________________________________________________

 The Order remains in effect until ____________________ (date), or upon the emancipation of the child,

or when the child attains the age of 18, or at the time this Order is modified, revoked, vacated, or

superseded by a Court with jurisdiction pursuant to §14-13-201 and §14-13-203, C.R.S.

 The Court orders the following relief:

____________________________________________________________________________________

A VIOLATION OF THIS ORDER AND THE CONTENTS THEREIN MAY SUBJECT THE

PARTY IN VIOLATION TO CIVIL AND CRIMINAL PENALTIES.

Date: ________________________________ ______________________________________

Judge Magistrate

CERTIFICATE OF MAILING

I certify that on ___________________ (date), I mailed this Order to the following:

 Petitioner

 Petitioner’s Attorney

 Co-Petitioner/Respondent

 Co-Petitioner/Respondent’s Attorney

 Child Support Enforcement Unit ___________________________________

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Completed 2 June 2021

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