400-00869 Motion for Genetic Testing (08/2015) Page 1 of 2
STATE OF VERMONT
SUPERIOR COURT
FAMILY DIVISION
Unit
Docket No.
Plaintiff Name
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) Page 2 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