OTSEGO COUNTY FRIEND OF THE COURT
PARENTING TIME VIOLATION COMPLAINT
This office can only process complaints which violate the written order of the court. In order to assist you
the following information is required:
1. Complaint must be received within 56 days of the date of violation.
2. You must include the specific date of violation or the date you became aware of the violation.
It is helpful to include the date of the order and which provision you believe has been violated.
A copy of your complaint (page 2) will be provided to the other party when this complaint is processed.
Today’s Date: ________________________________________
Case No._____________________________________________
Please Print Clearly
Your Name: __________________________________________
Current Address: ______________________________________
City/State: ________________________ Zip: ___________
Birth Date: ____________________________ SSN: ___________
Home Telephone: ___________________
Daytime and/or Cell Number: _____________
Driver’s Lic. & State: _____________________
Place of Employment: _____________________________
OTSEGO COUNTY FRIEND OF THE COURT
PARENTING TIME VIOLATION COMPLAINT
Complaint Against: ______________________________
Address: ________________________________________
City/State: _________________________ Zip: __________________________________________________
Home Telephone: __________________ Daytime/Cell Number: ____________________
Please give the specific complaint regarding denial of your court ordered parenting time:
Denied weekend? Yes____ No ____ If Yes, give dates: ___________________________________
Denied Holiday/Summer parenting time? Yes ___ No ___ If Yes, give dates: ____________________
Child picked up/returned late? Yes ___ No ___ If Yes, give dates: _____________________________
Please reference the date of the order and provision which you believe has been violated: ______________
Give brief explanation of any court order violations and names of children involved:
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Date: _____________________ Complainant’s Signature: _____________________________________