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: _____________________________________