Fillable PETITION FOR LEGITIMATION AND CUSTODY/VISITATION

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PETITION FOR LEGITIMATION AND CUSTODY/VISITATION

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Page 1 of 8 Petition for Legitimation
Provided by Rockdale County with Petition largely in part from Atlanta Legal Aid
IN THE SUPERIOR COURT FOR ROCKDALE COUNTY
STATE OF GEORGIA
______________________________, )
Petitioner, )
) Civil Action Case No.
vs. )
)
______________________________, )
Respondent. )
PETITION FOR LEGITIMATION AND CUSTODY/VISITATION
My name is ________________________________________. I am the Petitioner in this
legitimation action and am representing myself. In support of my case, I state as follows:
1. The Respondent is named _____________________________________ and is [Check
only one of the following]:
□ (a) the mother of my child(ren)
□ (b) the legal guardian of my child(ren)
□ (c) the legal custodian of my child(ren).
2. Jurisdiction and Venue:
[Check only one of the following]
□ (a) The Respondent is a resident of __________________ County, Georgia.
□ (b) The Respondent resides in _______________ County, Georgia and I am a
resident of ______________ County. The Respondent has acknowledged service
of process and has consented to the jurisdiction and venue of this Court.
□ (c) the Respondent resides outside the State of Georgia in _____________________,
but I reside in _______________County, Georgia and my child(ren) reside(s) in
Georgia.
Page 2 of 8 Petition for Legitimation
Provided by Rockdale County with Petition largely in part from Atlanta Legal Aid
□ (d) the Respondent resides outside the State of Georgia in______________________,
but my child(ren) reside(s) in __________________ County, Georgia.
□ (e) the Respondent’s whereabouts are unknown to me, but I am a resident of
______________ County and my child(ren) reside(s) in Georgia. I am filing
along with this Petition an Affidavit of Due Diligence and incorporating it herein
by reference.
□ (f) the Respondent’s whereabouts are unknown to me, but my child(ren) reside(s) in
______________County, Georgia. I am filing along with this Petition an
Affidavit of Due Diligence and incorporating it herein by reference.
3. Service of Process: The Respondent shall be served as provided under O.C.G.A. Section
9-11-4 in the following manner: [Check only one of the following]
□ (a) The Respondent may be served by the Sheriff’s Department at the Respondent’s
residence or work address, which is:
______________________________________________
______________________________________________
______________________________________________
□ (b) The Respondent has acknowledged service of process. I am filing with this
Petition an Acknowledgment of Service, which has been signed by the
Respondent before a notary public.
□ (c) The Respondent’s whereabouts are unknown to me. I am filing with this Petition
my Affidavit of Due Diligence. The Respondent shall be served by publication as
provided under O.C.G.A. Section 9-11-4(e)(1) for those who cannot be found
within the State of Georgia. To the best of my knowledge, information and belief,
Respondent’s last known address was:
______________________________________________
______________________________________________
______________________________________________
Page 3 of 8 Petition for Legitimation
Provided by Rockdale County with Petition largely in part from Atlanta Legal Aid
4. Minor Child(ren):
I am the father of the following _____ minor child(ren), born out of wedlock:
Name of Child
M/F
Year of Birth
Lives with (mother, father, other)
Name of Child
M/F
Date of Birth
Lives with (mother, father, other)
5. Child(ren)’s Current Residence:
The minor child(ren) currently live at _________________________________________
in ___________ County, with the following adult: ______________________________.
The child(ren) has/have lived at this address since approximately __________________.
6. Child(ren)’s Past Residences:
During the past five years, the child(ren) has/have lived at the following addresses:
Address
Dates at Address
7. Adults With Whom Child(ren) Has/Have Lived:
During the past five years, the child(ren) has/have lived with the following adults:
Name of Adult
Page 4 of 8 Petition for Legitimation
Provided by Rockdale County with Petition largely in part from Atlanta Legal Aid
8. Other Court Cases Involving Child(ren):
[Check only one of the following]
□ (a) I have never participated as a party or a witness or in any other capacity in any
other litigation concerning the custody of or visitation with the minor child(ren) in this or
any other state or jurisdiction.
□ (b) I have participated in other litigation concerning the custody of or visitation with
the minor child(ren) in Georgia or another state. The court, case number, and date of any
order concerning custody or visitation under the other litigation are as follows: ________
________________________________________________________________________
______________________________________________________________________.
9. Other Cases That Could Affect Custody or Visitation in This Case:
[Check only one of the following]
□ (a) I am not aware of any proceeding that could affect this case, including
proceedings for enforcement and proceedings relating to DFCS cases, family
violence, protective orders, termination of parental rights and adoptions, in this or
any other state or jurisdiction.
□ (b) I have information about a proceeding that could affect this case, including
proceedings for enforcement and proceedings relating to DFCS cases, family
violence, protective orders, termination of parental rights and adoptions, in this or
any other state or jurisdiction. The court, case number, and nature of the
proceeding are as
follows:___________________________________________________________
__________________________________________________________________
________________________________________________________________.
10. Others Claiming Custody or Visitation:
[Check only one of the following]
□ (a) I do not know of any person who is not a party to this case who has physical
custody of the child(ren) or who claims to have custody or visitation rights with
respect to the child(ren).
□ (b) I know of a person who is not a party to this case who has physical custody of the
child(ren) or who claims to have custody or visitation rights with respect to the
Page 5 of 8 Petition for Legitimation
Provided by Rockdale County with Petition largely in part from Atlanta Legal Aid
child(ren). The names and the present addresses of the/these person(s) are:
____________________________________________________________
____________________________________________________________
___________________________________________________________.
11. I want to legitimate my relationship with my child(ren).
12. I want to change the name of my child(ren) from:
________________________________ to _____________________________________
________________________________ to _____________________________________
________________________________ to _____________________________________
________________________________ to _____________________________________
________________________________ to _____________________________________
13. I seek to have my name entered as the father on the birth record of my child(ren).
14. Child Custody:
[Check and complete only one of the following]
I believe the following custody arrangement is in the best interests of the child(ren):
□ (a) The ____________________ should have full custody.
□ (b) The Petitioner and the Respondent should share joint legal custody, with primary
physical custody to the ________________________________.
□ (c) __________________________________________________________________
__________________________________________________________________
_________________________________________________________________.
□ (d) I am not asking the Court to address the issue of custody in this case.
15. Child Visitation:
[Check and complete only one of the following]
Page 6 of 8 Petition for Legitimation
Provided by Rockdale County with Petition largely in part from Atlanta Legal Aid
I believe that the following visitation arrangement is in the best interests of the child(ren):
□ (a) The _______________________ should have reasonable visitation.
□ (b) Visitation by the __________________ should be limited in the following way
and for the following reasons: _________________________________________
_________________________________________________________________
__________________________________________________________________
16. Child Support:
[Check and complete only one of the following]
□ (a) The Respondent has income, or is capable of earning sufficient money, to support
the minor child(ren). Based on the Respondent’s gross income of
$_________________ per month, and the Georgia child support guidelines
(O.C.G.A. Section 19-6-15), the Respondent should pay an amount of
$_________________ per month as support.
□ (b) Based on my gross income of $_________________ per month, and the Georgia
child support guidelines (O.C.G.A. Section 19-6-15), I can pay to the Respondent
as the primary custodial parent the amount of $__________________ per month
in child support.
□ (c) The issue of child support cannot be decided in this action because this Court does
not have personal jurisdiction over the Respondent.
□ (d) I am not asking the Court to address the issue of support in this case.
17. Health Insurance for Child(ren):
[Check and complete only one of the following]
□ (a) The Respondent should be ordered to maintain a policy for medical, dental and
hospitalization insurance for the minor child(ren).
□ (b) I already provide health insurance for the child(ren) and the Respondent should be
required to reimburse me for a fair share of the cost of such insurance each month.
□ (c) The issue of health insurance cannot be decided in this action because this Court
Page 7 of 8 Petition for Legitimation
Provided by Rockdale County with Petition largely in part from Atlanta Legal Aid
does not have personal jurisdiction over the Respondent.
□ (d) I am not asking the Court to address the issue of health insurance in this case.
18. Other Medical Expenses for the Child(ren):
[Check and complete only one of the following]
□ (a) The Respondent should be required to be responsible for all expenses incurred for
the medical, dental and hospitalization insurance for the minor child(ren) not
covered by insurance.
□ (b) The Respondent and I should share the cost of all expenses incurred for the
medical, dental and hospitalization insurance for the minor child(ren) not covered
by insurance.
□ (c) The issue of health care expenses cannot be decided in this action because this
Court does not have personal jurisdiction over the Respondent.
□ (d) I am not asking the Court to address the issue of health care expenses in this case.
19. Life Insurance to Support Child(ren):
[Check and complete only one of the following]
□ (a) The child(ren) depend(s) on the Respondent for support, and therefore the
Respondent should be required to maintain a policy of insurance on the
Respondent’s life, with a face amount of $ ________________________, for the
benefit of the minor child(ren). The Respondent should maintain the policy for so
long as the child (or at least one of the children) is a minor or otherwise entitled to
child support.
□ (b) The issue of life insurance for the child(ren) cannot be decided in this action
because this Court does not have personal jurisdiction over the Respondent.
□ (c) I am not asking the Court to address the issue of life insurance for the child(ren)
in this case.
FOR THESE REASONS, I REQUEST THE FOLLOWING RELIEF FROM THE COURT:
[Check and complete all boxes that apply, but no others]
□ (a) That a DNA test be performed to confirm the child is in fact my biological child;
Petition for Legitimation Rev. Feb., 2017 Page 8 of 8
Provided by the Appalachian Family Law Information Center with Petition largely in part from Atlanta Legal Aid
□ (b) That the Court enter an Order legitimating my relationship with the child(ren) so
that the child(ren) and I will be capable of inheriting from each other in the same
manner as if the child(ren) had been born in wedlock;
□ (c) That the child(ren)’s name(s) be changed to: _____________________________;
________________________________; ________________________________;
________________________________; ________________________________;
□ (d) That the Department of Vital Statistics be ordered and directed to amend the birth
records of each child and reissue a birth certificate showing me, the Petitioner, as
the father and (if applicable) changing each child’s name as requested above;
□ (e) That custody and visitation for the child(ren) be ordered in accordance with the
Petitioner’s requests in Paragraphs 14 and 15 of this Petition;
□ (f) That child support, health insurance, medical expenses and life insurance be
ordered in accordance with the Petitioner’s requests in Paragraphs 16, 17, 18 and
19 of this Petition;
□ (g) That the Respondent be served with notice of this Petition as provided by law;
□ (h) That a Rule Nisi be scheduled by the Court to decide on the relief I have
requested.
□ (i) That the Court order the parties to participate in mediation to try to resolve any
disputed issues in this matter;
□ (j) That the Court order any and all other relief that it finds appropriate under the
circumstances.
Dated:________________, 20______
_________________________________________
Petitioner, Pro se (Signature)
Print Name: _____________________________
Address: ________________________________
_________________________________________
Phone:_____________________________
Email: _____________________________
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PETITION FOR LEGITIMATION AND CUSTODYVISITATION

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Completed 6 April 2022

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