(Examples: You/the other parent have moved, there has been domestic violence,
you/the other parent have gotten married, you/the other parent have gotten a new
job, you/the other parent have started taking/stopped taking drugs, etc.) Be as
specific as possible about the circumstances. If you have moved, give the
previous address, the current address, say whether it is a house, apartment, etc.,
and give any other information that will show what the change has been.
9. Under “Therefore, the undersigned requests that the Order for Child Custody and/or
Visitation be modified as follows:,” state what you want the new arrangement to be.
For example, if you want to change the pick-up/drop-off location, give the address. If
you want a different day/time for visitation, write the days and times. If you want
primary care, write that you want custody and what the visitation schedule you’d like
for the other party to have. If you think there should be supervised visits, write that
you want supervised visitation.
10. Under “Date,” put the date, under “signature,” sign your name, and under “Name,”
write out your name.
11. Check either the “Plaintiff/Attorney” box if you are the plaintiff, or the
“Defendant/Attorney” box if you are the defendant.
II. Notice of Hearing and/or Calendar Request
Note: Instructions only to be used for Forsyth County (second page of the Forms). If you are in
Iredell, Stokes, or Davie, there are additional forms attached. If you are in Yadkin or Surry, go
to the Clerk’s office and ask how to get a hearing scheduled.
1. Under “Court File No.,” put the court file number from the other court documents.
2. Next to “(PLAINTIFF),” put the name of the plaintiff.
3. Next to “(DEFENDANT),” put the name of the defendant.
4. Next to “WEEK YOU ARE REQUESTING,” put the date of the Monday of the week
you would like to have your hearing. For example: put “Monday 07/24/2006” for the
week of 07/24/06 – 07/28/06.
5. Next to “Calendar Call Date,” put the date for the Thursday before the week that you
wish to have your hearing. For example: Put 07/20/2006 for a hearing during the
week of 07/24/06 – 07/28/06. Put “9:00” next to “A.M.” for the time to arrive that
6. Under “DOMESTIC CASES ONLY:,” check “Custody,” and/or “Visitation,” and
7. Under “GENERAL CIVIL:,” Check “Motion,” and “Non-jury.”
July 14, 2009 Version/Print Out