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SUPERIOR COURT OF GWINNETT COUNTY STATE OF GEORGIA

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Petition for Modification of Custody and Support — Rev. May 2016
Provided by the Gwinnett Family Law Clinic
1
SUPERIOR COURT OF GWINNETT COUNTY
STATE OF GEORGIA
Petitioner,
v.
Respondent.
Civil Action
File No.:
PETITION FOR MODIFICATION OF CUSTODY
☐ AND CHILD SUPPORT
My name is
I am representing myself in this modification petition. In support of my case, I state as
follows:
1.
Jurisdiction and Venue
[Check only one of the following, either (a), (b) or (c).]
☐
(a)
The Respondent is a resident of Gwinnett County, Georgia and is subject
to the jurisdiction of this Court.
☐
(b)
The Respondent lives in Georgia, outside of Gwinnett County, but I live
in Gwinnett County. The Respondent has acknowledged service
of
process and consented to the jurisdiction and venue of this Court.
☐
(c)
The Respondent is not a resident of Georgia, but this Court has exclusive,
continuing jurisdiction to modify custody because a Georgia court has
made a prior custody determination, and the children or a party to that
case lives in Gwinnett, County, Georgia, OCGA § 19-9-62(a).
2.
Service of Process: The Respondent shall be served as provided under OCGA §
9-11-4, in the following manner:
[Check only one of the following, either (a), (b), or (c).]
Petition for Modification of Custody and Support — Rev. May 2016
Provided by the Gwinnett Family Law Clinic
2
☐
(a)
The Respondent has acknowledged service of process. I am filing the
Acknowledgment of Service (which has been signed by the Respondent)
with this Petition.
☐
(b)
The Respondent may be served by the Sheriff’s Department at the
Respondent’s
☐
residence
☐
work address, which is:
☐
(b-1) [Check only if the Respondent lives outside Gwinnett County.]
The
Respondent resides outside of Gwinnett County, and shall therefore be
served by second original, as provided under OCGA § 9-10-
72. Service
shall be made by the sheriff’s department of the county where the
Respondent resides.
3. Minor Children:
The Defendant and I are the parents of the minor children, listed below:
Name of child
Sex
Year of
Birth
Lives with (Plaintiff,
Defendant, other)
4. Children’s Current Residence:
Child(ren’s current address:
City, State ZIP
County:
The child(ren) has/have lived at this address since
approximately (month and year):
Petition for Modification of Custody and Support — Rev. May 2016
Provided by the Gwinnett Family Law Clinic
3
5. Children’s Past Residences:
During the past five years, the child(ren) has/have lived at the following addresses:
Dates at Address Address
6. People With Whom Children Have Lived:
During the past five years, the children have lived with the following people:
Name of Person
Current Address
7.
Prior Custody Determination
Date of order:
Name of Court:
County/District and State where order was issued:
Legal custody was awarded to:
Physical custody was awarded to:
☐ A certified copy of the prior order is attached to this Petition.
8.
Other Proceedings That Could Affect Custody or Visitation in This Case:
[Check only one of the following, either (a) or (b).]
☐
(a)
I do not have any information of any proceeding that could affect this
case, including proceedings for enforcement and proceedings relating to
family violence, protective orders, termination of parental rights, and
adoptions in this or any other state.
Petition for Modification of Custody and Support — Rev. May 2016
Provided by the Gwinnett Family Law Clinic
4
☐
(b)
I have information about a proceeding that could affect this case,
including proceedings for enforcement and proceedings relating to family
violence, protective orders, termination of parental rights, or adoptions in
this or another state. The court, the case number and the nature of the
proceeding are as follows:
9.
Others Claiming Custody or Visitation:
[Check only one of these, either (a) or (b).]
☐
(a)
I do not know of any person who is not a party to this case, who has
physical custody of the children or who claims to have custody or
visitation rights with respect to the children.
☐
(b)
I know of someone who is not a party to this case, who has physical
custody of the children or who claims to have custody or visitation rights
with respect to the children. The names and current addresses of the
person(s) are as follows:
10.
Since the date of the prior custody determination, there has been a change in
circumstances which materially affects the welfare of the minor children.
[Check all that apply.]
☐
(a)
The Respondent has consented to the modification of custody. I am
filing the Consent (which has been signed by the Respondent) with this
Petition.
☐
(b)
The minor children want to live to me and have signed an Affidavit of
Custody Election. I am filing the Affidavit with this petition.
☐
(c)
The Respondent was awarded physical custody of the minor children in
the prior custody determination, but the minor children have been living
with me since .
Petition for Modification of Custody and Support — Rev. May 2016
Provided by the Gwinnett Family Law Clinic
5
☐
(d)
The Respondent is unable to care for the children because:
11.
Child Custody and Visitation: I am a fit and capable parent, and I believe that
the following custody arrangement is in the best interests of the children:
[Check only one of the following, either (a), (b), or (c) or (d).]
☐
(a)
I should have legal and physical custody.
☐
(b)
The Defendant and I should share joint legal custody but I should have
primary physical custody and the Defendant should have visitation.
☐
(c)
The Defendant and I should share joint legal custody but the Defendant
should have primary physical custody and I should have visitation.
☐
(d)
Other custody arrangement:
Permanent Parenting Plan. I understand I am required to prepare a
Parenting Plan which:
☐ I am filing a Parenting Plan with this Petition.
☐ I will file a Parenting Plan before the first hearing in this case.
☐
12.
I am requesting a modification of child support. A Domestic Relations Financial
Affidavit and Child Support Worksheet ☐ is being filed with this Petition
☐
will be filed before the first hearing in this case.
13.
I have not filed a Petition for Modification of
☐
custody
☐
child support within
two years of the filing of this Petition.
Petition for Modification of Custody and Support — Rev. May 2016 f
Provided by the Gwinnett Family Law Clinic
6
THEREFORE, I request the following [Check all that apply.]:
☐
(a)
That I be awarded legal custody and physical custody of the minor child(ren);
☐
(b)
That the Respondent and I be awarded joint legal custody, and I be awarded
physical custody of the minor child(ren);
☐
(c)
That the other custody arrangement is ordered as specified in Paragraph 11;
☐
(d)
That the prior child support order be modified if the prior child custody
determination is modified;
☐
(e)
That a Rule Nisi be scheduled by the Court to decide on the relief I have
requested;
☐
(f)
That the Court order the parties to participate in mediation to try to resolve this
matter;
☐
(g)
That the Respondent be required to pay all costs of this action; and
☐
(h)
That the Court order any and all other relief that the Court finds appropriate.
Dated:
Petitioner Pro se [signature]
Name:
Address:
City, State ZIP
Phone:
Email:
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Petition for Modification of Custody and Support — Rev. May 2016 f
Provided by the Gwinnett Family Law Clinic
7
SUPERIOR COURT OF GWINNETT COUNTY
STATE OF GEORGIA
Petitioner,
v.
Respondent.
Civil Action
File No.:
VERIFICATION
I am the Petitioner filing this action. I swear or affirm that I have read the Petition
for Modification of Custody and Child Support and that the facts contained within my
Complaint are true and correct.
Petitioner [signature]
SWORN AND AFFIRMED before me this
_____day of ____________________20____.
NOTARY PUBLIC
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SUPERIOR COURT OF GWINNETT COUNTY STATE OF GEORGIA

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Completed 22 October 2021

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