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SUPERIOR COURT OF GWINNETT COUNTY STATE OF GEORGIA

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______________________________________________________________________________
Petition for Registration and Modification of Custody Order —
Rev. February 2016 Page 1 of 7
Provided by the Gwinnett Family Law Clinic
SUPERIOR COURT OF GWINNETT COUNTY
STATE OF GEORGIA
Petitioner,
v.
Respondent.
Civil Action
File No.:
PETITION FOR REGISTRATION AND
MODIFICATION OF CUSTODY ORDER
My name is ______________________________ and I am representing myself in
this petition. In support of my case, I state the following:
1. Jurisdiction and Venue:
[Check only one of the following, either (a) or (b).]
(a) The Respondent is a resident of Gwinnett County, Georgia and is subject to
the jurisdiction of this Court.
(b) The Respondent is a resident of ____________________ County, Georgia,
but I live in Gwinnett County. The Respondent has acknowledged service
of process and consented to the jurisdiction and venue of this Court.
2. Service of Process: The Respondent shall be served as provided under OCGA §9-
11-4, following manner:
[Check only one of the following, either (a) or (b).]
(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 home work address, which is:
______________________________________________________________________________
Petition for Registration and Modification of Custody Order —
Rev. February 2016 Page 2 of 7
Provided by the Gwinnett Family Law Clinic
________________________________________
________________________________________
________________________________________
(b-1) [Check only if the Respondent resides outside of 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 in the
county where the Respondent resides.
3. Minor Children:
The Respondent and I are the parents of _____ minor children, listed below:
Name of Child Male / Female Year of Birth
4. Children’s Current Residence:
Child(ren’s current address:
City, State ZIP
County:
The child(ren) has/have lived at this address since
5. Children’s Past Residences:
During the past five years, the minor children have lived at the following
addresses:
______________________________________________________________________________
Petition for Registration and Modification of Custody Order —
Rev. February 2016 Page 3 of 7
Provided by the Gwinnett Family Law Clinic
Dates at Address Address
____________________ ________________________________________
____________________ ________________________________________
____________________ ________________________________________
____________________ ________________________________________
6. Adults With Whom Children Have Lived:
D
uring the past five years, the children have lived with the following adults:
Name of Person Person’s Current Address
____________________ ________________________________________
____________________ ________________________________________
____________________ ________________________________________
____________________ ________________________________________
____________________ ________________________________________
7. P
rior Custody Determination:
Another state entered a prior order concerning child custody. The information
concerning that order is as follows:
__________________________________
__________________________________
Date of
Order:
State:
County:
__________________________________
Court’s Name:
__________________________________
Case Number:
__________________________________
Legal Custody was awarded to:
Physical custody was awarded to:
T
his Order has not been modified. See attached two copies, including one
certified copy, of the Order marked Exhibit A and Exhibit B.
______________________________________________________________________________
Petition for Registration and Modification of Custody Order —
Rev. February 2016 Page 4 of 7
Provided by the Gwinnett Family Law Clinic
8. Other Proceedings That Could Affect Custody of Visitation in This Case:
[Check only one, 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.
(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 minor 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 minor children or who claims to have custody or visitation
right with respect to the children. The names and present addresses of the
person(s) are:
____________________________________________________________
____________________________________________________________
____________________________________________________________.
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
______________________________________________________________________________
Petition for Registration and Modification of Custody Order —
Rev. February 2016 Page 5 of 7
Provided by the Gwinnett Family Law Clinic
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 ____________________.
(d) The Respondent is unable to care for the children because:
____________________________________________________________
____________________________________________________________
____________________________________________________________.
11. Child Custody and Visitation: I believe that custody and visitation arrangement
set forth in the attached Permanent Parenting Plan is in the best interests of the
child(ren). Custody and visitation should be ordered as set forth in the attached
Parenting Plan.
12. Child Support:
[Check only one of these, either (a), (b), (c) or (d) if you are requesting a
modification of child support.]
(a) The Respondent has income or is capable of earning sufficient money to
support the minor child(ren).
(b) I have income or I am capable of earning sufficient money to support the
minor child(ren).
(c) I am not asking the Court to address this issue in this case.
(d) The issue of child support cannot be decided in this action because the
Court does not have personal jurisdiction over the Respondent.
______________________________________________________________________________
Petition for Registration and Modification of Custody Order – February 2016 Page 6 of 6
Provided by the Gwinnett Family Law Clinic
THEREFORE, I request the following:
[Check all that apply.]
(a) That the attached Custody Order be registered and filed as a foreign judgment;
(b) That the Court serve notice upon the Respondent and provide him/her with an
opportunity to contest the validity of the registered order;
(c) That a Rule Nisi be scheduled to decide on the relief I have requested:
(d) That the custody and visitation for the child(ren) be ordered according to
Paragraph 11;
(e) That the prior child support order be modified if the prior child custody
determination is modified;
(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 Registration and Modification of Custody Order - February 2016 Page 7 of 3
Provided by the Gwinnett Family Law Clinic
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 Registration and Modification of Custody 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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