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Affidavit Of Changes In Circumstance And Motion To Modify Adult Abuse-Stalking Judgment AA52 - Missouri
| Affidavit Of Changes In Circumstance And Motion To Modify Adult Abuse-Stalking Judgment Form. This is a Missouri form and can be used in Adult Abuse Circuit Court Statewide . |
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IN THE CIRCUIT COURT OF _____________________________ COUNTY, MISSOURI Judge or Division: Petitioner: Petitioner's DOB: Sex: F M Respondent: Alias/Nicknames: Work Phone Number: Work Hours: Petitioner's Relationship to Respondent: Spouse Unmarried with Child(ren) in Common Ex-Spouse Unmarried, Intimate Residing/Resided Together Related by Blood/Marriage Other (specify) ________________________________________________ Race: vs. Home Phone Number: Respondent's Work Address: (Date File Stamp) Case Number: Court ORI Number: Respondent's Home Address: Respondent's DOB: SSN (if known): Sex: F M Race: Affidavit of Changes in Circumstance and Motion to Modify Adult Abuse/Stalking Judgment Entry Full Order of Protection An Adult Abuse/Stalking Judgment Entry Full Order of Protection was entered in ____________________________ County, Missouri, on ____________________________ (date). A change has occurred in the circumstances of the petitioner, respondent or child(ren) and the modification is necessary to serve the best interests of the parties. Below are the specific facts, including dates and times, which petitioner respondent believes forms grounds for modification of the court's judgment: I request that the court find grounds for modification of: (check the box that applies) Installments of maintenance or support. Custody. Visitation. Other (specify): I swear /affirm under penalty of perjury that these facts are true according to my best knowledge and belief. ____________________________________________ _____________________________________________________ Date Your Signature NOTICE: Section 455.030.3 RSMo provides that a Petitioner seeking protection under the Adult Abuse Act is not required to reveal any current address or place of residence on this motion. Do not provide this information if doing so will endanger you. In witness thereof: ___________________________________ Date (Seal) _____________________________________________________ Your Street Address _____________________________________________________ City State Your Telephone Number Zip _____________________________________________________ ______________________________________________ Clerk Witnessing Signature Subscribed and sworn to before me on ____________________________________________ My commission expires: __________________ Date ___________________________________ Notary Public Directions for Completing This affidavit must be completed and signature witnessed by a court clerk or notary before filing it with the court. OSCA (10-1-05) AA52 1 of 1 455.060, 455.065 RSMo American LegalNet, Inc. www.USCourtForms.com
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