Petition To Establish Non-Parent Custody {DRNPEC11f} | Pdf Fpdf Doc Docx | Arizona

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Petition To Establish Non-Parent Custody {DRNPEC11f} | Pdf Fpdf Doc Docx | Arizona

Petition To Establish Non-Parent Custody {DRNPEC11f}

This is a Arizona form that can be used for Superior Court within Local County, Yavapai.

Alternate TextLast updated: 1/30/2007

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Name: Mailing Address: Daytime Telephone: Representing Self, Without a Lawyer IN THE SUPERIOR COURT OF ARIZONA, YAVAPAI COUNTY Regarding the matter of the custody of Minor Child(ren) Mother Father Applicant _______________________________________ ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) DO _______________________ PETITION TO ESTABLISH NON-PARENT CUSTODY [656] STATEMENTS TO THE COURT, UNDER OATH 1. INFORMATION ABOUT ME, THE APPLICANT Name: Address Soc. Sec. No: Occupation: My relationship to the child(ren) for whom I want the court order: [] The Applicant is enlisted in the military, and [ ] has deployed for at least one day during the past 6 months. [ ] Deceased Date of Birth Occupation: OR [ ] has not been Date of Birth 2. INFORMATION ABOUT THE MOTHER Name: Address Soc. Sec. No: My relationship to the child(ren) for whom I want the court order: [] The Mother is enlisted in the military, and Page 1 of 6 [ ] has OR [ ] has not been DRNPEC11f Superior Court of Arizona in Yavapai County January 2006 Use only most current version American LegalNet, Inc. www.FormsWorkflow.com deployed for at least one day during the past 6 months. 3. INFORMATION ABOUT THE FATHER Name: Address Soc. Sec. No: Occupation: My relationship to the child(ren) for whom I want the court order: [] The Father is enlisted in the military, and [ ] has OR deployed for at least one day during the past 6 months. [ ] has not been [ ] Deceased Date of Birth 4. INFORMATION ABOUT THE CHILD(REN) OF WHOM I AM SEEKING CUSTODY: Child's Name Soc. Sec. No. Birth date Address Length of time at address Names and addresses of persons lived with for the past five (5) years Present addresses of person(s) lived with Child's Name Soc. Sec. No. Birth date Address Length of time at address Names and addresses of persons lived with for the past five (5) years Present addresses of person(s) lived with Child's Name Soc. Sec. No. Birth date Address Length of time at address Names and addresses of persons lived with for the past five (5) years Present addresses of person(s) lived with Superior Court of Arizona in Yavapai County January 2006 Page 2 of 6 DRNPEC11f Use only most current version American LegalNet, Inc. www.FormsWorkflow.com 5. INFORMATION ABOUT CUSTODY OF THE CHILD(REN): (check one box) [] [] [] Mother has had physical custody of the child(ren) for the last 6 months. Father has had physical custody of the child(ren) for the last 6 months. A person other than mother or father has had physical custody of the child(ren) for the last 6 months, because of a court case or government agency, and there is no disagreement between the parents and the party(ies) who have physical custody. (Describe court case on next page.) Names of party(ies) with custody: Name of court or government agency: Type of case: Date of order of custody (if any): What order said: Court or government agency case number Location of court or government agency (city and state): Status of case now [] Final Order entered; case is over [] Hearing date set on (date) Location/address: [] Other (explain in detail): at (time) . 6. CUSTODY OR PARENTING TIME CASES INVOLVING THE MINOR CHILD(REN): [ ] I HAVE [ ] I HAVE NOT been a party or a witness in court, in this state or any other state, involving the custody or parenting time of any child(ren) named above. (If so, explain below, using extra pages if necessary) Name of child: Court state Court location Court case number Status How the child is involved: Summary of any court order: 7. PENDING/PAST CASES RELATED TO MINOR CHILD(REN): (check one box) [ ] I DO [ ] I DO NOT know of any court case, in this state or any other state, that could affect this case, including enforcement, domestic violence, protective orders, drug convictions, sexual offenses, termination of parental rights and adoptions. (If so, explain below, using extra pages if necessary). Court state Court location Court case number Status How the child is involved: Summary of any court order: Date of conviction Superior Court of Arizona in Yavapai County January 2006 Page 3 of 6 DRNPEC11f Use only most current version American LegalNet, Inc. www.FormsWorkflow.com 8. CUSTODY OR PARENTING TIME CLAIMS OF ANY OTHER PERSON: (Check one box) [ ] I KNOW [ ] I DO NOT KNOW the name and address of any person, other than the legal parents or the Applicant, who has physical custody of the child(ren) or claims rights of legal custody, physical custody or parenting time of any child(ren) named above. (If so, explain below, using extra pages if necessary.) Name of each child: Name of person with the claim: Address of person with the claim: Nature of the claim: OTHER STATEMENTS, UNDER OATH, TO THE COURT: 8. I believe I stand in loco parentis to the child(ren) because: ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ It would be significantly detrimental to the child(ren) to remain or be placed in the custody of either of the child(ren)'s living legal parents who wish to retain or obtain custody for the following reason(s): ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ [] I have filed on (date) to Establish Child Support. , or am filing with this Petition, a Petition 9. 10. 11. JURISDICTION. [] OR [] A custody order has been entered within the past year, but I believe the child(ren)'s present environment may seriously endanger the child(ren)'s physical, mental, emotional or moral health for the following reason(s): __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ [] This Court has jurisdiction to decide this custody issue pursuant to A.R.S. 25-1034 because the child(ren) is present in the state and is abandoned or an emergency exists such that the child(ren), sibling(s) and/or parent of the child(ren) is in danger of bodily injury. Facts supporting this claim A court of compete

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