Hamilton County Juvenile Court

HAMILTON COUNTY JUVENILE COURT

CASE NUMBER

PETITION FOR CUSTODY OR

SHARED PARENTING

IN RE: O.R.C. 2151.23 (A) (2)

(Minor Child or Children)

The undersigned petitioner, , herein being duly sworn, states:

1. The name(s) and birth date(s) of the child or children is/are:

Name: Birth Date: Sex:

Name: Birth Date: Sex:

2. The Petitioner’s relationship to the above child or children is: and the relationship has been determined by:

Unmarried Mother having given birth.

Married and child or children were born during marriage.

Acknowledgement of Paternity .

Court Ordered Determination of Paternity.

Other:

Are supporting documents attached? Yes No

3. The child or children currently live at and is/are cared for by

Phone: ().

4. The natural or biological mother is: and her current mailing address is .

Phone: ().

5. The natural or biological father is: and his current mailing address is .

Phone: ().

6. The biological mother:

Is the petitioner and supports an agreement of shared custody or parenting with the adjudicated father.

Is the petitioner and seeks custody from father custodian.

Is the petitioner and seeks custody from a non-parent custodian.

Other: .

7. The biological father:

Has been adjudicated and supports an agreement of shared custody or parenting with the mother.

Is the petitioner and seeks sole custody from mother.

Is the petitioner and seeks custody from a non-parent custodian.

Other: .

8. It would be in the best interest of the child or children for the petitioner(s) to have custody orders as requested for the following reasons:

Custody of said minor child or children pursuant to O.R.C. 2151.23 (a) (2) and O.R.C 3109.21 et seq.

Address

(Petitioner's Signature) City State Zip Code

Telephone Number ()

Sworn to and signed in my presence this day of , 20 .

Notary Public

Parent Custody – Page 1 of 2

Form 580 (B) (P) Revised 12/09