3 minutes
The applicant must be the biological parent of the child in question or have legal guardianship over the child.
Name
Date of Birth
Address
City
State/country
Zipcode
Phone Number
Type of incident
Custody/Visitation Court Order
Judge
Child(ren) Name and birth dates
Relationship to child
The relationship between the involved party and myself is
Provide a brief explanation of how the other parents/guardian refused to allow visitations, and/or steps you took to get your visitation; was your last contact with the other parent/guardian
Date
Signature