Form CHC104 "Notice of Motion and Motion to Establish Custody and Parenting Time" - Minnesota

What Is Form CHC104?

This is a legal form that was released by the Minnesota District Courts - a government authority operating within Minnesota. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on September 1, 2018;
  • The latest edition provided by the Minnesota District Courts;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;

Download a printable version of Form CHC104 by clicking the link below or browse more documents and templates provided by the Minnesota District Courts.

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Download Form CHC104 "Notice of Motion and Motion to Establish Custody and Parenting Time" - Minnesota

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State of Minnesota
District Court
County
Judicial District:
Court File Number:
Case Type:
In Re the Custody of:
Born (mo/day/yr)
Notice of Motion and Motion
To Establish Custody
Born (mo/day/yr)
And Parenting Time
Petitioner
and
Respondent
TO:
First
Middle
Last
Street Address
Apt. #
City
State
Zip Code
NOTICE
PLEASE TAKE NOTICE that on
,
, at
(date)
(year)
(time)
o’clock
m., before
(name
of Judge or Judicial Officer) in room
of the
located at
Minnesota, I will ask the court for an
Order granting me the following relief:
CHC104
State
ENG
Rev 9/18-D
www.mncourts.gov/forms
Page 1 of 6
State of Minnesota
District Court
County
Judicial District:
Court File Number:
Case Type:
In Re the Custody of:
Born (mo/day/yr)
Notice of Motion and Motion
To Establish Custody
Born (mo/day/yr)
And Parenting Time
Petitioner
and
Respondent
TO:
First
Middle
Last
Street Address
Apt. #
City
State
Zip Code
NOTICE
PLEASE TAKE NOTICE that on
,
, at
(date)
(year)
(time)
o’clock
m., before
(name
of Judge or Judicial Officer) in room
of the
located at
Minnesota, I will ask the court for an
Order granting me the following relief:
CHC104
State
ENG
Rev 9/18-D
www.mncourts.gov/forms
Page 1 of 6
MOTION
1. Granting legal custody of the children as follows: (check one)
(Legal custody identifies who will have a right to make decisions regarding the child’s upbringing,
including education, health care, and religious training).
 a. Jointly to both parents.
 b. Solely to (check one):
 Me
 The other parent (print full name)
2. Granting physical custody of the children as follows: (check one)
(
Physical custody identifies who will handle the routine daily care and control of the child and with
.
whom the children will live)
 a. Jointly to both parents.
 b. Solely to (check one):
 Me
 The other parent (print full name)
3. Determining parenting time as follows:
For the Petitioner:
 Granting parenting time to the Petitioner as provided in the schedules below;
 Granting parenting time to the Petitioner provided in the schedules below, with transfer
of the minor children at a safe place, preferably a visitation exchange center (if one is
available);
 Granting supervised parenting time to the Petitioner as provided in the schedules below; or
 Denying parenting time to the Petitioner.
For the Respondent:
 Granting parenting time to the Respondent as provided in the schedules below;
CHC104
State
ENG
Rev 9/18-D
www.mncourts.gov/forms
Page 2 of 6
 Granting parenting time to the Respondent provided in the schedules below, with transfer
of the minor children at a safe place, preferably a visitation exchange center (if one is
available);
 Granting supervised parenting time to the Respondent as provided in the schedules
below; or
 Denying parenting time to the Respondent.
PARENTING TIME SCHEDULES
(Use the space provided below to clearly explain when each parent will have the children.
State the time (o’clock) when the children will transfer from one parent to the other. If you
want the order to say who will pick up and drop off the children, or where transfer of the
children should take place, include that under “Other”).
Regular schedule:
Monday through Friday:
Weekends:
Summer (if you want a different schedule in summer)
Telephone contact with the children:
Unlimited or
Only at certain times as follows:
(describe the days and times when the parent and children may have telephone contact)
CHC104
State
ENG
Rev 9/18-D
www.mncourts.gov/forms
Page 3 of 6
Exceptions to the Regular Schedule:
[You can have a different schedule for holidays, school release days, and birthdays.]
Do you want a different schedule for school release days or breaks during the school year?
Yes
No
School Release days or breaks during the school year
Any school release day schedule will override the regular parenting schedule.
Do you want a different schedule for children’s or parents’ birthdays?
Yes
No
Birthdays (child's birthday, parent's birthday)
Do you want a different schedule for holidays?
Yes
No
State the specific holiday and schedule:
Any holiday or birthday schedule will override the regular and school release parenting schedule.
Do you have any other requests for a different parenting time schedule?
Yes
No
Other
CHC104
State
ENG
Rev 9/18-D
www.mncourts.gov/forms
Page 4 of 6
4. Under the above Schedule:
What is the annual number of overnights the children will spend with each parent?
Note: if parenting time is equal, use 182.5 overnights for each parent.
Number of overnights with Petitioner:
Number of overnights with Respondent:
5.
Establishing child support according to Minnesota child support guidelines. Child
support includes basic support, medical support, and child care support.
6.
Granting additional relief as follows:
7.
Granting such other and further relief as the court may deem just and equitable.
NOTICE TO OTHER PARENT
After reading this Motion, if you disagree with anything that is being requested, or if you want
the court to consider your facts and what you want, you must serve upon all parties and file with
the court a Responsive Motion and Responsive Affidavit. These documents are available online
at www.mncourts.gov under the link for “court forms,” or you may pick up court forms from any
county court administrator’s office. Your Responsive Motion and Responsive Affidavit must be
personally served on the other party at least five (5) days before the hearing or mailed to the
other party at least eight (8) days before the hearing. Your responsive papers must be filed
with the court administrator at least five (5) days before the hearing.
If you want to raise new issues at the hearing the other party has scheduled, you must serve and
file a Responsive Motion and Affidavit, which must be personally served on the other party ten
(10) days before the hearing or mailed to the other party at least thirteen (13) days before the
hearing. Your papers raising new issues must be filed with the court administrator at least ten
(10) days before the hearing.
If you do not understand what the other party is requesting, you may want to ask a lawyer for
help or contact other legal services provider for assistance.
CHC104
State
ENG
Rev 9/18-D
www.mncourts.gov/forms
Page 5 of 6