Orders Of Paternity Legal Decision Making Parenting Time {DRP81f}

Name: Mailing Address: Daytime Telephone Representing Self, Without a Lawyer For Clerk's Use Only IN THE SUPERIOR COURT OF ARIZONA, YAVAPAI COUNTY Regarding the matter of 1300DO ATLAS #: Petitioner and PETITION FOR ORDERS OF PATERNITY, LEGAL DECISIONMAKING, PARENTING TIME AND CHILD SUPPORT Respondent STATEMENTS TO THE COURT, UNDER OATH 1. INFORMATION ABOUT ME, THE PETITIONER Name: Address: Occupation: My relationship to the child(ren) for whom I request orders of Paternity, Legal Decision-Making, Parenting Time and Child Support: [ ] Mother [ ] I claim to be the Father [ ] I am a Court-appointed guardian, conservator or %22best friend%22 of the child(ren) who were born out of wedlock. [] The Petitioner is enlisted in the military and [ ] has OR [ ] has not been deployed for at least one day during the past 6 months. Date of Birth 2. INFORMATION ABOUT THE RESPONDENT Name: Address: Occupation: My relationship to the child(ren) for whom I request orders of Paternity, Legal Decision-Making, Parenting Time and Child Support: [ ] Mother [ ] He claims to be the Father [] The Respondent is enlisted in the military and [ ] has OR [ ] has not been deployed for at least one day during the past 6 months. Date of Birth Superior Court of Arizona in Yavapai County January 2013 Page 1 of 7 DRP11f American LegalNet, Inc. www.FormsWorkFlow.com 3. WHY I AM FILING THIS COURT CASE AGAINST THE RESPONDENT IN ARIZONA: (Check one or more boxes that are true.) [ ] The Respondent is a resident of Arizona [ ] I will personally serve the Respondent in Arizona. (see packet on service to learn how to do this.) [ ] The Respondent agrees to have the case heard here and will file written papers in the case. [ ] The Respondent lived with the child(ren) in Arizona at some time. [ ] The Respondent lived in Arizona and provided pre-birth expenses or support for the child(ren). [ ] The child lives in Arizona as a result of the acts or directions of the Respondent. [ ] The Respondent had sexual intercourse in Arizona as a result of which the child(ren) may have been conceived. [ ] The Respondent did any other acts that substantially connect the Respondent with Arizona (see a lawyer to help you determine this). INFORMATION ABOUT THE CHILD(REN) FOR WHOM I REQUEST ORDERS: Child's Name: Birth date: Address: Length of time at address: Names and addresses of persons lived with for the past five (5) years: 4. Present addresses of person(s) lived with: Child's Name: 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: 5. LEGAL DECISION-MAKING 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 legal decision-making or parenting time of any child(ren) named above. (If so, explain below, using extra pages if necessary.) Superior Court of Arizona in Yavapai County January 2013 Page 2 of 7 DRP11f American LegalNet, Inc. www.FormsWorkFlow.com Name of child: Court state: Court case number: How the child is involved: Summary of any court order: 6. 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, drugs, sexual offenses, termination of parental rights and adoptions. (If so, explain below, using extra pages if necessary.). Court state: Court case number: Nature of the proceeding: 7. LEGAL DECISION-MAKING 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 Petitioner or the Respondent, who provides primary physical residence for the child(ren) or claims rights of legal decision-making, primary physical care, 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: Court location: Status: Court location: Status: STATEMENTS ABOUT PATERNITY: 8. WHY I THINK CHILD(REN): IS THE FATHER OF THE Name of purported father (Check which box applies. More choices on next page.) [ ] AFFIDAVIT: Petitioner and Respondent signed an Affidavit of Paternity acknowledging that [ ] Petitioner [ ] Respondent is the child(ren)'s natural father. A certified copy is attached to this Petition. [] BLOOD TEST: The parties had DNA (Deoxyribonucleic Acid) Testing administered and is shown to be the minor child(ren)'s natural father. A copy of the report is attached to this Petition. PARTIES LIVING TOGETHER: Petitioner and Respondent were not married to each other at any time during the ten months before birth of the child(ren). However, the parties lived together during the period(s) when the child(ren) could have been conceived. [] Superior Court of Arizona in Yavapai County January 2013 Page 3 of 7 DRP11f American LegalNet, Inc. www.FormsWorkFlow.com [] SEXUAL INTERCOURSE: Petitioner and Respondent were not living together but had sexual intercourse at the probable date of conception of the child(ren). The mother of the child(ren) did not have sexual intercourse with anyone else during the period in which the child(ren) could have been conceived. OTHER (explain) [] 9. ABOUT MARRIAGE AND HUSBAND -- check one box. [ ] Mother was not married at time child(ren) were born or conceived or at least 10 months before child(ren) were born or conceived, OR [] Mother was married when child(ren) were born or conceived or at least 10 months before child(ren) were born or conceived, but husband is not father of child(ren). Husband is a party to this court case because of marriage. OTHER STATEMENTS TO THE COURT: 10. MEDICAL EXPENSES: [ ] THERE ARE [ ] THERE ARE NOT unreimbursed medical expenses incurred by the mother, resulting from the birth of the minor child(ren). If there are, these costs and expenses should be awarded to [ ] PETITIONER [ ] RESPONDENT according to A.R.S. § 25-320. OTHER EXPENSES: The parties should be ordered to divide between them any uninsured medical, dental, or health expenses, reasonably incurred for the minor child(ren), in proportion to their respective incomes. [] The Attorney General's office is involved in this case (TANF, IV-D, etc.). 11. 12. 13. WRITTEN AGREEMENTS. CHECK ONLY IF TRUE: [] For our child(ren), my