COURT OF COMMON PLEAS DIVISION OF DOMESTIC RELATIONS HAMILTON COUNTY, OHIO

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Plaintiff	Case No.
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Address	Judge
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City, State, and Zip Code	Magistrate
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vs
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COMPLAINT FOR ALLOCATION OF PARENTAL RIGHTS AND RESPONSIBILITIES (CUSTODY) AND/OR PARENTING TIME (VISITATION)
Defendant	:
Address	:
City, State, and Zip Code	:

I, , (name) am the Plaintiff and parent of the following child(ren):

Name	Birth Date:
Name	Birth Date:
Name	Birth Date:
Name	Birth Date:

The Defendant, , is the parent of the child(ren).

The parents of the child(ren) are married or divorced. Date of Marriage:

A copy of documentation providing proof of marital status is attached.

The child(ren) has/have resided in County, Ohio since (date residence established) as set out in the Affidavit in Compliance with 3127.23 of the Ohio Revised Code.

The parent-child relationship has has not (select one) been established. If it has been established, a copy of the order establishing the parent-child relationship or other supporting documentation is attached. A copy of the child(ren)’s birth certification is also attached.

6.	The following Court has issued an order about the following child(ren):

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7.	No Court has issued an order about the following child(ren):

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8.	I request that the Court (check all that apply):

Name the Plaintiff Defendant (select one) as the residential parent and legal	custodian of the child(ren).

Grant reasonable parenting time (visitation) to the non-residential parent.

Adopt the proposed Shared Parenting Plan for the child(ren) which is attached.

Order the appropriate amount of child support for the child(ren), allocate the income tax	dependency exemption for the child(ren), and determine who should provide health insurance	coverage for the child(ren).

Other (specify):

9.	It would be in the best interest of the child(ren) for the Plaintiff to have custody/visitation orders as requested for the following reasons:

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Plaintiff’s Signature	Date

CERTIFICATE OF SERVICE

I hereby certify that a copy of the foregoing Complaint has been served by Certified Mail/Personal Service/Ordinary U.S. Mail to:

Name
Address
City	State	Zip Code
On this date: