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

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Plaintiff	Case No.
:
Address	Judge
:
City, State, and Zip Code	Magistrate
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vs
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COMPLAINT FOR ALLOCATION OF PARENTAL RIGHTS AND RESPONSIBILITIES (CUSTODY), PARENTING TIME (VISITATION), CHILD SUPPORT, MEDICAL EXPENSES, TAX EXEMPTION, OR OTHER CHILD-RELATED EXPENSES
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):

.

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

.

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.

Other (specify): .

9.	I request that the Court order my right to receive support or my obligation to provide support for the	minor child(ren) as follows (check all that apply):

The amount of child support to be paid each month. I request the Court order

.

The person responsible for providing health insurance for the child(ren). I request the Court	order: .

The amount of non-insured health care expenses of the minor child(ren) that I have to pay.	I request the Court order: .

The person who can claim the child(ren) as tax dependents. I request the Court order: .

Other child-related expenses. I request the Court order: .

10.	I believe my requests are in the best interest of the child(ren) for the following reasons: .

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/Process Server to:

Name
Address
City	State	Zip Code
On this date:

NOTICE OF HEARING

Notice is hereby given that a hearing for Establishment of Custody and Child Support has been scheduled on (date)
at (time)	for 30 minutes before Magistrate
in Room	.	Said hearing will take place at 800 Broadway, Cincinnati, Ohio.