Petition, you may have to pay for things such as . Is this alternate residential parent (ARP) on probation or parole? IN THE CIRCUIT COURT OF DAVIDSON COUNTY, TENNESSEE NOTICE OF STATUTORY INJUNCTION PURSUANT TO T.C.A. 2. Tick mark in the appropriate box. Last Name: ___________________________________ First Name: _______________________________ Middle Name: _______________, Maiden Name: ________________________________. PETITION FOR CUSTODY AND/OR VISITATION . Reviewing the forms ahead of time can ease the stress. 10. Mother __________ Father __________ Both _________ Neither __________, Carrier name (excluding TennCare): ___________________________________________________________________________________________, Policy number: ____________________________________________ Insured’s name: _____________________________________________, Monthly insurance premium: _________________________________ Number of family members covered by policy: _____________________, Name(s) of the child(ren) who are covered by this policy, _________________________________________________________ ______________________________________________________, Do the child(ren) have any unpaid medical bills? Enter the information about other/additional contacts of ARP. Furnish the names of child(ren) covered under the policy. If you are the alternate residential parent (ARP), provide the following information about yourself. My case will be submitted to the IRS Treasury Offset Program if it meets the following conditions: A. Enter your name in the space provided on line 1 of the application. Law for Families provides all the legal information that you and your family need. If I get a private attorney to represent me in obtaining child support, I agree to tell the Child Support agency immediately. Mention the city, county, and state of the birth of the child. Furnish information about the employer of PRP in section 4. Information about the Child (Ren)’S Medical Support. Statute(s) Tennessee Code, Title 36, Chapter 6, Section 36-6-101, et seq. Yes No If yes, provide the following information about your parent or guardian: Last Name: _______________________________________ First Name : ________________________ Middle Name: ____________________, Address: _____________________________________________________________________________________________________________, City: _______________________________________________ State: ____________________________ Zip: ________________________, Phone (Home): (______)____________________________ (Cell): (______)_____________________ (Work): (_____)___________________, 3. Yes __ No __ (If no, provide the other party a copy of the unpaid bills, Do the child(ren) have any recurring medical expenses not covered by Yes __ No __, List below each of the children of the other parent shown on this application for whom you are requesting child support services. Describe. 4. Serve your spouse with the complaint and summons. Has the alternate residential parent (ARP) ever served in the armed forces? Child(ren) under 18 years of age . Yes No In which other state(s) did you receive these benefits? Edit & Download. If you and your spouse can agree to a custody arrangement, you will decide which spouse gets custody … The services provided by the Child Support agency only include enforcing rights to child support, obtaining and enforcing health insurance. Based on section 466(a)(13) of the Social, Security Act [42 U.S.C. Nothing will occur in the modification action until a change that affects the welfare of the child has been proven. Develop a temporary parenting plan, as encouraged by Tennessee courts. Child’s Last Name _____________________ First Name _______________________ Middle Name ____________, 6. 11. Your county clerk will typically have blank pre-printed forms you may use. More Info... Get Help With Tennessee Child Custody. Is the alternate residential parent (ARP) self-employed? JC-15 - Petition to modify order: For children's cases ; JC-17 - Notice to appeal ; JC-17A - Appeal bond ; JC-21 A&B - Petition for Custody and/or Visitation; JC-21C - Petition for contempt; JC-26A - Petition for child … You can have the sheriff's department perform the service, or do it by certified mail (return receipt requested) or regular mail. B. affidavit of the amount owed by the alternate residential parent (ARP). 8. Take the required parenting seminar. The Child Support attorney handling my case represents the State of Tennessee, not me personally. Temporary Assistance to Needy Families (TANF) benefits, the State will charge me a $25 annual fee for providing child support services, but only after collecting at least $500 for my case in an annual period. Specify marital relationship between the ARP and PRP between choices yes or no and proceed with furnishing information about marriage, separation, and, Provide the information of the child support service if any pursuant for child support. In Tennessee, this particular legal action can be filed by the mother, child, father, putative father, … ), Have you presented the unpaid medical bills to the insurance company? For help by phone, dial 211 for Tennessee’s community services help line or visit the 211 website. Continue furnishing the relationship of ARP with the child (ren) on the following line. (The PRP is the parent with whom the child(ren) resides more than 50% of the time) NOTE: For the purpose of completing this application. Furnish current/ last known mailing and living address of ARP and specify if it is a good address or not. (through court, IV-D agency, or directly to caretaker) Amount of support ordered, Pay frequency ordered (weekly, monthly, other, etc.) Mention the Social Security Number/s of all individuals related to the child. Has the primary residential parent (PRP) / caretaker ever been married to the alternate residential parent (ARP)? To the Honorable Dan H. Michael, Judge of the Juvenile Court of Memphis and Shelby County, Tennessee: COMES NOW the … Mention the employment status of ARP followed by the nature of occupation. §36-6-404, the Administrative Office of the Courts developed a parenting plan form that shall be used consistently by each court … • Guarantee that our attempts to establish or enforce child support will be successful, • Handle matters that are not related to child support such as divorce, visitation or custody disputes, or. Type the social security number and date of birth of the child in the space on the following line. benefits previously provided by the State. If yes, provide any information you have about the existing court order(s). What is the caretaker’s relationship to the child(ren) (mother / father / grandmother / etc.)? 14. … Child’s Last Name _____________________ First Name _______________________ Middle Name ____________, INFORMATION ABOUT THE CHILDREN (continued), 4. 12. It is possible that your SSN and those of the child(ren) will be used to file interstate child support, enforcement actions and to enroll the child(ren) as beneficiaries of health insurance coverage, and, as such, may be released to the other, parent. Describe any assets the alternate residential parent (ARP) may own. • You must notify us immediately if you move or change your telephone number. Do you want this case to be managed by a child support office located in a county other than the one in which you live? More Info... Family Court Fee. Identifying information for the primary residential parent (PRP) / caretaker, Date of Birth: ______/______/________ Social Security Number: ________-________-________ Sex: ______________, Address of the primary residential parent (PRP) / caretaker, MAILING address: __________________________________________________________________________________________________, City: ______________________________________ State: ______________ Zip: _______________ County: _______________________, Phone (Home): (_____)______________________ (Cell): (_____)_______________________ (Work): (_____)_______________________, LIVING address: ___________________________________________________________________________________________________, 4. I further understand that if my case is submitted for the IRS Treasury Offset Program: A. Jurisdiction to make custody determination. Appellate Court forms Divorce forms-no children (Supreme Court approved) NEW!! Courts rarely grant sole custody to a parent without a meaningful showing as to why it is in the child's best interest. • Establish and enforce court orders for child support payments, unpaid medical bills, and/or medical insurance, • Review and modify child support orders, and. These forms often require you to fill in the details, but contain the specific language needed to meet the legal requirements for a change in custody. Yes No. The alternate residential parent’s SSN is necessary to properly identify that parent for the purpose of locating him/her, for submitting. Mark your choice between yes or no in section 3 and proceed by furnishing supporting information in the space provided in subsequent lines in case response you mark is yes. overpayments or payments sent in error, I will pay the costs of such action, including court costs and attorney fees. The court will consider the following major factors: emotional ties of child with parent; parental ability to provide child with necessities; stability and continuity in the child's life, mental and physical health of parents; and home, school and community record of the child. Yes __ No __ (If yes, provide a copy of the Explanation of Benefits, Have you presented the unpaid medical bills to the other party? Address of the alternate residential parent (ARP): Current or last known MAILING address: ________________________________________________________________________________, City: _______________________________________________ State: ____________________________ Zip: ______________________, Current or last known LIVING address: __________________________________________________________________________________, City: _______________________________________________ State: _____________________________ Zip: ______________________, 6. 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