Form 41-1

This petition to modify an order rendered in a suit affecting the parent-child relationship must be filed under the same docket number in the court of continuing jurisdiction.

NOTICE: THIS DOCUMENT
CONTAINS SENSITIVE DATA

[Caption. See § 3 of the Introduction in volume 1 of this manual.]

Petition to Modify Parent-Child Relationship

1.Discovery
TRCP 190.1

1.Discovery

Discovery in this case is intended to be conducted under [level 2/level 3] of rule 190 of the Texas Rules of Civil Procedure. [If level 3, see form 5-1.]

Preservation of Evidence: Respondent is put on notice to preserve and not destroy, conceal, or alter any evidence or potential evidence relevant to the issues in this case, including tangible documents or items in Respondent’s pos­session or subject to Respondent’s control and electronic documents, files, or other data generated by or stored on Respondent’s home computer, work com­puter, storage media, portable systems, electronic devices, online repositories, or cell phone.

2.Objection to Assignment of Case to Associate Judge
§ 201.005

2.Objection to Assignment of Case to Associate Judge

Petitioner objects to the assignment of this matter to an associate judge for a trial on the merits or presiding at a jury trial.

3.Parties and Order
§§ 102.008, 156.001 et seq.; TCPRC § 30.014

3.Parties and Order to Be Modified

This suit to modify a prior order is brought by [name of petitioner], Peti­tioner. [The last three numbers of Petitioner’s driver’s license number are [numbers]./Petitioner has not been issued a driver’s license.] [The last three numbers of Petitioner’s Social Security number are [numbers]./Petitioner has not been issued a Social Security number.] Petitioner is the [specify] of the child[ren] and has standing to bring this suit. The requested modification will be in the best interest of the child[ren].

Respondent is [name of respondent].

The order to be modified is entitled [title of order] and was rendered on [date].

4.Jurisdiction
§ 102.008(b)(1)

4.Jurisdiction

This Court has continuing, exclusive jurisdiction of this suit.

5.Child[ren]
§ 102.008(b)(2)

5.Child[ren]

The following child[ren] [is/are] the subject of this suit:

Name:

Sex:

Birth date:

County of residence:

6.Parties Affected
§§ 102.008(b)(3)–(8), 156.003

6.Parties Affected

6.A.Parties

The following parties may be affected by this suit:

Name:

Relationship: [e.g., joint managing conservator, managing conservator, posses­sory conservator, parent, guardian of person, guardian of estate]

•Service
§ 102.009

1.Personal

Process should be served [include if applicable: at [address, city, state, zip code]].

2.Waiver

No service is necessary at this time.

3.Substituted
§ 102.010

Citation by publication or other substituted service is necessary for the reasons stated in the affidavit attached as Exhibit [exhibit number/letter].

6.B.UCCJEA Information
§ 152.209

Information required by section 152.209 of the Texas Family Code is provided in the affidavit attached as Exhibit [exhibit number/letter].

7.Nonresident Entitled to Citation
§ 102.011

7.Nonresident Entitled to Citation

[Name of nonresident], named above, is a nonresident of Texas.

7.A.Child[ren] Reside[s] in Texas
§ 102.011(b)(3)

The child[ren] the subject of this suit reside[s] in Texas as a result of the acts or directives of the nonresident person.

7.B.Former Resident
§ 102.011(b)(4)

The nonresident person has resided in Texas with the child[ren] the sub­ject of this suit.

7.C.Payment of Prenatal Expenses or Support
§ 102.011(b)(5)

The nonresident person has resided in Texas and provided prenatal expenses or support for the child[ren] the subject of this suit.

7.D.In-State Intercourse
§ 102.011(b)(6)

The nonresident person engaged in sexual intercourse in Texas, and the child[ren] the subject of this suit may have been conceived by that act of inter­course.

7.E.Personal Service of Citation
§ 102.011(b)(1)

The nonresident person was or will be personally served with citation in Texas.

7.F.Submission to Jurisdiction
§ 102.011(b)(2)

The nonresident person has submitted or will submit to the jurisdiction of Texas by consent, by entering a general appearance, or by filing a respon­sive document having the effect of waiving any contest to personal jurisdic­tion.

7.G.Paternity Registry/AOP
§ 102.011(b)(7)

The nonresident person [registered with the paternity registry main­tained by the vital statistics unit/signed an acknowledgment of paternity of a child born in Texas who is the subject of this suit] as provided by chapter 160 of the Texas Family Code.

7.H.Other Long-Arm Jurisdiction Facts
§ 102.011(b)(8)

8.Insurance Information
§§ 154.181(b), 154.1815(c)

8.Insurance Information

Information required by sections 154.181(b) and 154.1815(c) of the Texas Family Code is provided in the statement attached as Exhibit [exhibit number/letter].

9.Property

9.Child[ren]’s Property

9.A.No Change

There has been no change of consequence in the status of the child[ren]’s property since the prior order was rendered.

9.B.Change Since Prior Order

The following changes in the status of the child[ren]’s property have occurred since the prior order was rendered: [describe changes].

10.Protective Order Statement
§ 102.008(b)(11)

10.Protective Order Statement

10.A.No Order or Pending Application

No protective order under title 4 of the Texas Family Code, protective order under subchapter A of chapter 7B of the Texas Code of Criminal Proce­dure, or order for emergency protection under article 17.292 of the Texas Code of Criminal Procedure is in effect in regard to a party to this suit or a child of a party to this suit, and no application for any such order is pending.

10.B.Order Issued

[Include as applicable: A protective order under title 4 of the Texas Fam­ily Code/A protective order under subchapter A, chapter 7B, of the Texas Code of Criminal Procedure/An order for emergency protection under article 17.292 of the Texas Code of Criminal Procedure] in regard to [a party/[a] child[ren] of a party/a party to this suit and [a] child[ren] of a party] to this suit was issued by the [designation] Court in Cause No. [number] and was entered on [date]. A copy of the order is [attached to this petition as Exhibit [exhibit number/letter]/not available at this time, but a copy of the order will be filed with the Court before any hearing]. [Repeat as applicable if more than one order is in effect.]

10.C.Application Pending

An application for [include as applicable: a protective order under title 4 of the Texas Family Code/a protective order under subchapter A, chapter 7B, of the Texas Code of Criminal Procedure/an order for emergency protection under article 17.292 of the Texas Code of Criminal Procedure] is pending with regard to [a party/[a] child[ren] of a party/a party to this suit and [a] child[ren] of a party] to this suit. The application for [protective order/order for emer­gency protection] was filed on [date] in the [designation] Court in Cause No. [number]. [Repeat as applicable if more than one application is pending.]

11.Modification of Conservatorship or Possession and Access

11.Modification of [Conservatorship/Possession and Access]

11.A.Change of Conservatorship or Possession and Access—Grounds
§ 156.101

11.A.1.Change in Circumstances
§ 156.101(1)

11.A.1.a.Order Not Based on Agreement

The order to be modified is not based on a mediated or collaborative law settlement agreement. The circumstances of the child[ren], a conservator, or other party affected by the order to be modified have materially and substan­tially changed since the date of rendition of the order to be modified.

11.A.1.b.Order Based on Agreement

The order to be modified is based on a [mediated/collaborative law] set­tlement agreement. The circumstances of the child[ren], a conservator, or other party affected by the order to be modified have materially and substantially changed since the date of the signing of the [mediated/collaborative law] set­tlement agreement on which the order to be modified is based.

11.A.2.Preference of Child 12 or Older
§ 156.101(2)

[Name], [the/a] child the subject of this suit, is twelve years of age or older and [has expressed/will express] to the Court in chambers, as provided in section 153.009 of the Texas Family Code, the name of the person who is the child’s preference to have the exclusive right to designate the primary resi­dence of the child.

11.A.3.Voluntary Relinquishment by Conservator with Exclusive Right to Designate Primary Residence
§ 156.101(3)

The conservator who has the exclusive right to designate the primary residence of the child[ren] has voluntarily relinquished the primary care and possession of the child[ren] to another person for at least six months, and such temporary relinquishment is not a result of the conservator’s military deploy­ment, military mobilization, or temporary military duty as those terms are defined in section 153.701 of the Texas Family Code.

11.B.Modification of Exclusive Right to Designate Primary Residence of Child[ren] within 1 Year
§ 156.102

11.B.1.Order Not Based on Agreement

The order to be modified is not based on a mediated or collaborative law settlement agreement. This suit to modify the designation of the person having the exclusive right to designate the primary residence of the child[ren] is filed within one year after the date of the rendition of the order to be modified. Peti­tioner’s affidavit setting forth the statutory allegations and supporting facts is attached as Exhibit [exhibit number/letter].

11.B.2.Order Based on Agreement

The order to be modified is based on a [mediated/collaborative law] set­tlement agreement. This suit to modify the designation of the person having the exclusive right to designate the primary residence of the child[ren] is filed within one year after the date of the signing of the [mediated/collaborative law] settlement agreement on which the order to be modified is based. Petitioner’s affidavit setting forth the statutory allegations and supporting facts is attached as Exhibit [exhibit number/letter].

11.C.Respondent Convicted of Child Abuse
§ 156.104

[Respondent has been convicted of an offense under section 21.02 of the Texas Penal Code/Respondent has been convicted of an offense involving the abuse of a child under section [21.11/22.011/22.021] of the Texas Penal Code/Respondent has had an order deferring adjudication with regard to an offense involving the abuse of a child under section [21.11/22.011/22.021] of the Texas Penal Code].

11.D.Respondent Convicted of Family Violence
§ 156.1045

[Respondent has been convicted of/Respondent has had an order defer­ring adjudication with regard to] an offense involving family violence.

11.E.Death of Conservator
§ 156.106

[Name], who was [a/the] [sole managing/joint managing/possessory] conservator of the child[ren], has died.

11.F.Conservatorship—Relief Requested

11.F.1.Change of Conservatorship—by Agreement
§ 153.007

Petitioner believes that the parties will enter into a written agreement containing provisions for modification of the order providing for conservator­ship of the child[ren].

11.F.2.Change of Conservatorship— Requested Relief

Petitioner requests that [he/she] be appointed as the person who [has/does not have] the right to designate the primary residence of the child[ren].

Petitioner requests that the rights and duties of the respective conserva­tors of the child[ren] be modified to provide as follows: [state modification requested].

11.G.History or Pattern of Family Violence or Child Abuse or Child Neglect, or Final Protective Order Against Respondent
§ 153.005(c)

11.G.1.Family Violence
§ 153.005(c)(1)

Preceding the filing of this suit, Respondent has engaged in a history or pattern of family violence, as defined by section 71.004.

11.G.2.Child Abuse or Neglect
§ 153.005(c)(2)

Preceding the filing of this suit, Respondent has engaged in a history or pattern of [child abuse/child neglect/child abuse and child neglect].

11.G.3.Final Protective Order
§ 153.005(c)(3)

Preceding the filing of this suit, a final protective order was rendered against Respondent.

11.G.4.Request

Petitioner requests that the Court consider this conduct in appointing the Petitioner as sole managing conservator or the parties as joint managing con­servators.

11.H.Possession and Access—Relief Requested

11.H.1.Change of Possession and Access—by Agreement

Petitioner believes that the parties will enter into a written agreement containing provisions for modification of the order providing for possession of and access to the child[ren].

11.H.2.Change of Possession and Access—Requested Relief

Petitioner requests that the terms and conditions for access to or posses­sion of the child[ren] be modified to provide as follows: [state modification requested, including, if appropriate, a request for electronic communication].

11.H.3.Respondent Committed Family Violence or Sexual Offense Resulting in Pregnancy
§ 153.004(d)

11.H.3.a.Respondent Committed Family Violence
§ 153.004(d)(1)

Respondent has a history or pattern of committing family violence during the two-year period preceding the date of filing of this suit. Petitioner requests the Court to deny Respondent access to the child[ren]. Alternatively, if the Court finds that awarding Respondent access to the child[ren] would not endanger the child[ren]’s physical health or emotional welfare and would be in the best interest of the child[ren], Petitioner requests that the Court render a possession order that is designed to protect the safety and well-being of the child[ren] and any other person who has been a victim of family violence com­mitted by Respondent, including but not limited to ordering that the periods of access be continuously supervised by an entity or person chosen by the Court, ordering that the exchange of possession of or access to the child[ren] occur in a protective setting, [include if applicable: ordering Respondent to refrain from the consumption of alcohol or a controlled substance within the twelve hours before or during each of Respondent’s periods of possession of or access to the child[ren],] and ordering Respondent to attend and complete a battering inter­vention and prevention program or, if such a program is not available, to com­plete a course of treatment with a mental health professional in accordance with section 153.010 of the Texas Family Code.

11.H.3.b.Respondent Committed Sexual Offense Resulting in Victim’s Pregnancy with Child
§ 153.004(d)(2)

Respondent has engaged in conduct that constitutes an offense under section [21.02/22.011/22.021/25.02] of the Texas Penal Code and, as a direct result of the conduct, the victim of the conduct became pregnant with Respon­dent’s child, [name of child]. Petitioner requests the Court to deny Respondent access to the child. Alternatively, if the Court finds that awarding Respondent access to the child would not endanger the child’s physical health or emotional welfare and would be in the best interest of the child, Petitioner requests that the Court render a possession order that is designed to protect the safety and well-being of the child, including but not limited to ordering that the periods of access be continuously supervised by an entity or person chosen by the Court [,/and] ordering that the exchange of possession of or access to the child occur in a protective setting [include if applicable: , and ordering Respondent to refrain from the consumption of alcohol or a controlled substance within the twelve hours before or during each of Respondent’s periods of possession of or access to the child].

11.H.4.History of Family Violence or Child Abuse or Neglect
§ 153.004(e), (f)

There is a history or pattern of [child neglect/child abuse/family vio­lence/child neglect and abuse/child neglect and family violence/child abuse and family violence/child abuse, child neglect, and family violence] committed by [Respondent/[name], who [resides in Respondent’s household/is permitted by Respondent to have unsupervised access to the child[ren] during Respon­dent’s periods of possession of or access to the child[ren]]]. [Include if applica­ble: A protective order was rendered under chapter 85 of title 4 of the Texas Family Code against [Respondent/[name]] during the two-year period preced­ing the date of filing of this suit.] Petitioner requests the Court to deny Respon­dent access to the child[ren]. Alternatively, Petitioner requests that the Court render a possession order that provides that Respondent’s periods of visitation be continuously supervised by an entity or person chosen by the Court.

11.I.Election of Alternative Possession Times

If the Court renders the standard possession order set forth in chapter 153 of the Texas Family Code, Petitioner elects [all the alternative beginning and ending possession times set forth in section 153.317(a) of the Texas Fam­ily Code to which Petitioner is entitled/the alternative beginning and ending possession times set forth in section 153.317(a)([specify subsection(s) of Code section 153.317(a) containing alternative time(s) being elected]) of the Texas Family Code].

11.J.Declining Alternative Possession Times

If the Court renders the standard possession order set forth in chapter 153 of the Texas Family Code, Petitioner declines [all the alternative begin­ning and ending possession times provided in section 153.3171(a) of the Texas Family Code to which Petitioner is entitled/the alternative beginning and end­ing possession times provided in section 153.3171(a) that are set forth in sec­tion 153.317(a)([specify subsection(s) of Code section 153.317(a) containing alternative time(s) being declined]) of the Texas Family Code].

11.K.Increased Expenses Because of Change of Residence
§ 156.103

Respondent’s change of residence has caused Petitioner to incur increased costs. Petitioner requests that the increased costs incurred by Peti­tioner to exercise Petitioner’s periods of possession of the child[ren] be allo­cated in a manner deemed by the Court to be fair and equitable, taking into account the cause of the increased costs and the best interest of the child[ren]. Petitioner requests that any increase be made retroactive to the earlier of the time of service of citation on Respondent or the appearance of Respondent in this modification action.

11.L.Security for Possession and Access
§§ 153.011, 157.109(a)(1)

Respondent may violate the Court’s order relating to Respondent’s pos­sessory interest in the child[ren]. [Include if applicable: Respondent has denied possession of or access to the child[ren], [name[s]], on two or more occasions.] Petitioner requests the Court to order Respondent to execute a bond or deposit security in a reasonable amount, conditioned on Respondent’s compliance with the Court’s orders concerning possession of and access to the child[ren].

11.M.International Abduction
§ 153.501

Petitioner requests the Court to determine whether there is a risk of international abduction of the child[ren] by Respondent and to take such mea­sures as are necessary to protect the child[ren].

11.N.Parenting Coordinator/Facilitator
§§ 153.603(d), 153.605(a), (b), 153.6051(a), (b)

Petitioner requests the Court to appoint a parenting [coordinator/facilitator/coordinator or facilitator]. [This case is a high-conflict case./There is good cause for appointment of a parenting [coordinator/facilitator/coordinator or facilitator] in that [specify good cause], and the appointment would be in the best interest of the child[ren]].

11.O.Best Interest of Child[ren]

The requested modification is in the best interest of the child[ren].

12.Modification of Support

12.Support

12.A.Decrease or Increase— Changed Circumstances
§§ 156.401–.408

12.A.1.Order Not Based on Agreement

The order to be modified is not based on a mediated or collaborative law settlement agreement. The circumstances of the child[ren] or a person affected by the order have materially and substantially changed since the date of the rendition of the order to be modified, and the support payments previously ordered should be [decreased/increased until the child[ren] [is/are] eighteen years of age and, if the child[ren] [is/are] enrolled under chapter 25 of the Texas Education Code in an accredited secondary school in a program leading toward a high school diploma and complying with the minimum attendance requirements of subchapter C of chapter 25 of the Education Code, or enrolled under section 130.008 of the Education Code in courses for joint high school and junior college credit and complying with the minimum attendance require­ments of subchapter C of chapter 25 of the Education Code, or enrolled on a full-time basis in a private secondary school in a program leading toward a high school diploma and complying with the minimum attendance require­ments imposed by that school, until the end of the month in which the child[ren] graduate[s] from high school]. [Include if applicable: The support payments previously ordered are not in substantial compliance with the guide­lines in chapter 154 of the Texas Family Code, and the requested [decrease/increase] would be in the best interest of the child[ren].] [Include if applicable: Petitioner has been incarcerated in a [local/state/federal] [jail/prison] for a period exceeding 180 days.] [Include if applicable: Respondent’s child support obligation was [abated/reduced/suspended] during Respondent’s incarceration, and Respondent has been released from incarceration.] Petitioner requests that any [decrease/increase] be made retroactive to the earlier of the time of service of citation on Respondent or the appearance of Respondent in this modification action.

12.A.2.Order Based on Agreement

The order to be modified is based on a [mediated/collaborative law] set­tlement agreement. The circumstances of the child[ren] or a person affected by the order have materially and substantially changed since the date of the sign­ing of the [mediated/collaborative law] settlement agreement on which the order to be modified is based, and the support payments previously ordered should be [decreased/increased until the child[ren] [is/are] eighteen years of age and, if the child[ren] [is/are] enrolled under chapter 25 of the Texas Educa­tion Code in an accredited secondary school in a program leading toward a high school diploma and complying with the minimum attendance require­ments of subchapter C of chapter 25 of the Education Code, or enrolled under section 130.008 of the Education Code in courses for joint high school and junior college credit and complying with the minimum attendance require­ments of subchapter C of chapter 25 of the Education Code, or enrolled on a full-time basis in a private secondary school in a program leading toward a high school diploma and complying with the minimum attendance require­ments imposed by that school, until the end of the month in which the child[ren] graduate[s] from high school]. [Include if applicable: The support payments previously ordered are not in substantial compliance with the guide­lines in chapter 154 of the Texas Family Code, and the requested [decrease/increase] would be in the best interest of the child[ren].] [Include if applicable: Petitioner has been incarcerated in a [local/state/federal] [jail/prison] for a period exceeding 180 days.] [Include if applicable: Respondent’s child support obligation was [abated/reduced/suspended] during Respondent’s incarceration, and Respondent has been released from incarceration.] Petitioner requests that any [decrease/increase] be made retroactive to the earlier of the time of service of citation on Respondent or the appearance of Respondent in this modification action.

12.B.Decrease or Increase— Three Years
§§ 156.401–.408

It has been three years since the order to be modified was [rendered/last modified], and the monthly amount of support ordered differs by [20 percent/$100] from the amount that would be awarded in accordance with the guide­lines in chapter 154 of the Texas Family Code. The support payments previ­ously ordered should be [decreased/increased until the child[ren] [is/are] eighteen years of age and, if the child[ren] [is/are] enrolled under chapter 25 of the Texas Education Code in an accredited secondary school in a program leading toward a high school diploma and complying with the minimum atten­dance requirements of subchapter C of chapter 25 of the Education Code or enrolled under section 130.008 of the Education Code in courses for joint high school and junior college credit and complying with the minimum attendance requirements of subchapter C of chapter 25 of the Education Code, or enrolled on a full-time basis in a private secondary school in a program leading toward a high school diploma and complying with the minimum attendance require­ments imposed by that school, until the end of the month in which the child[ren] graduate[s] from high school]. Petitioner requests that any [decrease/increase] be made retroactive to the earlier of the time of service of citation on Respondent or the appearance of Respondent in this modification action.

12.C.Increase or Decrease— Agreement
§ 154.124

Petitioner believes that the parties will enter into a written agreement containing provisions for modification of the order providing for support of the child[ren].

12.D.Disabled Child
§ 154.302

12.D.1.Minor Disabled Child

[Name of child], a child the subject of this suit, requires substantial care and personal supervision because of a mental or physical disability and will not be capable of self-support. The Court is requested to order that payments for the support of this child be continued after the child’s eighteenth birthday and extended for an indefinite period.

12.D.2.Adult Disabled Child

[Name of child], an adult child of this marriage, requires substantial care and personal supervision because of a mental or physical disability and will not be capable of self-support. The disability existed or its cause was known to exist before or on [name of child]’s eighteenth birthday. The Court is requested to order that payments for the support of this child be extended for an indefi­nite period.

12.E.Child in School beyond 18 Years
§ 154.002

[Name of child], a child the subject of this suit, is [enrolled under chapter 25 of the Texas Education Code in an accredited secondary school in a pro­gram leading toward a high school diploma and is complying with the mini­mum attendance requirements of subchapter C of chapter 25 of the Education Code/enrolled under section 130.008 of the Texas Education Code in courses for joint high school and junior college credit and is complying with the mini­mum attendance requirements of subchapter C of chapter 25 of the Education Code/enrolled on a full-time basis in a private secondary school in a program leading toward a high school diploma and is complying with the minimum attendance requirements imposed by the school in which the child is enrolled]. The Court is requested to order that payments for the support of this child be continued until the end of the month in which the child graduates from high school.

12.F.Change in Physical Possession
§ 156.409

[Name] has [voluntarily relinquished the actual care, control, and pos­session of the child[ren]/been [incarcerated/sentenced to be incarcerated] for at least ninety days/relinquished the primary care and possession of the child[ren] in a proceeding under [title 3/chapter 262] of the Texas Family Code]. [Petitioner/[name of person with physical possession]] has had physical pos­session of the child[ren] for at least six months. The Court is requested to mod­ify the child support order to provide that [Petitioner/[name of person with physical possession]] shall have the right to receive and give receipt for pay­ments of support for the child[ren] and to hold or disburse money for the bene­fit of the child[ren].

12.G.Security for Child Support
§ 157.109(a)(2)

[Respondent is employed by an employer not subject to the Court’s jurisdiction./It is unworkable or inappropriate under existing circumstances for the Court to order withholding from Respondent’s earnings for child support.] Petitioner requests the Court to order Respondent to execute a bond or post security payable through the registry of the Court to Petitioner, conditioned on Respondent’s payment of child support.

12.H.Life Insurance
§ 154.016

Petitioner requests the Court to order Respondent to obtain and maintain a life insurance policy payable to Petitioner for the benefit of the child[ren] to be applied toward Respondent’s support obligation under the child support order in the event of Respondent’s death.

12.I.Order in Title IV-D Case Lacks Provision for Health or Dental Care Coverage
§ 156.401(a–2)

The order to be modified was rendered in a title IV-D case and does not provide for [health-care coverage as required under section 154.182/dental care coverage as required under section 154.1825/health-care coverage as required under section 154.182 or dental care coverage as required under sec­tion 154.1825] of the Texas Family Code. The Court is requested to order insurance coverage for the child in accordance with section[s] [154.182/154.1825/154.182 and 154.1825] of the Texas Family Code.

12.J.Best Interest of Child[ren]

The requested modification is in the best interest of the child[ren].

13.Temporary Orders
§ 105.001

13.Request for Temporary Orders

Petitioner requests the Court, after notice and hearing, to make tempo­rary orders for the safety and welfare of the child[ren], including but not lim­ited to the following:

13.A.Temporary Joint Managing Conservators
§ 105.001(a)(1)

Appointing Petitioner and Respondent temporary joint managing con­servators [include if applicable: and designating Petitioner as the conservator who has the exclusive right to designate the primary residence of the child[ren]].

13.B.Temporary Conservator with Right to Designate Primary Residence
§ 105.001(a)(1)

Appointing Petitioner the temporary conservator who has the right to designate the primary residence of the child[ren].

13.C.Temporary Support
§§ 105.001(a)(2), 101.0095, 101.020

Ordering Respondent to provide support for the child[ren], including the payment of child support and medical and dental support in the manner speci­fied by the Court, while this case is pending.

13.D.Temporary Conservator without Right to Designate Primary Residence
§ 105.001(a)(1)

Appointing Petitioner the temporary conservator who does not have the right to designate the primary residence of the child[ren].

13.E.Electronic Communication
§ 153.015(b)

Ordering reasonable periods of electronic communication between the child[ren] and Petitioner to supplement Petitioner’s periods of possession of the child[ren].

13.F.Residence Restriction
§§ 105.001(a)(1), (4), 153.134(b)(1)(A)

Restricting the primary residence of the child[ren] to [geographic area].

13.G.School Enrollment
§ 105.001(a)

[Awarding Petitioner the exclusive right to enroll the child[ren] in school./Ordering the parties to enroll the child[ren] in the public schools for the attendance zone of Petitioner’s residence./Ordering the parties to enroll the child[ren] as follows: [name of child] in [name and address of school] as long as the child is eligible to attend that school [repeat for each child if more than one].]

13.H.Travel Restriction
§ 105.001(a)(4)

Enjoining Respondent from removing the child[ren] beyond [geo­graphic area], acting directly or in concert with others.

13.I.Denial or Restriction of Possession or Access
§ 153.004(d), (d–1), (e)

Denying Respondent access to the child[ren] or, alternatively, rendering a possession order [in accordance with section 153.004(d–1)(2) of the Texas Family Code/providing that Respondent’s periods of visitation be continuously supervised]. [If Tex. Fam. Code §§ 153.501–.503 (international parental abduc­tion risk) apply, see form 55-1 for further restrictions.]

13.J.Child Custody Evaluation
§ 107.103

Ordering the preparation of a child custody evaluation regarding the cir­cumstances and condition of the child[ren] [,/and] the parties [include if appli­cable: , and the residence of any person requesting conservatorship of, possession of, or access to the child[ren]] and any issue or question relating to the suit at the request of the Court before or during the evaluation process.

13.K.Psychological or Psychiatric Evaluation
TRCP 204.4

Ordering the [psychological/psychiatric] evaluation of [name[s]] and the child[ren].

13.L.Parent Education and Family Stabilization Course
§ 105.009

Ordering the parties to attend a parent education and family stabilization course.

13.M.Parenting Coordinator/Facilitator
§§ 153.605(a), (b), 153.6051(a), (b)

Appointing a parenting [coordinator/facilitator/coordinator or facilita­tor]. [This case is a high-conflict case./There is good cause for appointment of a parenting [coordinator/facilitator/coordinator or facilitator] in that [specify good cause], and the appointment would be in the best interest of the child[ren].]

13.N.Ad Litem or Amicus
§§ 107.001, 107.021

13.N.1.Guardian Ad Litem

Appointing a guardian ad litem to represent the best interests of the child[ren].

13.N.2.Attorney Ad Litem

Appointing an attorney ad litem to provide legal services for the child[ren].

13.N.3.Amicus Attorney

Appointing an amicus attorney to provide legal services necessary to assist the Court in protecting the best interests of the child[ren].

13.O.ADR Participation
§ 153.0071; TCPRC § 154.021

Ordering the parties to participate in an alternative dispute resolution process before trial of this matter.

13.P.Tax Returns
§ 154.063

Ordering Respondent to produce copies of income tax returns for tax years [years], a financial statement, and current pay stubs by a date certain.

13.Q.Execution of Releases

Ordering Respondent to execute all necessary releases required by Peti­tioner to obtain any discovery allowed by the Texas Rules of Civil Procedure.

Ordering Respondent to execute all necessary releases pursuant to the Health Insurance Portability and Accountability Act (HIPAA) and 45 C.F.R. section 164.508 to permit Petitioner to obtain health-care information regard­ing the child[ren].

Ordering Respondent to execute for all health-care providers of the child[ren] an authorization for disclosure of protected health information to Petitioner pursuant to the Health Insurance Portability and Accountability Act (HIPAA) and 45 C.F.R. section 164.508.

Ordering Respondent to designate Petitioner as a person to whom pro­tected health information regarding the child[ren] may be disclosed whenever Respondent executes an authorization for disclosure of protected health infor­mation pursuant to the Health Insurance Portability and Accountability Act (HIPAA) and 45 C.F.R. section 164.508.

13.R.Interim Attorney’s Fees
§ 105.001(a)(5)

Ordering Respondent to pay reasonable interim attorney’s fees and expenses.

13.S.Pretrial Conference
TRCP 166

Ordering a pretrial conference to simplify the issues in this case and determine the stipulations of the parties and for any other matters the Court deems appropriate.

13.T.Basis for Order Changing Managing Conservator

With regard to the requested temporary order for managing conservator­ship, Petitioner would show the Court the following:

13.T.1.Endangering Environment
§ 156.006(b)(1)

These temporary orders are necessary because the child[ren]’s present circumstances would significantly impair the child[ren]’s physical health or emotional development, and the requested temporary order is in the best inter­est of the child[ren]. See the affidavit of Petitioner attached as Exhibit [exhibit number/letter].

13.T.2.Voluntary Relinquishment
§ 156.006(b)(2)

The child[ren]’s conservator who has the exclusive right to designate the primary residence of the child[ren] has voluntarily relinquished the primary care and possession of the child[ren] for more than six months, the requested temporary order is in the best interest of the child[ren], and such voluntary relinquishment is not a result of the conservator’s military deployment, mili­tary mobilization, or temporary military duty as those terms are defined in sec­tion 153.701 of the Texas Family Code.

13.T.3.Preference of Child 12 or Older
§ 156.006(b)(3)

The child[ren] [is/are] twelve years of age or older and [will express/[has/have] expressed] to the Court in chambers, as provided by section 153.009 of the Texas Family Code, the name of the person who is the child[ren]’s preference to have the exclusive right to designate the primary res­idence of the child[ren], and the requested temporary order is in the best inter­est of the child[ren].

14.Combined TRO and Temporary Injunction

14.Request for Temporary Restraining Order

Petitioner requests the Court to dispense with the necessity of a bond, and Petitioner requests that Respondent be temporarily restrained immediately, without hearing, and after notice and hearing be temporarily enjoined, pending the further order of this Court, from:

14.A.Ex Parte Temporary Orders without Affidavit
§ 105.001(a)(3), (b)

1.Disturbing Child[ren] or Another Party
§ 105.001(a)(3)

Disturbing the peace of the child[ren] or of another party.

2.Withdrawing Child[ren] from School or Day Care

Withdrawing the child[ren] from enrollment in the school or day-care facility where the child[ren] [is/are] presently enrolled.

3.Hiding Child[ren] from Petitioner

Hiding or secreting the child[ren] from Petitioner.

4.Disparaging Remarks

Making disparaging remarks regarding Petitioner [include if applicable: or Petitioner’s family] in the presence or within the hearing of the child[ren].

5.Consumption of Alcohol

Consuming alcohol within the [number] hours before or during each of Respondent’s periods of possession of or access to the child[ren].

6.Affecting Health or Dental Insurance

Canceling, altering, failing to renew or pay premiums on, or in any man­ner affecting the level of coverage that existed at the time this suit was filed of, any health or dental insurance policy insuring the child[ren].

14.B.Ex Parte Parent-Child Orders with Affidavit
§ 105.001(c)

As the basis for the extraordinary relief requested below, Petitioner would show that before the filing of this petition Respondent has engaged in the conduct stated in the affidavit attached as Exhibit [exhibit number/letter]. Based on that affidavit, Petitioner requests the Court to grant the following relief:

1.Attaching Child[ren]
§ 105.001(c)(1)

Issue an order attaching the [body/bodies] of the child[ren], [name[s]].

2.Taking Possession of Child[ren]
§ 105.001(c)(2)

Issue an order taking the child[ren], [name[s]], into possession of [Petitioner/the Court].

3.Excluding Respondent from Child[ren]
§ 105.001(c)(3)

Issue an order excluding Respondent from possession of or access to the child[ren], [name[s]].

15.Temporary Orders and Injunction

15.Request for Temporary Orders and Injunction

Petitioner requests the Court to dispense with the necessity of a bond, and Petitioner requests that, after notice and hearing, Respondent be further restrained and enjoined, pending the further order of the Court, from:

15.A.Disturbing Child[ren] or Another Party
§ 105.001(a)(3)

Disturbing the child[ren] or Petitioner or interfering in any way with Petitioner’s possession of the child[ren] by taking or attempting to take posses­sion of the child[ren], directly or through any other person, from the residence, school, or any other place.

15.B.Withdrawing Child[ren] from School or Day Care

Withdrawing the child[ren] from enrollment in the school or day-care facility where the child[ren] [is/are] presently enrolled.

15.C.Hiding Child[ren] from Petitioner

Hiding or secreting the child[ren] from Petitioner.

15.D.Disparaging Remarks

Making disparaging remarks regarding Petitioner [include if applicable: or Petitioner’s family] in the presence or within the hearing of the child[ren].

15.E.Consumption of Alcohol

Consuming alcohol within the [number] hours before or during each of Respondent’s periods of possession of or access to the child[ren].

15.F.Affecting Health or Dental Insurance

Canceling, altering, failing to renew or pay premiums on, or in any man­ner affecting the level of coverage that existed at the time this suit was filed of, any health or dental insurance policy insuring the child[ren].

16.Request for Permanent Injunction

16.Request for Permanent Injunction

Petitioner requests the Court, after trial on the merits, to grant the fol­lowing permanent injunction[s]: [specify].

17.Attorney’s Fees, Expenses, Costs, and Interest
§§ 106.001, 106.002

17.Request for Attorney’s Fees, Expenses, Costs, and Interest

It was necessary for Petitioner to secure the services of [name of attor­ney], a licensed attorney, to preserve and protect the child[ren]’s rights. [Include if applicable: If the parties are unable to reach an agreement on all issues,] Respondent should be ordered to pay reasonable attorney’s fees, expenses, and costs through trial and appeal, and a judgment should be ren­dered in favor of this attorney and against Respondent and be ordered paid directly to Petitioner’s attorney, who may enforce the judgment in the attor­ney’s own name. Petitioner requests postjudgment interest as allowed by law.

18.Prayer

18.Prayer

•Required in All Petitions

Petitioner prays that citation and notice issue as required by law and that the Court enter its orders in accordance with the allegations contained in this petition.

•Combined TRO and Temporary Injunction

Petitioner prays that the Court immediately grant a temporary restrain­ing order restraining Respondent, in conformity with the allegations of this petition, from the acts set forth above, and Petitioner prays that, after notice and hearing, this temporary restraining order be made a temporary injunction.

•Temporary Injunction

Petitioner prays that the Court, [include if applicable: in addition to the temporary restraining order and temporary injunction prayed for above,] after notice and hearing, grant a temporary injunction enjoining Respondent, in con­formity with the allegations of this petition, from the acts set forth above while this case is pending.

•Permanent Injunction

Petitioner prays that the Court, on final hearing, enter a permanent injunction enjoining Respondent, in conformity with the allegations of this petition, from the acts set forth above.

•Attorney’s Fees, Expenses, Costs, and Interest

Petitioner prays for attorney’s fees, expenses, costs, and interest as requested above.

•Temporary Relief Pending Appeal

Petitioner prays that the Court grant the temporary relief pending appeal if the Court’s final judgment is appealed, as requested above.

•Required in All Petitions

Petitioner prays for general relief.

   
[Name]
Attorney for Petitioner
State Bar No.:
[Email address]
[Address]
[Telephone]
[Fax]