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Fill Your Connecticut Custody Application Form

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The Connecticut Custody Application form is a crucial document for parents and guardians seeking legal custody or visitation rights concerning their children. This form, officially designated as JD-FM-161, serves as the starting point for parents to establish their legal relationship with their child or children in the eyes of the court. When filling out the form, applicants must indicate whether they are applying for custody or visitation, and provide essential information about themselves, the child, and any other involved parties. It is important to attach additional documents, such as the Order to Attend Hearing and the Affidavit Concerning Children, to support the application. The form requires applicants to demonstrate their legal standing as a parent by submitting relevant documents like birth certificates or court orders. Furthermore, the applicant must confirm that Connecticut has jurisdiction over the case, providing reasons such as residency or significant connections to the state. This form not only outlines the procedural steps necessary for filing but also includes sections for specific requests regarding custody arrangements and visitation rights. Understanding the requirements and correctly completing this form is essential for navigating custody and visitation matters effectively.

Documents used along the form

The Connecticut Custody Application form is a crucial document for parents seeking custody or visitation rights. Along with this form, several other documents are often required to support the application. Each of these documents serves a specific purpose in the custody process.

  • Order to Attend Hearing (JD-FM-162): This document informs the parties involved about the date and time of the court hearing. It is essential for ensuring that all parties are present for the proceedings.
  • Notice of Automatic Court Orders (JD-FM-158): This notice outlines the automatic orders that take effect once a custody application is filed. It helps parties understand their rights and responsibilities during the custody process.
  • Texas Motorcycle Bill of Sale: Essential for anyone buying or selling a motorcycle in Texas, the billofsaleforvehicles.com/editable-texas-motorcycle-bill-of-sale serves as legal proof of the transaction and is necessary for registration purposes.
  • Affidavit Concerning Children (JD-FM-164): This affidavit provides detailed information about the children involved, including their living arrangements and any relevant history. It helps the court assess the best interests of the children.
  • Certification of Notice (JD-FM-175): This document confirms that the required notices have been sent to the appropriate parties, such as the Office of the Attorney General or the local City or Town Clerk, if applicable.

Gathering these documents is an important step in the custody application process. Each form plays a role in ensuring that the court has all necessary information to make informed decisions regarding custody and visitation rights.

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Preview - Connecticut Custody Application Form

Page 1 of 2
Use for visitation
applications
Use for custody
applications
a.
b.
c.
Connecticut is the home state of the child (or children) at the time of the filing of this case.
The child (or children) has (or have) lived in Connecticut for the past 6 months, or from birth if the child (or children)
is (or are) younger than 6 months old.
The child (or children) lived in Connecticut for at least 6 months but was (or were) taken from Connecticut less than
6 months ago by a person claiming custody, and a parent or guardian continues to live here.
The child (or children) and at least one parent have a significant connection to Connecticut, and there is substantial
evidence in Connecticut concerning the child's (or children's) present or future care, protection, training, and
personal relationships.
The child (or children) is (or are) in Connecticut now and has (or have) been abandoned, or there is an emergency
affecting the child's (or children's) well-being.
No other state has an interest in hearing this case, and it is in the best interest of the child (or children) for a
Connecticut court to hear the case.
5. Connecticut has the authority to decide this case and should decide this case because: (Select all that apply)
CUSTODY/VISITATION
APPLICATION - PARENT
JD-FM-161 Rev. 4-23
C.G.S. §§ 46b-56, 46b-61;
P.B. §§ 25-3, 25-4, 25-5
1. I am the child's or children's parent.
4. I want: (Select one)
Child's name (First, middle, last)
Date of birth
3. The respondent(s) is/are the:
Instructions
1. Select the “Custody” or “Visitation” box above, and complete pages 1 and 2 of this form. Attach the Order to Show Cause and Notice to the
Respondent (form JD-FM-162), Notice of Automatic Court Orders (form JD-FM-158), and Affidavit Concerning Children (form JD-FM-164).
2. By the first scheduled court date for this case, you must file the accompanying document(s) listed in number 2 below that prove the existing legal
relationship between the parents and the child or children. You must redact (remove) any personal identifying information, as defined by Section
4-7 of the Connecticut Practice Book, from the accompanying document(s). If you plan to file a copy of an acknowledgment of parentage, make
sure the original is completed and filed with the Department of Public Health before filing this Application. (Contact the Department of Social
Services or the Department of Public Health Vital Records Office for assistance with acknowledgments of parentage.)
3. If you are a grandparent or a third party (not a legal parent), and you want to file for visitation with the child or children, use the Verified Petition
for Visitation - Grandparents & Third Parties (form JD-FM-221).
(Attach additional sheets if necessary)
Name(s) of parent(s) or guardian(s) (First, middle initial, last)
STATE OF CONNECTICUT
SUPERIOR COURT
www.jud.ct.gov
d.
e.
f.
Docket numberJudicial District of
At (Town)
Applicant's name (Last, first, middle initial) Respondent's name (Last, first, middle initial)
Additional respondent's name (If applicable) (Last, first, middle initial)
Parent Grandparent
Other: (Specify)
custody of the child (or children) listed below
visitation rights with the child (or children) listed below
Court use only
*APPLCUS* *APPLVIS*
APPLCUS APPLVIS
2. I understand that by the first scheduled date for this case, I must file the applicable accompanying document(s) from this
list that prove the existing legal relationship between the parents and the child or children named in this application with
any personal identifying information, as defined by Section 4-7 of the Connecticut Practice Book, redacted (removed) or
the case may be dismissed. I plan to file the following document(s) to prove parentage: (Select all that apply)
Other parent's name (If other parent is not the respondent)(Last, first, middle initial) Other parent's address (If other parent is not the respondent)
VisitationCustody
A copy of the birth certificate of the child or children naming the parents;
A copy of a properly executed (finalized) acknowledgement of parentage;
A court order or decree naming the legally responsible parents (including an adoptive parent);
A surrogacy agreement naming the parents (see General Statutes Section 7-36);
Document(s) showing that the child or children was/were born during my marriage to the respondent; or
Any other evidence sufficient (enough) to prove legal parentage of the child or children.
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JD-FM-161 Rev. 4-23
Page 2 of 2
If you selected yes for Financial Support and/or HUSKY, send a copy of this Application, Order to Show Cause and Notice to the
Respondent, Notice of Automatic Court Orders, and any other document filed with this application to the Office of the Attorney
General, 165 Capitol Avenue, Hartford, CT 06106, and file the Certification of Notice (form JD-FM-175) with the court clerk.
6. The applicant, respondent, or any child (or children) listed has (or have) received financial support and/or HUSKY from
the State of Connecticut:
7. The applicant, respondent, or any child (or children) listed has (or have) received financial support from a city or town in
Connecticut: (Select one)
Claim for Relief
Signature of Applicant or Petitioner
If you selected yes, send a copy of this Application, Order to Show Cause and Notice to the Respondent, Notice of Automatic
Court Orders, and any other document filed with this application to the City or Town Clerk of the city or town providing assistance,
and file the Certification of Notice (form JD-FM-175) with the court clerk.
Regarding decision-making responsibility:
For Custody: (The Applicant asks the Court for custody orders) (Select all that apply)
Print name of person signing at left Date signed
Address
Telephone (Area code first)
Yes No Do not know
Yes No Do not know
Yes (City or town):
No Do not know
Sole legal custody
Joint legal custody
A parenting responsibility plan, which includes a plan for the parental decision-making regarding the child or children
And
Regarding physical custody:
Primary residence with:
A parental physical access schedule and/or visitation
Child Support
Regarding child support: (If custody application — includes cash medical, health insurance, unreimbursed medical
expenses, and qualifying child care)
For Visitation: (The Applicant asks the Court for visitation orders as follows)
An order for the educational support of my child (or children) for post-high school education or training under General
Statutes Section 46b-56c.
Additional Instructions:
• If you are the parent and want custody, go to Number 6 below, and continue from there.
• If you are the parent and want visitation, go to the Claim For Relief section below, and continue from there.
Financial Support: (Select one)
HUSKY Health Insurance: (Select one)
ADA NOTICE
The Judicial Branch of the State of Connecticut
complies with the Americans with Disabilities Act
(ADA). If you need a reasonable accommodation
in accordance with the ADA, contact the
Centralized ADA Office at 860-706-5310 or go to:
www.jud.ct.gov/ADA/
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Common Questions

What is the purpose of the Connecticut Custody Application form?

The Connecticut Custody Application form is used to request custody or visitation rights for children. It is designed for parents, grandparents, or third parties who seek to establish or modify legal relationships with children. The form helps ensure that all necessary information is collected and submitted to the court for consideration.

Who can file this application?

This application can be filed by parents seeking custody or visitation of their children. Additionally, grandparents and third parties can file for visitation using a different form, the Verified Petition for Visitation — Grandparents & Third Parties (form JD-FM-221).

What documents must be attached to the application?

When submitting the application, you must attach several documents. These include the Order to Attend Hearing (form JD-FM-162), the Notice of Automatic Court Orders (form JD-FM-158), and the Affidavit Concerning Children (form JD-FM-164). These documents help establish the context and legal basis for your request.

What information is required about the child or children?

You need to provide the names and dates of birth of the child or children involved in the application. Additionally, you should include the names of the parents or guardians. This information is essential for the court to identify the parties involved in the case.

How does Connecticut determine jurisdiction over the case?

Connecticut courts can decide custody cases if certain conditions are met. For instance, the child must be a resident of Connecticut, or have lived there for a specified period. Other factors include the child's significant connections to the state and any emergency situations affecting the child's well-being.

What if the applicant or child has received state assistance?

If the applicant, respondent, or any child listed has received financial support or HUSKY health insurance from the State of Connecticut, you must notify the Office of the Attorney General. This involves sending a copy of the application and related documents to their office and filing a Certification of Notice with the court clerk.

What are the options for custody and visitation requests?

The application allows you to request various types of custody arrangements, such as sole legal custody or joint legal custody. You can also request a parenting responsibility plan. For visitation, you can specify the desired visitation schedule. These options help tailor the request to meet the needs of the child and the parents involved.

How should personal identifying information be handled?

When submitting documents, it is important to redact any personal identifying information as defined by Section 4-7 of the Connecticut Practice Book. This protects the privacy of all parties involved in the case and ensures compliance with legal standards.

Where can I find more information or assistance regarding the application?

For additional guidance, you can visit the Connecticut Judicial Branch website at www.jud.ct.gov. The site provides resources and information about the application process, including contact details for court clerks and ADA accommodations.

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Guide to Filling Out Connecticut Custody Application

Once you have gathered the necessary information and documents, you are ready to fill out the Connecticut Custody Application form. This form is essential for initiating a custody or visitation case in Connecticut. Completing it accurately is crucial to ensure that your application is processed smoothly.

  1. Begin by checking the appropriate box at the top of the form to indicate whether you are applying for custody or visitation. Complete pages 1 and 2 of the form as instructed.
  2. Attach the required documents: the Order to Attend Hearing (form JD-FM-162), the Notice of Automatic Court Orders (form JD-FM-158), and the Affidavit Concerning Children (form JD-FM-164).
  3. Before the first scheduled court date, file the accompanying documents that establish a legal relationship between the parents and the child or children. Remember to redact any personal identifying information from these documents as specified by Section 4-7 of the Connecticut Practice Book.
  4. If you are a grandparent or a third party seeking visitation, use the Verified Petition for Visitation — Grandparents & Third Parties (form JD-FM-221) instead.
  5. Fill in the Judicial District of the court, the town, and the docket number if known.
  6. Provide your name as the applicant, including your last name, first name, and middle initial.
  7. List the respondent’s name in the same format. If there is another parent involved, include their name as well.
  8. If applicable, include the additional respondent’s name.
  9. Indicate your relationship to the child or children by selecting either Mother or Father.
  10. In the next section, specify whether you want custody or visitation rights for the child or children listed. Include their names and dates of birth, as well as the names of their parents or guardians.
  11. Explain why Connecticut has jurisdiction over this case by checking all applicable reasons outlined in the form.
  12. If you are the mother or father seeking custody, proceed to fill out the relevant sections regarding financial support and HUSKY Health Insurance.
  13. If you checked "yes" for financial support or HUSKY, remember to send copies of your application and related documents to the Office of the Attorney General and file the Certification of Notice (form JD-FM-175) with the court clerk.
  14. Complete the Claim for Relief section by selecting the custody or visitation orders you are requesting from the court.
  15. Finally, sign and date the application, providing your address and phone number.

Dos and Don'ts

When filling out the Connecticut Custody Application form, follow these guidelines to ensure a smooth process.

  • Do check the appropriate box for custody or visitation at the top of the form.
  • Do complete all required pages of the form accurately.
  • Do attach necessary documents, such as the Order to Attend Hearing and Affidavit Concerning Children.
  • Do file your application and supporting documents by the first scheduled court date.
  • Do redact any personal identifying information from the documents you submit.
  • Don't forget to include any evidence proving your legal relationship to the child.
  • Don't submit documents that have not been properly completed or executed.
  • Don't ignore the requirement to notify the Office of the Attorney General if you have received financial support or HUSKY.
  • Don't leave out any additional sheets if you need more space to list children or other details.