§ Mothers Petition for Declaration of Paternity, Custody and/or Support
Mother’s Petition for Declaration of Paternity, Custody and/or Support
[Publisher's note: Referenced interactive forms can be accessed at www.selfrepresent.mo.gov]
In what Missouri county will this case be In the Circuit Court of MISSOURI
filed?
If this is an amended petition, what is the case Case Number Division Number
number of the pending case?
Answer all questions on this form completely.
The Parties (1) I am filing this case and I am the PLAINTIFF. My name is:
______________________ ____________ _________________
(Mother's First Name) (Middle Name) (Mother's Last Name)
(2) I am also the Next Friend of my child(ren) who are PLAINTIFF(S) in this case. They are: (List only the
child(ren) that you allege have the man listed in paragraph 3 below as their father.)
a. ________________________________________ Birth Date: __________
(Child's full name as it appears on the birth certificate) (mm/dd/ yyyy)
b. ________________________________________ Birth Date: __________
(Child's full name as it appears on the birth certificate) (mm/dd/ yyyy)
c. ________________________________________ Birth Date: __________
(Child's full name as it appears on the birth certificate) (mm/dd/ yyyy)
d. ________________________________________ Birth Date: __________
(Child's full name as it appears on the birth certificate) (mm/dd/ yyyy)
e. ________________________________________ Birth Date: __________
(Child's full name as it appears on the birth certificate) (mm/dd/ yyyy)
f. ________________________________________ Birth Date: __________
(Child's full name as it appears on the birth certificate) (mm/dd/ yyyy)
(3) The father of the child(ren) listed in (2) above is a DEFENDANT in this case and his name is: (He will
be referred to as “ Father” on these forms)
______________________ ____________ _________________ _________
(Father's First Name) (Middle Name) (Father' s Last Name) (Jr./Sr./III)
(4) The following men are DEFENDANT(S) in this case. Either they--
• were married to me at the time of birth of each child listed above in(2) or
• were married to me within 300 days prior to the birth of each child listed above in (2) or
• are considered “presumed” fathers of the child(ren) listed above in(2) pursuant to § 210.822,
RSMo.
(They will be referred to as “First Presumed Father” and “ Second Presumed Father” on these
forms)
a. __________________ ____________ _________________ _________
(First Name) (Middle Name) (Last Name) (Jr./Sr./III)
b. __________________ ____________ _________________ _________
(First Name) (Middle Name) (LastName) (Jr./Sr./III)
Mother's Petition for Declaration of Paternity, Child Custody and/or Support--Page 1 of 7
Form CAFC302-01/01/ This form is available for free at www.selfrepresent.mo.gov
2011
(1) Your 5. My mailing address is:
Information
(Plaintiff) _______________________________________________________________
(Street)
_________________________ ___________________ _________________
(City) (State) (Zip)
________________________ ______________________________________
(Telephone Number) (E-Mail Address)
6. [ ] This is the first petition I have filed in this case. (Original Petition)
[ ] This is the second petition I have filed in this case.
[ ] This is the third petition I have filed in this case.
7. The last four numbers of my Social Security Number are:
XXX-XX-__________
8. I am _____ years old.
9. I reside in the Country of __________.
10. I reside in the State of __________.
11. I reside in the County of__________--
Employment 12. [ ] I am self-employed
Information [ ] I am unemployed
[ ] I am employed at:
_______________________________________________________________
(Name of Employer)
_______________________________________________________________
(Street)
_________________________ ___________________ _________________
(City) (State) (Zip)
13. [ ] Father is self-employed
[ ] Father is unemployed
[ ] I don't know Father's employment status
[ ] Father is employed at:
_______________________________________________________________
(Name of Employer)
_______________________________________________________________
(Street)
_________________________ ___________________ _________________
(City) (State) (Zip)
Mother's Petition for Declaration of Paternity, Child Custody and/or Support--Page 2 of 7
Form CAFC302-01/01/ This form is available for free at www.selfrepresent.mo.gov
2011
(3) Father's 14. Father's mailing address is:
Information
(Defendant) _______________________________________________________________
(Street)
_________________________ ___________________ _________________
(City) (State) (Zip)
________________________ ______________________________________
(Telephone Number) (E-Mail Address)
15. The last four numbers of Father's Social Security Number are:
XXX-XX-_______________.
16. Father is ___ years old.
17. Father resides in the Country of _______________.
18. Father resides in the State of _______________.
19. Father resides in the County of _______________.
20. [ ] Father is NOT on active duty in the United States military.
[ ] Father is on active duty in the United States military.
21. [ ] Father has signed a verified “Answer to Mother's Petition for Declaration of Paternity, Custody
and/or Support” which is being filed with this petition. Therefore, do not issue a summons.
[ ] Father should be served at his residence.
_______________________________________________________________
(Street)
_________________________ ___________________ _________________
(City) (State) (Zip)
[ ] Father should be served at his place of employment.
____________________________________________ __________________
(Employer's Name--if applicable) (Hours of Employment)
_______________________________________________________________
(Street)
_________________________ ___________________ _________________
(City) (State) (Zip)
[ ] Service by publication. I don't know where Father is and I have no way of locating him. Therefore,
I am requesting that he be served by publication.
[ Other method of service:
] ____________________________________________________________
Mother's Petition for Declaration of Paternity, Child Custody and/or Support--Page 3 of 7
Form CAFC302-01/01/ This form is available for free at www.selfrepresent.mo.gov
2011
(4a) This is the person named on line 4a on the first page of this
Information petition.
about the 22. First Presumed Father's mailing address is:
First
Presumed _______________________________________________________________
Father (Street)
(Defendant)
_________________________ ___________________ _________________
(City) (State) (Zip)
________________________ ______________________________________
(Telephone Number) (E-Mail Address)
23. The last four numbers of First Presumed Father's Social Security Number are:
XXX-XX-_______________
24. First Presumed Father is ___ years old.
25. First Presumed Father resides in the Country of __________.
26. First Presumed Father resides in the State of __________.
27. First Presumed Father resides in the County of __________.
28. [ ] First Presumed Father is NOT on active duty in the United States military.
[ ] First Presumed Father is on active duty in the United States military.
29. [ ] First Presumed Father has signed a verified “Answer to Father's Petition for Declaration of
Paternity, Custody and/or Support” which is being filed with this motion. Therefore, do not issue a
summons.
[ ] First Presumed Father should be served at his residence.
_______________________________________________________________
(Street)
_________________________ ___________________ _________________
(City) (State) (Zip)
[ ] First Presumed Father should be served at his place of employment.
____________________________________________ __________________
(Employer's Name--if applicable) (Hours of Employment)
_______________________________________________________________
(Street)
_________________________ ___________________ _________________
(City) (State) (Zip)
[ ] Service by publication. I don't know where First Presumed Father is and I have no way of locating
him. Therefore, I am requesting that he be served by publication. I have filed an Affidavit for
Service by Publication and a Notice of Publication.
[ Other method of service:
] ____________________________________________________________
Mother's Petition for Declaration of Paternity, Child Custody and/or Support--Page 4 of 7
Form CAFC302-01/01/ This form is available for free at www.selfrepresent.mo.gov
2011
(4b) This is the person named on line 4b on the first page of this
Information petition.
about the 30. Second Presumed Father's mailing address is:
Second
Presumed _______________________________________________________________
Father (Street)
(Defendant)
_________________________ ___________________ _________________
(City) (State) (Zip)
________________________ ______________________________________
(Telephone Number) (E-Mail Address)
31. The last four numbers of Second Presumed Father's Social Security Number are:
XXX-XX-__________
32. Second Presumed Father is ___ years old.
33. Second Presumed Father resides in the Country of __________.
34. Second Presumed Father resides in the State of __________.
35. Second Presumed Father resides in the County of__________--
36. [ ] Second Presumed Father is NOT on active duty in the United States military.
[ ] Second Presumed Father is on active duty in the United States military.
37. [ ] Second Presumed Father has signed a verified “Answer to Father's Petition for Declaration of
Paternity, Custody and/or Support” which is being filed with this motion. Therefore, do not issue a
summons.
[ ] Second Presumed Father should be served at his residence.
_______________________________________________________________
(Street)
_________________________ ___________________ _________________
(City) (State) (Zip)
[ ] Second Presumed Father should be served at his place of employment.
____________________________________________ __________________
(Employer's Name--if applicable) (Hours of Employment)
_______________________________________________________________
(Street)
_________________________ ___________________ _________________
(City) (State) (Zip)
[ ] Service by publication. I don't know where Second Presumed Father is and I have no way of
locating him. Therefore, I am requesting that he be served by publication. I have filed an Affidavit
for Service by Publication and a Notice of Publication.
[ Other method of service:
] ____________________________________________________________
Mother's Petition for Declaration of Paternity, Child Custody and/or Support--Page 5 of 7
Form CAFC302-01/01/ This form is available for free at www.selfrepresent.mo.gov
2011
Family
Support 38. [ ] The parent receiving support is not receiving public assistance.
Division [ ] I don't know if the parent receiving support is receiving public assistance.
[ ] The parent receiving support is receiving public assistance and therefore the State of Missouri must
be served. Summons to issue to be served on:
Director, Family Support Division
615 Howerton Court
Jefferson City, Missouri 65102
39. The child(ren) have lived with the following persons at the following address(es) during the past five
years. (State the dates at each address)
Additional
Information _______________________________________________________________
about the
Children _______________________________________________________________
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
40. Check all boxes that apply to your case.
[ ] Someone other than me or the other parent has physical custody of one or more of the child(ren) or
claims to have custody or visitation rights with respect to one or more of the child(ren).
[ ] There are other custody proceeding(s) concerning one or more of the child(ren) pending in a court
of this or another state.
[ ] I have participated in other litigation concerning the custody of one or more of the child(ren) in this
or another other state.
[ ] One or more of the child(ren) has been a victim of abuse or neglect.
41. Explanation: (If you checked any of the boxes in paragraph 40, please explain in detail here.)
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
Mother's Petition for Declaration of Paternity, Child Custody and/or Support--Page 6 of 7
Form CAFC302-01/01/ This form is available for free at www.selfrepresent.mo.gov
2011
Request for
Relief
THEREFORE, I am requesting that the man listed in paragraph (3) be declared the father of the children listed in
paragraph (2) of this petition, and that the men listed in paragraph (4) of this petition be excluded as fathers of
the children listed in paragraph (2) of this petition.
I also request the following relief:
[ ] Child custody should be as set forth in Part A of the attached Parenting plan marked Exhibit 1. The
custody arrangement that is in the best interests of the minor children is set forth in Part A of the
attached parenting plan marked Exhibit 1.
[ ] Child support should be set as set forth in Part B of the attached parenting plan marked Exhibit 1.
[ ] I am without sufficient funds to pay for my attorney and I request that the other party pay my
attorney's fees for this case.
[ I want to change the child(ren)'s names as follows:
] ____________________________________________________________
______________________________________________________________
[ ] Other (Please state the other requests)
_______________________________________________________________
_______________________________________________________________
Plaintiff, being of lawful age and duly sworn on her oath, states that she is the plaintiff named above and that the facts stated in this Petition for Declaration of Paternity, Child Custody and/or Support are true according to her best knowledge and belief.
____________________________________ ____________________________________
SIGN HERE PRINT YOUR NAME HERE
Subscribed and sworn to this _____ day of __________, 20 ___.
__________________________
Notary Public (Sign this in front of a Notary Public) (This should only be completed if a
lawyer helped you with this form)
My Commission Expires:
__________________________
ATTORNEY INFORMATION (To be completed by your attorney) Do not enter any information here if
you are
___________________________ _____________________ filing this case without the
Attorney--SIGN HERE Missouri Bar Number assistance of a lawyer.
This information should be
__________________________________________________ completed by your attorney.
Attorney for Plaintiff--PRINT YOUR NAME HERE
[ ]I have assisted Plaintiff
__________________________________________________ in the preparation of these
(Street) pleadings, but I am not
_ ______________________________ ___________ _____ entering my appearance on
(City) (State) (Zip) behalf of Plaintiff.
________________ ____________ ___________________
(Telephone Number) (Fax Number) (Email Address)
Mother's Petition for Declaration of Paternity, Child Custody and/or Support--Page 7 of 7
Form CAFC302-01/01/
2011 This form is available for free at www.selfrepresent.mo.gov
[Publisher's note: Referenced interactive forms can be accessed at www.selfrepresent.mo.gov]