Petition/Motion to Modify Custody/Visitation - mdcourts.gov

Circuit Court for Case No. City or County Name Name VS. Street Address Apt. # Street Address Apt. #. ( ) ( ). City State Zip Code Area Telephone City State Zip Code Area Telephone Code Code Plaintiff Defendant No. 1. Name Street Address Apt. #. ( ). City State Zip Code Area Telephone Code Defendant No. 2. Petition/Motion TO Modify custody VISITATION. (DR 7). I, , representing myself, state that: My name 1. I am the mother/ father or of : Relationship (for example, aunt, grandfather, guardian, etc). name of child date of birth name of child date of birth name of child date of birth name of child date of birth name of child date of birth name of child date of birth name of child date of birth name of child date of birth 2. On the Circuit Court for issued City or County an order in case number , granting custody of the child(ren) to and visitation to.

Page 2 of 2 DR 7 - Revised 10/2015 4. I know of the following additional cases concerning the child(ren) (such as domestic violence (protective order), paternity, divorce of the child(ren)’s parents, custody, visitation, or

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