What You Are Asking For

a. General Information

Yes. Check this box if you want to appear before the judge and answer questions in person. Hearing Date: Leave blank unless the court told you the date. The court usually fills this in. Hearing Time: Leave blank unless the court told you the time. The court usually fills this in. Family Courts & Services Center, 601 N. Pecos Rd. Las Vegas, NV 89101, courtroom Check this box if your hearing will be at the Family Courts & Services Center on Pecos Road. courtroom Enter the courtroom number at the Family Courts & Services Center, if known. Regional Justice Center, 200 Lewis Ave. Las Vegas, NV 89101, courtroom Check this box if your hearing will be at the Regional Justice Center on Lewis Avenue. courtroom Enter the courtroom number at the Regional Justice Center, if known. No. The judge will write a decision after reviewing the request in chambers on: Check this box if you want the judge to decide based only on the written papers, with no hearing. write the city/town and state where you would like to move Write the city or town and state where you want to move with the children. date you plan to move Enter the date you plan to make the move. The court has already awarded me primary physical custody or sole physical custody through the order dated Check this box if a court already gave you primary or sole custody of the children. If you check it, stop and go to question 4. date of order Enter the date the court signed the order that gave you custody. I do not have primary / sole physical custody of the children. The current order gives me Check this box if you do not currently have primary or sole custody of the children. joint physical custody Check this box if your current order gives you joint physical custody.

b. Possession & Access

visitation Check this box if your current order gives you visitation only. there is no custody order Check this box if there is no custody order in place right now. Substantial Change in Circumstances Affecting Child(ren). Since the last custody order, there has been a substantial change in circumstances affecting the welfare of the child(ren) (explain major changes since the last order and how they affect the kids): Explain the big changes that have happened since the last custody order and how those changes affect your children. My proposed move is in good faith. I have a good reason for the move, and I am not moving to deprive the other parent of contact with the child. I want to move because: Tell the court your real reason for moving, such as a new job, family support, or a better home. Show you are not moving just to keep the other parent away. The proposed move is in the best interest of the child(ren) because: (Explain) Explain how the move helps your child, like better schools, a safer home, or being closer to family. The child(ren) and I would benefit from the move in the following ways: (Explain) Describe the good things the move brings to both you and your child, such as more money, a bigger home, or more help nearby. The proposed move is likely to improve the quality of life for my child(ren) and myself. (Explain. Include information about where you would live, where you would work, the school and surroundings for the children) Explain how moving will make life better for you and your kids. Include where you will live, where you will work, and details about the new school and neighborhood. I tried to resolve this issue with the other party before filing this motion. Check this box if you talked to the other parent and tried to work things out before filing this motion. (Explain when and how you asked the other parent for permission to move) Describe when and how you asked the other parent for permission to move. Include dates and how you contacted them. I did not try to resolve this issue with the other party before filing this motion. Any attempt to resolve the issue would have been useless or impractical because Check this box if you did not try to work things out with the other parent first because it would not have helped. (explain why you did not try to resolve this issue directly with the other party before filing this motion) Explain why trying to talk to the other parent would have been pointless or not possible. The other parent will not agree to the relocation because: (Describe your understanding of why the other parent will not agree to the move) Describe why you think the other parent does not want you to move with the children.

c. Child Support

Child support should not be changed. (STOP. Go to Section C.) Check this box if you do not want the child support amount changed. If you check this, skip ahead to Section C. There is no child support order. Child support needs to be set. Check this box if there is no current child support order and you want the court to set one for the first time. Child support should be changed. (Name) ____ currently pays (amount) $____ per month in child support. This should be changed: Check this box if you want the court to raise or lower the current child support amount. Child support should be changed. (Name) Write the name of the person who currently pays child support. This is the parent making the monthly payments now. (amount) $______ per month in child support. Enter the dollar amount of child support paid each month right now. Use the figure from the current court order. Because of the change in custody I am requesting. Check this box if support should change because you are asking for a different custody arrangement. Because it has been more than three years since child support was last entered. Check this box if more than three years have passed since the support amount was last set. Because the gross monthly income of the person paying child support has changed by more than 20% since the last child support order was entered. Check this box if the paying parent's monthly income has gone up or down by more than 20% since the last order. It is in the best interest of the child to change child support because (explain): Explain why changing the support amount is good for the children. Give real reasons, such as new costs or a change in income. Child support should be set so that (name of person who should pay child support) Write the full name of the parent who you think should pay child support. $ ____ per month in child support. Check this if you want to ask for a specific dollar amount of child support each month. $ ____ per month in child support. Enter the dollar amount you want paid for child support each month. I'm not sure how much child support should be paid. The judge should set child support. Check this if you do not know the amount and want the judge to decide how much child support should be paid. Other (explain how much child support should be ordered and why): Check this if your request does not fit the other two choices and you need to explain it. Other (explain how much child support should be ordered and why): Explain how much child support you think should be paid and why. No, there are no child care costs for either parent. Check this if neither parent pays any costs for child care, like daycare or babysitting. Yes, the monthly child care costs for the child(ren) are: $ Check this if there are child care costs each month, then fill in the amount. Yes, the monthly child care costs for the child(ren) are: $ Enter the total amount paid each month for child care, like daycare or a babysitter. should be paid by me only Check this if you think you should pay all of the child care costs. the other parent only Check this if you think the other parent should pay all of the child care costs. both parents equally. Check this if you think both parents should split the child care costs evenly.

d. Health & Medical Support

Medicaid. Check this if the children should get medical coverage through Medicaid. Private / Employer Insurance. The monthly premium should be paid by Check this if the children should be covered by private or job-based health insurance. me only Check this if you think you should pay the full monthly insurance cost. the other parent only Check this if you think the other parent should pay the full monthly insurance cost. both parents equally. Check this if you think both parents should split the monthly insurance cost evenly. Other: Check this if the children should get medical coverage some other way that you need to describe. Other: Describe the other way the children should get medical coverage. In addition to the relief requested above, I would like the Court to also order the following: (Explain anything else that you would like the judge to order, or enter "N/A" if you do not want anything else. Be specific.) Write down anything extra you want the judge to order that wasn't already listed. If you don't want anything else, just write "N/A". Be clear and specific.