Plaintiff’s	name,	address,	and	telephone	no.

	moving	party	

Defendant’s	name,	address,	and	telephone	no.

	moving	party

Third	party	name,	address,	and	telephone	no.

	moving	party

v

		 1.

a.	On	

Date

	a	judgment

or	order	was	entered	regarding	parenting	time.				
b. There	is	currently	no	order	regarding	parenting

time.

2. Attached	is	a	completed	Uniform	Child	Custody	Jurisdiction	Enforcement	Act	Affidavit	(MC	416).

 
D

	3.	

Name

	has	disobeyed	the	parenting-time	order	as	follows:

a. he/she	has	denied	me	parenting	time	with	the	child(ren)	as	follows:
b. he/she	has	not	had	parenting	time	with	the	child(ren)	as	follows:
c. he/she	has	made	changes	in	parenting	time	without	court	order	as	follows:
d. he/she	has	not	followed	the	specific	conditions	of	parenting	time	as	follows:
Use	a	separate	sheet	to	explain	in	detail	what	has	happened	and	attach.	Include	all	necessary	facts.

	4.	

	and	I	have	agreed	to	parenting	time	as	follows:

Name
Use	a	separate	sheet	to	explain	in	detail	what	you	have	agreed	on	and	attach.	Include	all	necessary	facts.

5. It	is	in	the	best	interests	of	the	child(ren)	to

	establish	parenting	time	

	change	parenting	time	

because:

Use	a	separate	sheet	to	explain	why	it	is	in	the	best	interests	of	the	child(ren)	and	attach.

6. I ask the court to order that parenting time be 

	established
Use	a	separate	sheet	to	explain	in	detail	what	you	want	the	court	to	order	and	attach.

 

	changed	

	made	up	

as	follows:

/s/
Moving	party’s	signature

NOTICE OF HEARING

A	hearing	will	be	held	on	this	motion	before	

Judge/Referee

at	

Time

at	

Location

Bar	no.

	.

If	you	require	special	accommodations	to	use	the	court	because	of	a	disability,	or	if	you	require	a	foreign	language	interpreter
to	help	you	fully	participate	in	court	proceedings,	please	contact	the	court	immediately	to	make	arrangements.	When	contacting
the	court,	provide	your	case	number(s).
Note:	If	you	are	the	person	receiving	this	motion,	you	may	file	a	response.	Contact	the	friend	of	the	court	office	and	request	form	FOC	66.

CERTIFICATE OF MAILING

I	certify	that	on	this	date	I	served	a	copy	of	this	motion,	a	Uniform	Child	Custody	Jurisdiction	Enforcement	Act	Affidavit	and	
notice	of	hearing	on	the	parties	or	their	attorneys	by	first-class	mail	addressed	to	their	last-known	addresses	as	defined	in
MCR	3.203.

 
J

Date

Moving	party’s	signature

Date

on	

Date

 
E

F

  	

	
G

 
H

	
I

FOC 65 (6/17) MOTION REGARDING PARENTING TIMEMCL 552.14, MCR 2.119Approved, SCAO Original - Court1st copy - Other party2nd copy - Moving party3rd copy - Friend of the court4th copy - Proof of service5th copy - Proof of serviceSTATE OF MICHIGANJUDICIAL CIRCUITCOUNTY MOTION REGARDING PARENTING TIMECASE NO.Court addressCourt telephone no.ABC