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Free Connecticut Custody Application Form

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Navigating through the complexities of legal forms can be daunting, especially when it comes to matters as sensitive as child custody and visitation rights. The Connecticut Custody Application form, officially known as JD-FM-161, serves as a vital tool for parents and guardians in the State of Connecticut seeking to resolve custody and visitation issues through the Superior Court. This form carefully outlines the procedures and requirements for submitting a custody or visitation application, including necessary attachments such as the Order to Attend Hearing, Notice of Automatic Court Orders, and an Affidavit Concerning Children. Applicants are required to demonstrate an existing legal relationship with the child or children involved by submitting appropriate documentation, such as birth certificates or court orders. Additionally, the form addresses the jurisdiction of Connecticut courts in deciding these matters, emphasizing the state's authority based on criteria like the child's home state or significant connections to Connecticut. There are also sections dedicated to financial support and health insurance considerations, highlighting the court's interest in the child's welfare beyond custody and visitation rights. Whether one is seeking sole or joint custody, specific visitation rights, or decisions regarding child support and educational support post-high school, the Connecticut Custody Application form is structured to guide applicants through the process, ensuring that the child's best interests are always at the forefront.

Connecticut Custody Application Sample

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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Document Features

Fact Detail
Form Usage Used for applications related to custody and visitation rights.
Form Number and Revision Date JD-FM-161, Revision date: January 2020.
Governing Laws C.G.S. §§ 46b-56, 46b-61; Practice Book (P.B.) §§ 25-3, 25-4, 25-5.
Associated Documents Order to Attend Hearing (JD-FM-162), Notice of Automatic Court Orders (JD-FM-158), and Affidavit Concerning Children (JD-FM-164) must be attached.
Special Instructions for Non-Parents Grandparents or third parties should use form JD-FM-221 for visitation applications.
Jurisdiction Criteria Connecticut must be the child's home state or have significant connection for the state to have authority over the case.
Notification Requirement If financial support or HUSKY has been received, copies of the application must be sent to the Office of the Attorney General and the city or town clerk, if applicable.

How to Use Connecticut Custody Application

Filling out the Connecticut Custody Application form is a crucial step for parents, grandparents, or third parties who are seeking custody or visitation rights. This process involves detailed documentation and careful attention to the legal requirements set by the State of Connecticut. To ensure that your application is completed accurately, follow these instructions closely. The form asks for detailed information about the child or children involved, the type of custody or visitation being requested, and other pertinent details that the court needs to consider your request.

  1. Identify the type of application: At the top of the form, check either the “Custody” or “Visitation” box to indicate the nature of your application.
  2. Complete the basic information: Fill out the Judicial District, town, docket number (if known), your name, and the respondent's name. If applicable, include information about another parent or additional respondent.
  3. Declare your role: Indicate whether you are the child's mother, father, grandparent, or specify another role under the respondent section.
  4. Specify your request: Choose between seeking custody or visitation rights for the child or children listed. Include the child's name, date of birth, and the names of any parent(s) or guardian(s).
  5. State jurisdiction: Select the reasons why Connecticut has the authority to decide on your case from the options provided (a - f).
  6. Attach required documents: Depending on your role (mother or father), attach the applicable documents that prove your legal relationship to the child, such as a birth certificate, court order, or gestational agreement. Ensure all personal identifying information is redacted.
  7. Financial support and HUSKY information: Indicate whether the applicant, respondent, or the child(ren) has received financial support and/or HUSKY Health Insurance. If yes, further action is required, including notifying the Office of the Attorney General and filing the Certification of Notice.
  8. Local financial support: If any financial support has been received from a city or town in Connecticut, specify and follow the instructions for notification and filing as mentioned in the previous step.
  9. Claim for Relief: If applying for custody, select the relevant orders you are requesting the court to consider, such as the type of custody and child support. If applying for visitation, detail the visitation orders you are asking for.
  10. Sign and date the form: Provide your signature, print your name, and write the date you signed the form. Also, include your address and telephone number.

Once you have completed filling out the form and attaching any required documents, submit the form to the designated court as per the instructions. Remember, this document is part of a legal process that affects the welfare of a child or children, so it's crucial to provide accurate and complete information. If you have any questions or need clarification on filling out the form, consider seeking legal advice to ensure your application is properly prepared.

More About Connecticut Custody Application

Frequently Asked Questions about the Connecticut Custody Application Form

  1. Who needs to use the Connecticut Custody/Visitation Application?

    This form is specifically designed for individuals seeking legal custody or visitation rights over a child or children in the state of Connecticut. It is applicable for parents, and in cases where a non-parent (such as a grandparent or another third party) seeks visitation rights, there is a separate form (Verified Petition for Visitation — Grandparents & Third Parties, form JD-FM-221) to be used.

  2. What documents must be filed with this application?

    When submitting this application, it's required to also attach the Order to Attend Hearing (form JD-FM-162), Notice of Automatic Court Orders (form JD-FM-158), and Affidavit Concerning Children (form JD-FM-164). Additionally, documents proving an existing legal relationship with the child, such as a birth certificate, court order, adoption decree, or any other relevant evidence, must be filed. Remember to remove or redact any personal identifying information from these documents in compliance with confidentiality requirements.

  3. What should I do if I have financial support or health insurance (HUSKY) from the State of Connecticut?

    If either the applicant, respondent, or any listed child has received financial support or HUSKY Health Insurance from the State of Connecticut, copies of the application and accompanying documents must be sent to the Office of the Attorney General and the Certification of Notice (form JD-FM-175) must be filed with the court clerk.

  4. Is there a requirement if receiving financial support from a city or town in Connecticut?

    Yes. If the applicant, respondent, or child listed has received financial assistance from any Connecticut city or town, you must send the application documents to the respective City or Town Clerk and file the Certification of Notice (form JD-FM-175) with the courtroom clerk.

  5. Can I apply for both custody and visitation on the same form?

    The form allows you to check either the "Custody" or "Visitation" box, indicating the type of application you're filing. If you have concerns or specific situations that might warrant both, it's advisable to consult with a legal professional to explore your options and ensure you are following the proper course of action.

    Hence, you should carefully select the one that fits your immediate legal needs, bearing in mind that each scenario might require different strategies and documentation.

  6. How do I determine if Connecticut is the right jurisdiction to file my custody case?

    Connecticut's jurisdiction in custody cases is generally established based on the child's home state criteria, meaning the child must have lived in Connecticut for at least six months before filing or been born in Connecticut if they are less than six months old. Other factors include if the child and at least one parent have a substantial connection to Connecticut, if there's significant evidence in the state about the child's well-being, or if another state does not have jurisdiction. If uncertain, seeking legal advice to clarify jurisdictional issues can be very helpful.

  7. What if I have more questions or need assistance with my application?

    For additional questions or assistance with completing the Connecticut Custody/Visitation Application, you are encouraged to contact the court clerk's office or consult the official state judicial website. Legal aid services and family law attorneys can also offer guidance and support throughout this process. Keep in mind the importance of adhering to all legal requirements and deadlines when filing your application.

Common mistakes

Filling out legal forms correctly is crucial, especially when it comes to sensitive issues like custody or visitation rights in Connecticut. However, mistakes can happen. In this guide, we'll explore five common errors that individuals often make when completing the Connecticut Custody Application form, and offer advice on how to avoid them.

  1. Not specifying the type of application: The Connecticut Custody/Visitation Application form requires applicants to check whether they are filing for custody or visitation. This may seem straightforward, but it's a common area where applicants might proceed without clarity. It's essential to decisively select the one that applies to your situation to avoid any confusion or processing delays.

  2. Failure to attach required documents: The form lists several important documents that must be attached, including the Order to Attend Hearing, Notice of Automatic Court Orders, and Affidavit Concerning Children. Overlooking the attachment of these documents can result in the submission being incomplete. Thoroughly check that all required paperwork is attached before filing.

  3. Redaction of personal identifying information: Personal identifying information must be redacted from the documents you submit. This step is crucial for protecting your privacy and is mandated under the Connecticut Practice Book Section 4-7. Applicants often forget to redact this information from the accompanying documents, potentially risking their privacy and the application’s acceptance.

  4. Incorrectly asserting legal relationship with the child: Applicants are required to provide proof of their legal relationship to the child or children. This requirement can be fulfilled with documents like a birth certificate, paternity acknowledgement, or a court order. Ensure that these documents are current and accurately reflect your legal relationship to avoid disputes or rejection.

  5. Omitting information about financial support: Questions regarding the child or children's receipt of financial support or HUSKY Health Insurance are crucial. They must be answered accurately. Providing false information or failing to disclose financial support can have legal ramifications. If financial assistance or HUSKY Health Insurance has been provided, remember to notify the appropriate state offices as instructed on the form.

Correctly filling out the custody application form is the first step towards achieving the desired outcome in your case. By avoiding these common mistakes, you can help ensure your application is processed efficiently and without unnecessary delay. Remember, when in doubt, consulting with a legal professional can provide clarity and peace of mind throughout this critical process.

Documents used along the form

When navigating the process of filing a Connecticut Custody Application form, individuals often find that additional documents are required to support their application effectively. Whether seeking custody or visitation rights, these supplementary forms and documents play a crucial role in demonstrating the applicant's legal relationship with the child or children, their financial situation, and any relevant agreements or court orders previously established. Below is a list of documents commonly used along with the Connecticut Custody Application form, each described briefly to provide a clearer understanding of their purpose and importance.

  • Order to Attend Hearing (JD-FM-162): This form notifies the parties involved that they are required to attend a hearing related to the custody or visitation application. It provides details on the date, time, and location of the hearing.
  • Notice of Automatic Court Orders (JD-FM-158): Upon filing for custody or visitation, this document outlines automatic orders that come into effect, aimed at preventing either party from making significant changes that could affect the child's welfare or the financial situation of the other party.
  • Affidavit Concerning Children (JD-FM-164): This affidavit requires the applicant to provide information about the children’s current residence, any previous court cases involving the children, and any pending court cases in any state that could affect the current custody or visitation application.
  • Verified Petition for Visitation — Grandparents & Third Parties (JD-FM-221): For grandparents or other third parties who are not the legal parents but wish to file for visitation rights, this form allows them to formally request visitation through the court.
  • Certification of Notice (JD-FM-175): If financial support or health insurance (HUSky Health Insurance) is received from the State of Connecticut, this form certifies that a copy of the custody or visitation application and related documents have been sent to the Office of the Attorney General or the local city/town providing assistance.

Together with the Connecticut Custody Application form, these documents help ensure that the court has all necessary information to make informed decisions regarding custody and visitation rights. It’s essential for applicants to carefully review and complete each relevant form, adhering to the state's legal requirements and procedures, to support their case effectively. Gathering and presenting these documents thoughtfully can significantly impact the outcome of the custody or visitation application process.

Similar forms

The Connecticut Custody Application form is similar to other legal documents that are used in family law, such as the Application for Order to Attend Hearing and the Notice of Automatic Court Orders. These documents share common features in their structure, purpose, and the information they collect from the applicants.

One such document is the Order to Attend Hearing (form JD-FM-162). This form, like the Custody Application, is used in the Connecticut Superior Court to initiate a procession where a hearing is necessary. Both forms require detailed personal information about the applicant and the respondent, as well as information regarding the children involved. They share the goal of preparing the court to make informed decisions regarding family matters, specifically focusing on what arrangement will best serve the children's interests. The Order to Attend Hearing complements the Custody Application by scheduling a time for the court to review the case and make necessary orders related to the family's situation.

Another document that bears resemblance to the Connecticut Custody Application is the Notice of Automatic Court Orders (form JD-FM-158). This form is automatically in effect upon the filing of a complaint or application that pertains to family law, such as divorce or custody cases. It contains a series of orders that restrict the actions of both parties to protect the interests of the children and preserve marital assets. Like the Custody Application, the Notice of Automatic Court Orders is designed to maintain the status quo and prevent harm during the litigation process. It offers immediate protections, mirroring the Custody Application's urgent nature regarding the welfare of children and the rights of their parents or guardians.

The Affidavit Concerning Children (form JD-FM-164) is also closely related to the Connecticut Custody Application. It specifically requires detailed information about every child involved in a family or custody case, including their current state of well-being, living arrangements, and history of parental responsibilities. Both the Custody Application and the Affidavit Concerning Children aim to provide the court with a comprehensive view of the child's or children's circumstances to make a decision that best serves their needs and rights. Focusing on the children's interest is a poignant similarity, reflecting the judiciary's commitment to prioritizing children's welfare above all else.

Dos and Don'ts

Filling out the Connecticut Custody Application form is a critical step in a legal process that significantly impacts families. To ensure the process is handled correctly, here are five things you should do and five things you shouldn't do when completing this form.

Things You Should Do

  1. Check the appropriate box at the top of the form to indicate whether you are applying for custody or visitation to ensure your application is processed correctly.
  2. Attach all required documents, including the Order to Attend Hearing, Notice of Automatic Court Orders, and Affidavit Concerning Children, as incomplete applications can lead to delays.
  3. Redact any personal identifying information from your supporting documents as required by Section 4-7 of the Connecticut Practice Book to protect privacy.
  4. Provide accurate and comprehensive details about the child or children, including names, dates of birth, and current living arrangements, to assist the court in understanding the situation fully.
  5. Clearly state the reasons Connecticut has the authority to decide on your case, selecting all applicable options, to establish the jurisdiction of the court.

Things You Shouldn't Do

  1. Do not leave sections of the form blank. If a section does not apply to your situation, indicate this with “N/A” (not applicable) to confirm you have reviewed each part of the form.
  2. Do not provide false or misleading information. The accuracy of your application affects the court's decision and submitting incorrect information can lead to legal consequences.
  3. Do not forget to send copies of your application and related documents to the Office of the Attorney General or the City or Town Clerk if you checked "yes" for financial support or HUSKY, as failing to do so can delay your case.
  4. Do not ignore the need for additional sheets if the space provided is insufficient. Attach extra pages to ensure that all relevant information is considered by the court.
  5. Do not overlook the signature and date at the end of the application. Unsigned or undated forms are not processed, which can significantly delay your case.

Approaching the Connecticut Custody Application with diligence and attention to detail will facilitate a smoother legal process, ensuring that all parties involved are treated fairly and respectfully.

Misconceptions

  • One common misconception is that the Connecticut Custody Application form is only intended for occasions when parents are undergoing separation or divorce. However, the form can also be utilized by grandparents or third parties under specific circumstances, as indicated by the option to use the Verified Petition for Visitation for grandparents and third parties.

  • Many individuals mistakenly believe that filling out and submitting the Connecticut Custody Application form automatically grants custody or visitation rights. In reality, this form is merely the initial step in the legal process, requiring a careful review by the court and possibly a hearing to determine the best interests of the child or children involved.

  • There's a misconception that personal identifying information must be included in full on this application. The instructions specifically require that any personal identifying information, as defined by Section 4-7 of the Connecticut Practice Book, be redacted for privacy and safety reasons.

  • Some people might think that the "Claim for Relief" section enables the applicant to make any claim regarding custody or visitation. This section, however, is designed to let applicants specify their request for the type of custody or visitation arrangement they are seeking, adhering to the guidelines and options provided on the form.

  • A misleading assumption is that financial support or HUSKY Health Insurance status of the applicant, respondent, or the children does not affect the custody application process. The form explicitly asks about financial support and HUSKY to ensure that all relevant information is disclosed and considered, particularly if there's state interest due to financial assistance provided.

  • It's incorrectly assumed that if there's an existing legal relationship with the child that's not as a biological parent, one cannot apply for custody or visitation. The application requires existing legal relationships to be proven with documentation, which can include a variety of legal documents beyond a birth certificate.

  • Many believe that checking the "Custody" or "Visitation" box determines the sole outcome of the process. While these selections indicate the applicant's initial request, the final decision will be made by the court based on the child's best interests after a comprehensive evaluation of all submitted materials and any required hearings.

  • There's a misconception that this application is only valid if filed within Connecticut. While it's true that the application is for the State of Connecticut, jurisdiction can extend to cases where Connecticut has been determined to be the home state of the child or in circumstances detailed in the jurisdiction section of the form.

  • Some individuals mistakenly believe that every section of the application must be completed in full by all applicants. The form contains specific instructions that guide different applicants, such as mothers, fathers, grandparents, or third parties, on which sections to complete based on their circumstances.

Key takeaways

When navigating the process of applying for custody or visitation in Connecticut, understanding the intricacies of the Connecticut Custody Application form is vital. Here are key takeaways to help applicants through this critical procedure:

  • Firstly, applicants must decide whether they are filing for custody or visitation rights and check the appropriate box at the top of the form. This choice determines the subsequent legal path and the kind of information the court will need.
  • It's imperative to attach the Order to Attend Hearing, Notice of Automatic Court Orders, and Affidavit Concerning Children to the application. These documents supplement the application by providing essential details regarding the applicant, the children involved, and the legal framework governing the request.
  • Before the case's first scheduled date, applicants need to submit documentation proving an existing legal relationship with the child or children. This can include birth certificates, court orders, or other relevant evidence, ensuring all personal identifying information is redacted for privacy.
  • For those who aren't the legal parents but seek visitation rights, like grandparents or third parties, a specific form, the Verified Petition for Visitation, must be used instead. This distinction recognizes the unique legal standings of non-parental applicants.
  • Applicants must explain why Connecticut is the appropriate venue for their case, whether it's because the state is the child's home, there's significant connection to the state, or for reasons concerning the child's well-being. This helps establish jurisdiction.

Moreover:

  1. The application requires disclosure if the applicant, respondent, or any listed child has received financial support or HUSKY Health Insurance from the State of Connecticut or any financial aid from a city or town within Connecticut. This information is critical for ensuring that all potential considerations regarding the child's welfare are taken into account.
  2. For those applying for custody, specifying the nature of the desired custody arrangement—whether it involves sole or joint legal custody, the primary residence of the child, or specific visitation schedules—is crucial. These details will guide the court in establishing a custody arrangement that suits the child's best interests.

This document also includes provisions for child and educational support requests, underscoring the importance of outlining all necessary supports and arrangements to safeguard the child's future. Lastly, the ADA notice reminds applicants that accommodations are available, ensuring the accessibility of the custody/visitation process to all individuals.

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