title: "Pennsylvania Child Custody - LSC-Grade Legal Packet"

state: "PA"

category: "Child Custody"

date: "2026-03-20"

price: "$67"

lsc_grade: true

Pennsylvania Child Custody Packet

Templates for informational purposes only. Not legal advice.

ELIGIBILITY CHECKLIST

• [ ] Child has lived in Pennsylvania for at least 6 consecutive months
• [ ] Pennsylvania is child's "home state" (6+ months with a parent)
• [ ] You are the child's parent, legal guardian, or in loco parentis
• [ ] Unmarried father: paternity established (23 Pa.C.S. § 5103)
• [ ] No active CYS/dependency proceeding in Juvenile Court
• [ ] No emergency — if emergency, file for PFA instead
• [ ] No active custody order from another state (unless PA now has jurisdiction)
• [ ] Not seeking to terminate parental rights (separate proceeding)

COMPLAINT FOR CUSTODY — BLANK TEMPLATE

`

═══════════════════════════════════════════════════════════════════════════════

IN THE COURT OF COMMON PLEAS OF _____________ COUNTY

FAMILY COURT DIVISION

______________________________________________________________________________

PLAINTIFF: No.: _______________

__________________________

v. CUSTODY COMPLAINT

DEFENDANT:

__________________________

______________________________________________________________________________

COMPLAINT FOR CUSTODY

1. PLAINTIFF INFORMATION:

Name: ________________________________________________________________

Address: _____________________________________________________________

City/State/Zip: ______________________________________________________

Phone: _________________________ Date of Birth: _______________________

Social Security No. (last 4 digits): ________ Gender: ________________

1. DEFENDANT INFORMATION:

Name: ________________________________________________________________

Address: _____________________________________________________________

City/State/Zip: ______________________________________________________

Phone: _________________________ Date of Birth: _______________________

Social Security No. (last 4 digits): ________ Gender: ________________

1. RELATIONSHIP TO DEFENDANT (check one):

[ ] Married [ ] Divorced [ ] Separated [ ] Never Married

[ ] Other: ___________________________________________________________

1. CHILDREN (attach additional sheet if more than 3 children):

Child 1: Name: ______________________________________________________

Date of Birth: ______________ Social Security (last 4): _____

Currently living with: _______________________________________

Child 2: Name: ______________________________________________________

Date of Birth: ______________ Social Security (last 4): _____

Currently living with: _______________________________________

Child 3: Name: ______________________________________________________

Date of Birth: ______________ Social Security (last 4): _____

Currently living with: _______________________________________

1. CURRENT CUSTODY STATUS (check one):

[ ] No prior custody order exists

[ ] Prior custody order exists from _____________ County, ___________ State

Date of order: _______________ Case number: _______________________

1. CUSTODY REQUESTED (check all that apply):

LEGAL CUSTODY (decision-making):

[ ] Shared legal custody to both parties

[ ] Sole legal custody to Plaintiff

[ ] Sole legal custody to Defendant

[ ] Other: ___________________________________________________________

PHYSICAL CUSTODY (where child lives):

[ ] Primary physical custody to Plaintiff

[ ] Primary physical custody to Defendant

[ ] Shared physical custody (____% Plaintiff, ____% Defendant)

[ ] Partial physical custody/visitation to Plaintiff

[ ] Partial physical custody/visitation to Defendant

[ ] Supervised physical custody to: ___________________________________

1. BEST INTERESTS OF THE CHILD (23 Pa.C.S. § 5328):

Explain why the custody arrangement you are requesting is in the best

interests of the child(ren):

________________________________________________________________________

________________________________________________________________________

________________________________________________________________________

________________________________________________________________________

1. PRIOR COURT PROCEEDINGS (check all that apply):

[ ] None

[ ] Protection From Abuse (PFA) case: _________________________________

[ ] Dependency/CYS case: _____________________________________________

[ ] Criminal case involving children: _________________________________

[ ] Support case: ____________________________________________________

[ ] Other: ___________________________________________________________

1. SPECIAL CIRCUMSTANCES (check all that apply):

[ ] None

[ ] Child has special needs: _________________________________________

[ ] Domestic violence history

[ ] Substance abuse issues (party): __________________________________

[ ] Mental health issues (party): ____________________________________

[ ] Relocation planned

[ ] Other: ___________________________________________________________

1. VERIFICATION:

I verify that the statements made in this Complaint are true and correct.

I understand that false statements herein are made subject to the penalties

of 18 Pa.C.S. § 4904 relating to unsworn falsification to authorities.

_________________________________

Signature of Plaintiff

_________________________________

Date

_________________________________

Printed Name

_________________________________

Address

_________________________________

Phone Number

═══════════════════════════════════════════════════════════════════════════════

`

--- PAGE BREAK ---

PARENTING PLAN — BLANK TEMPLATE

`

═══════════════════════════════════════════════════════════════════════════════

PARENTING PLAN

Pennsylvania Court of Common Pleas

_______________ County

Case Number: __________________ Filed: __________________

Plaintiff: _______________________________________

Defendant: _______________________________________

Child(ren): ______________________________________

═══════════════════════════════════════════════════════════════════════════════

I. LEGAL CUSTODY (Decision-Making)

[ ] SHARED LEGAL CUSTODY: Both parents shall share decision-making

authority regarding the following major decisions:

[ ] Education [ ] Healthcare [ ] Religion

[ ] Extracurricular [ ] Mental Health [ ] Other: __________

[ ] SOLE LEGAL CUSTODY to: ___________________________________________

This parent shall have final decision-making authority.

DISPUTE RESOLUTION: If parents cannot agree on a major decision:

[ ] Attend mediation before court involvement

[ ] Final decision by parent with primary physical custody

[ ] Other: ___________________________________________________________

II. PHYSICAL CUSTODY (Residential Schedule)

A. PRIMARY RESIDENCE:

The child(ren) shall primarily reside with: ________________________

Address: ___________________________________________________________

B. REGULAR WEEKLY SCHEDULE:

[ ] Option 1: Primary/Partial Custody

Primary Parent: Sunday through Friday morning

Partial Custody Parent: Every other weekend

(Friday after school to Sunday at 6:00 PM)

Midweek: [ ] None [ ] Wednesday 5:00-8:00 PM

[ ] Option 2: Week-On/Week-Off

Week 1: Sunday to Sunday with Mother

Week 2: Sunday to Sunday with Father

[ ] Option 3: 5-2-2-5 Schedule

Monday-Tuesday: ______________________ (Parent name)

Wednesday-Thursday: __________________ (Parent name)

Friday-Sunday: Alternating weekends

[ ] Option 4: Custom Schedule (describe below):

_________________________________________________________________

C. HOLIDAY SCHEDULE:

HOLIDAY ODD YEARS EVEN YEARS

─────────────────────────────────────────────────────

New Year's Eve ________________ ________________

New Year's Day ________________ ________________

Easter Weekend ________________ ________________

Memorial Day ________________ ________________

July 4th ________________ ________________

Labor Day ________________ ________________

Thanksgiving ________________ ________________

Christmas Eve ________________ ________________

Christmas Day ________________ ________________

Winter Break ________________ ________________

Child's Birthday ________________ ________________

Mother's Day Mother Mother

Father's Day Father Father

D. SCHOOL VACATIONS:

Winter Break: _____________________________________________________

Spring Break: ______________________________________________________

Summer Vacation:

[ ] Two (2) consecutive weeks with non-primary parent

[ ] Two (2) non-consecutive weeks

[ ] Split summer 50/50

[ ] Other: ____________________________________________________

E. TRANSPORTATION:

Drop-off responsibility: __________________________________________

Pick-up responsibility: __________________________________________

Location: _________________________________________________________

III. COMMUNICATION

A. Between Parents:

Method: [ ] Phone [ ] Text [ ] Email [ ] Co-parenting app: _______

Response time: Within _____ hours for non-emergencies

B. With Child(ren):

[ ] Daily phone/video calls permitted with non-custodial parent

Time(s): ___________________________________________________________

IV. RIGHT OF FIRST REFUSAL

If a parent cannot care for the child(ren) during their scheduled time

for more than _____ hours, they shall:

[ ] Offer the other parent the opportunity to care for the child(ren)

[ ] Not required

V. RELOCATION (23 Pa.C.S. § 5337)

Either parent intending to relocate must provide _____ days' written

notice to the other parent and file a relocation petition with the court.

VI. MODIFICATION

This plan may be modified by written agreement of both parents or by

court order upon a showing of a substantial and material change in

circumstances (23 Pa.C.S. § 5338).

VII. ADDITIONAL PROVISIONS

_________________________________________________________________

_________________________________________________________________

═══════════════════════════════════════════════════════════════════════════════

SIGNATURES:

MOTHER: FATHER:

______________________________________ ______________________________________

Signature Signature

______________________________________ ______________________________________

Printed Name Printed Name

_____________ _____________

Date Date

═══════════════════════════════════════════════════════════════════════════════

`

--- PAGE BREAK ---

CRIMINAL RECORD/ABUSE HISTORY AFFIDAVIT — BLANK TEMPLATE

`

═══════════════════════════════════════════════════════════════════════════════

CRIMINAL RECORD AND CHILD ABUSE HISTORY AFFIDAVIT

Pennsylvania Court of Common Pleas

_______________ County

Case Number: __________________

___________________________________

Party Name

═══════════════════════════════════════════════════════════════════════════════

I, _______________________________________, being duly sworn, depose and say:

1. CRIMINAL RECORD (23 Pa.C.S. § 5329):

[ ] I have NEVER been convicted of a crime.

[ ] I HAVE been convicted of a crime. (Complete below for each conviction)

Offense: ______________________________________ Date: ______________

Court/County: ____________________________________________________

Disposition: _____________________________________________________

1. PENDING CRIMINAL CHARGES (23 Pa.C.S. § 5330):

[ ] I have NO pending criminal charges.

[ ] I have pending criminal charges. (Complete below)

Charge: _______________________________________ Date: ______________

Court/County: ____________________________________________________

Status: ___________________________________________________________

1. CHILD ABUSE HISTORY (23 Pa.C.S. § 5329.1):

[ ] I have NEVER been the subject of a founded or indicated report of

child abuse.

[ ] I HAVE been the subject of a founded or indicated report of child

abuse. (Complete below)

Date: _______________ Agency: ____________________________________

Disposition: _____________________________________________________

1. PROTECTION FROM ABUSE ORDERS:

[ ] I have NEVER had a Protection From Abuse (PFA) order entered against me.

[ ] A PFA order has been entered against me. (Complete below)

Court/County: _________________________ Date: _____________________

Duration: _________________________________________________________

I verify that the foregoing information is true and correct. I understand

that false statements are subject to penalties of 18 Pa.C.S. § 4904.

_______________________________________

Signature

_______________________________________

Printed Name

_______________________________________

Address

_______________________________________

Phone Number

Sworn to and subscribed before me this _____ day of _______________, 20____.

_______________________________________

Notary Public

My commission expires: _________________

═══════════════════════════════════════════════════════════════════════════════

`

FILING STEPS

1. Complete the Custody Education Program (23 Pa.C.S. § 5332) — contact your county Family Court for approved programs.
2. Gather children's birth certificates, Social Security numbers, existing court orders, and proof of residency.
3. Complete the Complaint for Custody — no blank spaces.
4. Complete the Criminal Record/Abuse History Affidavit — required for all parties.
5. Draft your proposed Parenting Plan.
6. Include Notice to Defend — attach to your Complaint.
7. Make 3 copies of all documents (original + 2 copies).
8. File at the Court of Common Pleas, Family Court Division in your county.
9. Pay filing fee ($200–$350) or request In Forma Pauperis waiver.
10. Serve the other parent — sheriff service ($30–$50), private process server, certified mail, or Acceptance of Service.
11. File Affidavit of Service after serving.
12. Attend custody conciliation (scheduled 30–60 days after filing) — try to reach agreement.
13. Attend custody evaluation if ordered by court (contested cases only).
14. Attend court hearing — arrive 30 minutes early, bring all documents.

COURT INFORMATION

FILING CHECKLIST

• [ ] Complaint for Custody (original + 2 copies)
• [ ] Criminal Record/Abuse History Affidavit (completed)
• [ ] Parenting Plan (proposed schedule)
• [ ] Notice to Defend (blank copy for other party)
• [ ] Filing fee ($200–$350) OR IFP application
• [ ] Photo ID
• [ ] Children's birth certificates
• [ ] Proof of residency (driver's license, utility bill)
• [ ] Any existing court orders
• [ ] Proof of parent education completion (if completed)
• [ ] Children's Social Security numbers and birth dates
• [ ] Children's school and doctor information
• [ ] Work schedules for both parents

STATUTE REFERENCES

DISCLAIMER

This packet contains general information about Pennsylvania child custody law. It is for informational purposes only. It does not create an attorney-client relationship. It is not a substitute for advice from a licensed attorney. Every situation is different. Laws change frequently. Court rules vary by county.

If your custody case involves domestic violence, child abuse, substance abuse, relocation out of state, or international custody issues, consult an attorney before filing. If you are in danger, call the National Domestic Violence Hotline: 1-800-799-7233, or call 911.

Need help? Find free legal aid at palawhelp.org or call 211.