Maryland Child Custody FormMaryland Child Custody FormMaryland Child Custody Form
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Circuit Court for

Case No.

City or County

Name

Name
Apt. #

Street Address

City

State

Zip Code

Area
Code

Apt. #

Street Address

Telephone

City

State

Plaintiff

Zip Code

Area
Code

Telephone

Defendant No. 1
Name
Apt. #

Street Address

City

State

Zip Code

Area
Code

Telephone

Defendant No. 2

COMPLAINT FOR CUSTODY
(DOM REL 4)
I,
1.

, representing myself, state that:

Your name

I am the

mother

father or
Relationship (for example, aunt, grandfather, guardian, etc.)

of the following minor child(ren):

2.

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