FORM 5.10B Emergency Petition for Special Relief

IN THE COURT OF COMMON PLEAS OF

__________________ COUNTY, PENNSYLVANIA

CIVIL ACTION-LAW

PLAINTIFF

vs No. CI -

DEFENDANT

EMERGENCY PETITION FOR SPECIAL RELIEF

Plaintiff, __________________, files this Emergency Petition for Special Relief and avers as

follows:

1. Plaintiff is __________________, [Mother/Father], who currently resides at

__________________.

2. Defendant is __________________, [Mother/Father], who currently resides at

__________________.

3. The parties hereto are the parents of the following minor [Child/Children], who currently

reside(s) at __________________.

4. On __________________, 20______, the Honorable __________________

__________________, entered an Order of Custody in the Court of Common Pleas of

__________________ County, Pennsylvania. A true and correct copy of said Order of Court

is marked Exhibit ``A,'' attached hereto and made a part hereof.

5. Pursuant to said Order of Court, the [Child/Children] is/are scheduled to spend

__________________ with [Mother/Father].

6. [Mother/Father] has informed [Mother/Father] that he/she does not intend to comply with

said Order of Court, and will not produce the [Child/Children] at [Mother's/Father's] scheduled

time for physical custody. WHEREFORE, Plaintiff respectfully requests that this Honorable

Court order Defendant to produce the [Child/Children] at __________________. M., on

__________________, at __________________, in order for Plaintiff to exercise his/her

physical custody rights, or be subject to sanctions of this Court. Plaintiff further requests that this

Honorable Court order Defendant to pay Plaintiff's reasonable counsel fees and costs.

OR

5. Pursuant to said Order of Court, [Mother/Father] has joint legal custody of the

[Child/Children].

6. [Mother/Father] is entitled to access to the [Child's/Children's] school records.

7. [Mother/Father] has refused to provide [Mother/Father] with copies of the

[Child's/Children's] report cards and has instructed the [Child's/Children's] school not to provide

the report cards to [Mother/ Father].

8. [Mother/Father] is in willful violation of the __________________, 20______, Order of

Court.

WHEREFORE, Plaintiff respectfully requests that this Honorable Court order Defendant to

provide copies of the [Child's/Children's] report cards to Defendant, and to instruct the

[Child's/Children's] school that Defendant is entitled to receive copies of the report cards.

Plaintiff further requests that this Honorable Court order Defendant to pay Plaintiff's reasonable

counsel fees and costs.

Respectfully submitted,

__________________

[VERIFICATION]