IN THE COURT OF COMMON PLEAS FOR ADAMS COUNTY, PENNSYLVANIA CIVIL ACTION - LAW

Name_1(ConCM)

Name PLAINTIFF vs. Name DEFENDANT 1 and (if applicable) Name DEFENDANT 2 CASE NO. _____

Name_2(ConCM)
Name_3(ConCM)
CASE NO(ConCM)

CASE NO.

ACTION IN CUSTODY

CONCILIATION CONFERENCE MEMORANDUM

And now, comes the undersigned party who submits the following custody conference memorandum pursuant to Adams C.Civ.R. No. 1915.4-3.2(h):

  1. 1. Brief factual background, including current custody schedule for the child/ren:
Background(ConCM)
  1. 2. Initials and current age of each child:

Child #1:_____

Child 1(ConCM)

Child#3:

Child 3(ConCM)

Child #2:_____ Child#3:_____

Child 2(ConCM)

Child #4:_____

Child 4(ConCM)