Pennsylvania Custody Modification Agreement
PENNSYLVANIA CUSTODY MODIFICATION AGREEMENT
Stipulation to Modify Existing Custody Order
Filed Pursuant to 23 Pa.C.S. § 5338 and Chapter 53 (Pennsylvania Child Custody Act)
PENNSYLVANIA MODIFICATION STANDARD
Under 23 Pa.C.S. § 5338, a court may modify an existing custody order upon consideration of all 16 best interest factors enumerated in 23 Pa.C.S. § 5328(a). Unlike many other states, Pennsylvania does not require a threshold showing of a "substantial change in circumstances" before the court will consider a modification petition. Instead, the court conducts a fresh best interest analysis each time modification is sought.
However, any petition for modification must be accompanied by:
- A criminal record / abuse history verification under Pa.R.C.P. 1915.3-2 and 23 Pa.C.S. § 5329;
- A verification regarding child abuse and protective services involvement under 23 Pa.C.S. § 5329.1(a).
If the modification involves relocation, the additional requirements of 23 Pa.C.S. § 5337 (60-day notice, counter-affidavit, 10 relocation factors) must also be satisfied.
1. COURT AND CASE INFORMATION
Court of Common Pleas of [________________________________] County, Pennsylvania
Family Division
Docket Number: [________________________________]
Case Caption: [________________________________] v. [________________________________]
1.1 Parties
Parent A (Plaintiff/Defendant):
Full Legal Name: [________________________________]
Address: [________________________________]
City, State, ZIP: [________________________________]
Telephone: [________________________________]
Email: [________________________________]
Parent B (Plaintiff/Defendant):
Full Legal Name: [________________________________]
Address: [________________________________]
City, State, ZIP: [________________________________]
Telephone: [________________________________]
Email: [________________________________]
1.2 Minor Child(ren)
| Child's Full Legal Name | Date of Birth | Age | Current School / Grade |
|---|---|---|---|
| [________________________________] | [__/__/____] | [____] | [________________________________] |
| [________________________________] | [__/__/____] | [____] | [________________________________] |
(Each individually a "Child" and collectively the "Children.")
1.3 Original Custody Order
This Modification amends the custody order entered on [__/__/____] by the Honorable [________________________________], Judge of the Court of Common Pleas, Family Division, of [________________________________] County, Pennsylvania (the "Original Order").
Docket Number of Original Order: [________________________________]
Summary of Current Custody Arrangement Under Original Order:
| Custody Type | Current Award |
|---|---|
| Legal Custody | ☐ Shared legal ☐ Sole legal to [________________________________] |
| Physical Custody | ☐ Shared physical ☐ Primary to [________________________________] / Partial to [________________________________] ☐ Sole to [________________________________] ☐ Supervised to [________________________________] |
1.4 Effective Date
This Modification shall become effective as of [__/__/____], or upon the date of the Court's order incorporating this Modification, whichever is later.
1.5 Criminal Record / Abuse History Verification (Pa.R.C.P. 1915.3-2)
Pursuant to Pa.R.C.P. 1915.3-2, each Parent has filed the required verification regarding criminal record or abuse history, disclosing any convictions, guilty pleas, or no-contest pleas to offenses enumerated under 23 Pa.C.S. § 5329(a), and any involvement with child protective services under 23 Pa.C.S. § 5329.1(a).
Since the Original Order:
☐ Neither Parent has had any new criminal charges, convictions, or child protective services involvement.
☐ The following has occurred: [________________________________]
☐ The Court has considered the above and determined that the modification below is in the Children's best interest and does not pose a threat of harm.
2. BASIS FOR MODIFICATION
2.1 Reason(s) for Seeking Modification
The Parents agree that modification of the Original Order serves the Children's best interests for the following reason(s):
☐ Change in a Parent's residence or work schedule
☐ Change in the Children's school, activities, or developmental needs
☐ The Children's maturity and well-reasoned preference (23 Pa.C.S. § 5328(a)(7))
☐ Resolution of conditions that necessitated the original arrangement (e.g., completion of treatment, end of supervision)
☐ Deterioration or improvement in a Parent's circumstances
☐ Persistent non-compliance with the Original Order
☐ Relocation by one Parent (subject to 23 Pa.C.S. § 5337)
☐ Change in sibling arrangements
☐ Desire to transition from supervised to unsupervised custody
☐ Other: [________________________________]
Detailed explanation: [________________________________]
2.2 Best Interest Factors (23 Pa.C.S. § 5328(a))
The Parents acknowledge that the Court must consider all 16 best interest factors when evaluating this Modification. The Parents agree that the following factors are particularly relevant to this Modification:
☐ Factor (1): Encouraging contact — [________________________________]
☐ Factor (2): Abuse history — [________________________________]
☐ Factor (3): Parental duties — [________________________________]
☐ Factor (4): Stability and continuity — [________________________________]
☐ Factor (5): Extended family — [________________________________]
☐ Factor (6): Sibling relationships — [________________________________]
☐ Factor (7): Child's well-reasoned preference — [________________________________]
☐ Factor (8): Alienation attempts — [________________________________]
☐ Factor (9): Loving, stable relationship — [________________________________]
☐ Factor (10): Daily needs — [________________________________]
☐ Factor (11): Proximity of residences — [________________________________]
☐ Factor (12): Availability for care — [________________________________]
☐ Factor (13): Cooperation and conflict — [________________________________]
☐ Factor (14): Drug or alcohol history — [________________________________]
☐ Factor (15): Mental and physical condition — [________________________________]
☐ Factor (16): Other relevant factor — [________________________________]
3. MODIFICATIONS TO LEGAL CUSTODY
3.1 Modification of Legal Custody Type
☐ No change to legal custody. Legal custody remains as provided in the Original Order.
☐ Legal custody is modified as follows:
| Original Order | Modified to | |
|---|---|---|
| Legal Custody | ☐ Shared legal ☐ Sole legal to [________] | ☐ Shared legal ☐ Sole legal to [________] |
3.2 Modified Decision-Making Allocation (If Shared Legal Custody)
☐ Not applicable (sole legal custody or no change).
☐ The decision-making protocol is modified as follows:
(a) Education decisions: [________________________________]
(b) Medical decisions: [________________________________]
(c) Mental health decisions: [________________________________]
(d) Religious upbringing: [________________________________]
(e) Extracurricular activities: [________________________________]
(f) Tiebreaking authority (if any): [________________________________]
3.3 Appointment of Parenting Coordinator (23 Pa.C.S. § 5334)
☐ Not applicable.
☐ The Parents consent to the appointment of a parenting coordinator under 23 Pa.C.S. § 5334 to assist in resolving decision-making disputes.
Name: [________________________________]
4. MODIFICATIONS TO PHYSICAL CUSTODY
4.1 Modification of Physical Custody Type
☐ No change to physical custody type. Physical custody type remains as in the Original Order.
☐ Physical custody type is modified as follows:
| Original Order | Modified to | |
|---|---|---|
| Physical Custody | [________________________________] | [________________________________] |
Use Pennsylvania statutory terms from 23 Pa.C.S. § 5322(a): shared physical, primary physical, partial physical, sole physical, supervised physical (professional or nonprofessional).
4.2 Modified Custodial Schedule
☐ No change to custodial schedule.
☐ The regular custodial schedule is modified as follows:
Parent A's Custodial Time (Modified):
[________________________________]
Parent B's Custodial Time (Modified):
[________________________________]
Effective Date of New Schedule: [__/__/____]
4.3 Modified Holiday / School Break Schedule
☐ No change to holiday schedule.
☐ The holiday schedule is modified as follows:
| Holiday | Modified Arrangement |
|---|---|
| [________________________________] | [________________________________] |
| [________________________________] | [________________________________] |
| [________________________________] | [________________________________] |
4.4 Modified Summer / Vacation Schedule
☐ No change to summer/vacation schedule.
☐ The summer/vacation schedule is modified as follows:
[________________________________]
4.5 Modified Exchange Location and Transportation
☐ No change.
☐ Exchange location modified to: [________________________________]
☐ Transportation responsibility modified to: [________________________________]
5. MODIFICATION OF SUPERVISION REQUIREMENTS
☐ Not applicable — no supervised custody in original or modified arrangement.
☐ Supervision is being added.
Reason: [________________________________]
Type: ☐ Professional supervised ☐ Nonprofessional supervised
Supervisor / Facility: [________________________________]
Schedule: [________________________________]
☐ Supervision is being reduced or removed.
Basis for reduction/removal:
☐ Completion of substance abuse treatment program
☐ Completion of parenting education program
☐ Clean drug/alcohol test results for [____] consecutive months
☐ Successful completion of anger management program
☐ Satisfactory mental health evaluation and treatment compliance
☐ Compliance with PFA order for [____] months without incident
☐ Recommendation of custody evaluator or guardian ad litem
☐ Other: [________________________________]
Modified Arrangement:
☐ Transition from professional supervised to nonprofessional supervised
☐ Transition from supervised to unsupervised partial physical custody
☐ Graduated transition schedule:
Phase 1 ([____] months): [________________________________]
Phase 2 ([____] months): [________________________________]
Phase 3: [________________________________]
6. MODIFICATION INVOLVING RELOCATION (23 Pa.C.S. § 5337)
☐ Not applicable — this modification does not involve relocation.
☐ This modification involves or results from a proposed relocation.
6.1 Compliance with 60-Day Notice (23 Pa.C.S. § 5337(c))
☐ The relocating Parent provided the required 60-day notice by certified mail on [__/__/____].
☐ The non-relocating Parent received the notice on [__/__/____].
☐ The non-relocating Parent consents to the relocation.
☐ The non-relocating Parent filed a counter-affidavit and the parties have reached this agreement in resolution.
6.2 Relocation Details
Current residence: [________________________________]
New residence: [________________________________]
Reason for relocation: [________________________________]
Date of relocation: [__/__/____]
New school enrollment: [________________________________]
6.3 Relocation Factors (23 Pa.C.S. § 5337(h))
The Parents agree that this relocation serves the Children's best interests after consideration of the 10 relocation factors:
(1) Nature and quality of relationships: [________________________________]
(2) Child's age, developmental stage, and needs: [________________________________]
(3) Feasibility of preserving non-relocating parent's relationship: [________________________________]
(4) Child's preference: [________________________________]
(5) Pattern of promoting or thwarting relationship: [________________________________]
(6) Enhancement of relocating parent's quality of life: [________________________________]
(7) Enhancement of child's quality of life: [________________________________]
(8) Motivations for seeking/opposing relocation: [________________________________]
(9) Abuse history and risk of harm: [________________________________]
(10) Other best interest factors: [________________________________]
7. CHILD'S PREFERENCE (23 Pa.C.S. § 5328(a)(7))
☐ Not applicable — no Child has expressed a well-reasoned preference, or the Child(ren) are too young.
☐ Applicable — [________________________________] (Child's name), age [____], has expressed a well-reasoned preference regarding the custody arrangement. The Parents have considered the Child's preference, taking into account the Child's maturity and judgment, along with all other best interest factors.
8. PROVISIONS REMAINING UNCHANGED
Unless expressly modified above, all other provisions of the Original Order remain in full force and effect, including but not limited to:
☐ Communication provisions
☐ Non-disparagement provisions
☐ Information sharing and record access
☐ Substance use restrictions
☐ Firearms safety requirements
☐ Right of first refusal
☐ Financial provisions / child support
☐ Other: [________________________________]
9. DISPUTE RESOLUTION
9.1 Parenting Coordinator (23 Pa.C.S. § 5334)
☐ A parenting coordinator is appointed per Section 3.3 above.
☐ Not applicable.
9.2 Mediation
Disputes regarding this Modification shall first be addressed through mediation with a qualified family mediator before court intervention.
9.3 Court Proceedings
Either Parent may file a petition with the Court of Common Pleas, Family Division, of [________________________________] County. The court shall schedule an initial conference within 45 days per Pa.R.C.P. 1915.4.
Philadelphia County: File at the Family Court Division, 1501 Arch Street, 11th Floor, Philadelphia, PA 19102.
9.4 Contempt and Enforcement (23 Pa.C.S. § 5323(g))
Willful violation of the modified custody order may result in contempt sanctions including imprisonment (up to six months), fines, probation, suspension of driving privilege, make-up custodial time, and attorney's fees.
9.5 Governing Law
This Modification is governed by the Pennsylvania Child Custody Act, 23 Pa.C.S. Chapter 53, and the Pennsylvania Rules of Civil Procedure, Pa.R.C.P. 1915.1 et seq.
10. REPRESENTATIONS
10.1 Voluntary Agreement
Each Parent enters this Modification voluntarily, without coercion, duress, or undue influence.
10.2 Best Interests
Both Parents represent that this Modification serves the Children's best interests.
10.3 Full Disclosure
Each Parent has disclosed all material information relevant to this Modification, including criminal record / abuse history, current living situations, employment, and any circumstances affecting the Children's welfare.
10.4 Compliance with Original Order
Each Parent represents ☐ substantial compliance / ☐ the following issues with compliance: [________________________________] with the Original Order.
11. GENERAL PROVISIONS
11.1 Integration with Original Order
This Modification, together with the unmodified provisions of the Original Order, constitutes the entire custody arrangement.
11.2 Severability
If any provision is unenforceable, the remaining provisions remain in full force.
11.3 Further Modification
Either Parent may seek further modification by filing a petition under 23 Pa.C.S. § 5338, accompanied by a criminal record / abuse history verification under Pa.R.C.P. 1915.3-2.
11.4 Counterparts and Electronic Signatures
This Modification may be executed in counterparts and by electronic signature.
11.5 Notice
All notices shall be sent to the addresses in Section 1.1 or as updated in writing.
12. EXECUTION
IN WITNESS WHEREOF, the Parents have executed this Modification as of the date(s) below.
PARENT A:
Signature: _________________________________
Print Name: [________________________________]
Date: [__/__/____]
PARENT B:
Signature: _________________________________
Print Name: [________________________________]
Date: [__/__/____]
ATTORNEY FOR PARENT A (if applicable):
Signature: _________________________________
Print Name: [________________________________]
PA Supreme Court ID No.: [________________________________]
Date: [__/__/____]
ATTORNEY FOR PARENT B (if applicable):
Signature: _________________________________
Print Name: [________________________________]
PA Supreme Court ID No.: [________________________________]
Date: [__/__/____]
13. ORDER OF COURT
IN THE COURT OF COMMON PLEAS OF [________________________________] COUNTY, PENNSYLVANIA
FAMILY DIVISION
Docket No.: [________________________________]
The Court, having reviewed the foregoing Stipulation to Modify the Existing Custody Order, having considered all 16 best interest factors under 23 Pa.C.S. § 5328(a), the criminal record / abuse history disclosures under 23 Pa.C.S. § 5329 and Pa.R.C.P. 1915.3-2, ☐ the 10 relocation factors under 23 Pa.C.S. § 5337(h) (if applicable), and finding that the proposed modification serves the best interests of the minor child(ren):
IT IS HEREBY ORDERED that:
-
The custody order entered on [__/__/____] is MODIFIED as set forth in the foregoing Stipulation.
-
The modified custody arrangement is effective as of [__/__/____].
-
All provisions of the original custody order not expressly modified remain in full force and effect.
-
Willful failure to comply with this Modified Order may result in contempt sanctions under 23 Pa.C.S. § 5323(g).
Date: [__/__/____]
_________________________________
Judge, Court of Common Pleas
[________________________________] County, Pennsylvania
Sources and References
Pennsylvania Child Custody Act
- 23 Pa.C.S. Chapter 53 — Child Custody: https://www.legis.state.pa.us/WU01/LI/LI/CT/HTM/23/00.053..HTM
- 23 Pa.C.S. § 5328 — Best Interest Factors: https://www.legis.state.pa.us/WU01/LI/LI/CT/HTM/23/00.053.028.000..HTM
- 23 Pa.C.S. § 5337 — Relocation: https://www.legis.state.pa.us/WU01/LI/LI/CT/HTM/23/00.053.037.000..HTM
- 23 Pa.C.S. § 5338 — Modification of Existing Order: https://law.justia.com/codes/pennsylvania/title-23/chapter-53/section-5338/
Pennsylvania Rules of Civil Procedure
- Pa.R.C.P. 1915.1 et seq. — Custody Actions: https://www.pacodeandbulletin.gov/Display/pacode?file=/secure/pacode/data/231/chapter1915/chap1915toc.html
- Pa.R.C.P. 1915.3-2 — Criminal Record or Abuse History: https://www.pacodeandbulletin.gov/Display/pacode?file=/secure/pacode/data/231/chapter1915/s1915.3-2.html
- Pa.R.C.P. 1915.17 — Relocation Notice and Counter-Affidavit: https://www.pacodeandbulletin.gov/Display/pacode?file=/secure/pacode/data/231/chapter1915/s1915.17.html
Key Legal Analysis
- Understanding the 16 Custody Factors in Pennsylvania: https://thebetterwaylaw.com/blog-/understanding-the-16-custody-factors-in-pennsylvania
- PA Unified Judicial System — Custody Proceedings: https://www.pacourts.us/learn/representing-yourself/custody-proceedings
Prepared for attorney review. This template is provided for informational purposes only and does not constitute legal advice.
About This Template
Family law covers the paperwork that shapes divorce, custody, child support, adoption, guardianship, and other family matters. These filings are emotional and high-stakes, and they also have to meet strict procedural rules for service, financial disclosure, and parenting plans. Clean, accurate paperwork keeps the focus on getting a workable outcome for the family instead of getting derailed by technical problems that delay hearings or force amended filings.
Important Notice
This template is provided for informational purposes. It is not legal advice. We recommend having an attorney review any legal document before signing, especially for high-value or complex matters.
Last updated: April 2026