Person Filing: Address (if not protected): City, State, Zip Code: Telephone: Email Address: ATLAS Number: Lawyer222s Bar Number: Representing Self, without a Lawyer or Attorney for Petitioner OR Respondent SUPERIOR COURT OF ARIZONA IN MARICOPA COUNTY Leave Blank. For Court Use Only. Petitioner (in o ut - of - state case) Arizona Superior Court Case Number AFFIDAVIT TO REGISTER FOREIGN (OUT OF STATE) CUSTODY, LEGAL DECISION-MAKING, PARENTING TIME, or NON-PARENT VISITATION ORDER in ARIZONA (A.R.S. 247 25 - 1055 ) (UCCJEA) Respondent (in o ut - of - state case) PURPOSE OF REGISTERING THE OTHER STATE222S ORDER IN ARIZONA: Registration Only: I only want to register the order at this time. Enforcement: I want to be able to enforce the order in Arizona. Modification: I want to be able to change the order in Arizona. (Note: Separate forms are required to request either enforcement or modification.) For Clerk222s Use Only 251 Superior Court of Arizona in Maricopa County DRFOC12f-031418 ALL RIGHTS RESERVED Page 1 of 4 American LegalNet, Inc. www.FormsWorkFlow.com Arizona Case No. UNDER OATH OR AFFIRMATION 1. INFORMATION ABOUT THE OTHER STATE222S ORDER I WANT TO REGISTER IN ARIZONA: 1. A. Case Name: Title of Order: Case Number: Date Signed: Name of Court: State Which Issued the Order: Information About Adult Parties in the Case (Name and relation to any childre n involved) Petitioner: Father Mother Other Respondent: Father Mother Other Other (1) (if any) : Relation: Other (2) (if any) : Relatio n: I state to the Court to the best of my knowledge and belief this is the most recent and valid order and has not been modified. 1. B. Have all parties named in the other state222s order moved out of the issuing state? Yes No 2. INFORMATION ABOUT THE PARTIES IN THE OUT-OF-STATE CASE: Note: If specific address or identifying information would endanger a party or child and the information is not already known to other parties, write 223Protected224 in the space for that information and supply it to the Court on the 223Request for Protected Address224 form available from the Law Library Resource Center or other form designated by the Clerk of Court. Petitioner : Full Legal Name: Name as Listed in Other State222s Case: (if different) P revious Name or Aliases: Current Address: (Street Address, City, State, Zip) Employer Name : Employer Address: 251 Superior Court of Arizona in Maricopa County DRFOC12f-031418 ALL RIGHTS RESERVED Page 2 of 4 American LegalNet, Inc. www.FormsWorkFlow.com Arizona Case No. Respondent : Full Legal Name: Name as Listed in Other State222s Case: (if different) Previous Name or Aliases: Current Address: (Street Address, City, State, Zip) Employer Name: Employer Address: OTHER ADULT (or agency) : Full Legal Name: Name as Listed in Other State222s Case: (if different) Previous Name or Aliases: Relation to this Case: Has legal decision-making authority or is court appointed guardian of minor(s) Is caretaker or someone the child(ren) live s with Other. Explain: Current Address: (Street Address, City, State, Zip) In this case, this Person is: Petitioner Respondent 3rd Party OTHER ADULT (or agency): Full Legal Name: Name as Listed in Other State222s Case: (if different) Previous Name or Aliases: Relation to this Case: Has legal decision-making authority or is the court-appointed guardian of minor(s) Is caretaker or someone the child(ren) lives with Other. Explain: Current Address: (Street Address, City, State, Zip) In this case, this Person is: Petitioner Respondent 3rd Party 251 Superior Court of Arizona in Maricopa County DRFOC12f-031418 ALL RIGHTS RESERVED Page 3 of 4 American LegalNet, Inc. www.FormsWorkFlow.com Arizona Case No. 3. INFORMATION ABOUT MINOR CHILD(REN) IN THE OUT-OF-STATE CASE: (For Place of Birth: enter city (or county) and state (or country, if outside the U.S.). (Enter child222s sex as 223M224 for male, 223F224 for Female.) Child222s Name Place of Birth Current Age Sex A. B. C. D. E. 4. ADDITIONAL CASE INFORMATION: This order is registered in the following states (other than the issuing state and Arizona): I am enclosing an 223Affidavit Regarding Minor Children to Register Foreign Order224 containing additional information required by the Uniform Child Custody Jurisdiction and Enforcement Act (UCCJEA), A.R.S. 247 25-1039. UNDER OATH OR BY AFFIRMATION I swear or affirm under penalty of perjury that the contents of this document are true and correct and that the attached order has not been modified to the best of my knowledge and belief Date Signature Printed Name STATE OF COUNTY OF Subscribed and sworn to or affirmed before me this: by (date) . (notary seal) Deputy Clerk or Notary Public 251 Superior Court of Arizona in Maricopa County DRFOC12f-031418 ALL RIGHTS RESERVED Page 4 of 4 American LegalNet, Inc. www.FormsWorkFlow.com