CONNECTICUT PROBATE COURTS Affidavit/Custody of Minor Child PC-610 REV. 4/18 Affidavit/Custody of Minor Child PC-610 RECEIVED : Instructions: 1) A petitioner must file this form at each hearing on a matter affecting the custody of a minor child, including a proceeding for temporary custody, removal of parent or guardian, termination of parental rights, adoption and temporary guardian. 2)If there is a proceeding in another court affecting the custody of the minor child, Probate Court Name District Number In the Matter of (Name and present address) The subscriber hereby swears, affirms, or avers that: To the best of my knowledge andThere is a proceeding in another court affecting the custody of the minorThe representations made in this affidavit are made under the penalty of false statement. Signature Type or Print Name Address Date American LegalNet, Inc. www.FormsWorkFlow.com