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Affidavit Form. This is a New York form and can be use in Family Court Statewide.
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Tags: Affidavit, UCCJEA-3, New York Statewide, Family Court
COURT COUNTY OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .:::::::Index No.Calendar No.D.R.L. § 76-hForm UCCJEA-3 (Affidavit--UCCJEA) 8/2002 FAMILY COURT OF THE STATE OF NEW YORK COUNTY OF .............................................................................................In the Matter of a Proceeding for Custody Visitation under the Uniform Child Custody Jurisdiction and Enforcement ActJUDICIAL SUBPOENAPlaintiff(s) -against-Defendant(s). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..Petitioner,THE PEOPLE OF THE STATE OF NEW YORK TODocket No. -against -AFFIDAVIT -- UCCJEARespondent. .............................................................................................GREETINGS:WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before Court at the the HonorableSTATE OF NEW YORK ) :ss.: COUNTY OF,located at County ofo'clock in the day of, on the, 20, at or adjourned date, to testify and give evidence as a witness in this action on the part of thenoon, and at any recessed in room)I [specify name]:, being duly sworn, deposes and states the following:Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a result of your failure to comply.1. I reside am located at [specify address or indicate if ordered to be kept confidential pursuant to Family Court Act §154-b(2) or Domestic Relations Law §254]:, one of the Justices of theI am the [specify relationship to child(ren); if foster parent, agency, institution or other relationship, so state]:Court in Witness, Honorableday of, 20 County,and am the Petitioner Respondent in the above-entitled proceeding.(Attorney must sign above and type name below)2. (Upon information and belief) Each child who is the subject of this proceeding resides at:NameAddress1Date of BirthAttorney(s) forOffice and P.O. Address3. (Upon information and belief) During the last five years each child who is theTelephone No.: Facsimile No.: E-Mail Address:1Specify address or indicate if ordered to be kept confidential pursuant to Family Court Act §154-b(2) or Domestic Relations Law §254.Mobile Tel. No.:American LegalNet, Inc. www.USCourtForms.comCOURT COUNTY OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .:::::::Index No.Calendar No.FormUCCJEA-3Page2JUDICIAL SUBPOENAPlaintiff(s) -against-Defendant(s)subject of this proceeding resided at: NameAddress2Duration (from/to)4. (Upon information and belief) The name and present address of the person(s) with whom each child resided during the past five years are as follows; Name. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Address3Duration (from/to)THE PEOPLE OF THE STATE OF NEW YORK TO5. I [check applicable box(es)]: a. have have not participated as a party in other litigation concerning the custody visitation of one or more of the same children in New York State another state, territory, tribal jurisdiction or country [specify]:GREETINGS:[If so, specify court, jurisdiction, children involved, parties, case number, date of determination and status]:WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before Court at the the Honorable,located at County ofb. have have not participated as a witness in other litigation concerning the custody visitation of one or more of the same children in New York Stateo'clock in the day of, on the, 20, at or adjourned date, to testify and give evidence as a witness in this action on the part of thenoon, and at any recessed in room another state, territory, tribal jurisdiction or country [specify]: [If so, specify court, jurisdiction, custody or visitation, children involved, parties, case number, date of determination and status]:Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a result of your failure to comply.c. have have not participated as a [specify other capacity]: in other litigation concerning the custody visitation of one or more of the same children in New York State another state, territory, tribal jurisdiction or country [specify]:, one of the Justices of theCourt in Witness, Honorableday of, 20 County,[If so, specify court, jurisdiction, custody or visitation, children involved, parties, case number, date of determination and status]:(Attorney must sign above and type name below)6. [Check applicable box(es)]: a. (Upon information and belief) I have the following information regarding a custody proceeding concerning custody visitation of one or more of the same child(ren) that is pending in New York State another state, territory, tribal jurisdictionAttorney(s) forOffice and P.O. Address2Telephone No.: Facsimile No.: E-Mail Address:Specify address or indicate if ordered to be kept confidential pursuant to Family Court Act §154-b(2) or Domestic Relations Law §254. 3Specify address or indicate if ordered to be kept confidential pursuant to Family Court Act §154-b(2) or Domestic Relations Law §254.Mobile Tel. No.:American LegalNet, Inc. www.USCourtForms.comCOURT COUNTY OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .:::::::Index No.Calendar No.FormUCCJEA-3Page3JUDICIAL SUBPOENAPlaintiff(s) -against-Defendant(s)or country [specify specify court, jurisdiction, custody or visitation, children involved, parties, case number, date of determination, and status; if the order has been stayed, so state, including date of stay and expiration, if any]:. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .THE PEOPLE OF THE STATE OF NEW YORK TOb. (Upon information and belief) an order of custody visitation of one or more of the same child(ren) has been registered in New York State another state, territory, tribal jurisdiction or country [specify court(s) and jurisdiction(s) in which order registered, date of registration(s), court and jurisdiction that issu