COURT COUNTY OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .:::::::Index No.Calendar No.DRL§77-dForm UCCJEA-14 Affidavit Application for Registration of an Custody or Visitation Order UCCJEA 8/2002 FAMILY COURT OF THE STATE OF NEW YORK COUNTY OF .................................................................................In the Matter Of The Registration Of An Out-Of-State GCustody G Visitation OrderJUDICIAL SUBPOENAPlaintiff(s) -against-Defendant(s). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .AFFIDAVIT APPLICATION FOR Under the Uniform Child Custody JurisdictionREGISTRATION OF AN and Enforcement ActOUT-OF-STATE G CUSTODY G VISITATION ORDER UCCJEA Petitioner,THE PEOPLE OF THE STATE OF NEW YORK TOagainstRespondent. ....................................................................STATE OF NEW YORKGREETINGS:))ss.:WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before Court at the the Honorable,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 room1. I [specify name]:am the Petitioner in this application to register the attached out-of-state order of [check applicable box(es)]: 9 custody 9 visitation, that had been issued by [specify court, state or other jurisdiction and date]: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.2. The child(ren) who (is) (are) the subject of the attached order (is) (are): Name(s)Date(s) of Birth, one of the Justices of the3. I reside at [specify address or, if ordered to be kept confidential pursuant to Domestic Relations Law §§76-h, 254 or Family Court Act §154-b, the name and address of the agent designated for service of process and papers]: 4. The Respondent [specify name]:Court in Witness, Honorableday of, 20 County,(Attorney must sign above and type name below)resides at [specify last-known address or, if ordered to be kept confidential pursuant to Domestic Relations Law §§76-h, 254 or Family Court Act §154-b, the name and address of the agent designated for service of process and papers]:Attorney(s) for5. The name(s) and address(es) of any person(s) who were awarded custody or visitation in the order sought to be registered are as follows [specify]:1 Name(s)AddressRelationship to Child(ren)Office and P.O. AddressTelephone No.: Facsimile No.: E-Mail Address:1 Do not include address if ordered to be kept confidential pursuant to Domestic Relations Law §§76-h, 254 or Family Court Act §154-b. An application for address confidentiality, General Form 21, available at www.courts.state.ny.us (Family Court forms), may be filed with this affidavit, if disclosure would place the health or safety of a party or child unreasonably at risk.Mobile Tel. No.:American LegalNet, Inc. www.USCourtForms.comCOURT COUNTY OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .:::::::Index No.Calendar No.Form UCCJEA-14Page 2JUDICIAL SUBPOENAPlaintiff(s) -against-Defendant(s)6. To the best of my knowledge and belief, the attached order that I am seeking to register is in effect and has not been stayed or modified. 7. a. This order has been registered in the following other jurisdictions [specify]:. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .b. Registration of this order was denied in the following jurisdiction(s) [specify and indicate date]:c. An application for registration of this order is pending in the following jurisdiction(s) [specify and indicate status of application]:THE PEOPLE OF THE STATE OF NEW YORK TOGREETINGS:WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before Court at the the Honorable,WHEREFORE, for the reasons stated above, I am requesting this Court to register the above-mentioned order in accordance with Section 77-d of the Uniform Child Custody Jurisdiction and Enforcement Act [Domestic Relations Art. 5-A]. Sworn to before me this day oflocated at County of,Name (Deputy) Clerk of Court Notary Publico'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 roomYour 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.NOTICE: Attach two copies of the order sought to be registered, at least one of which is certified. A sworn, notarized letter, containing the above information may be submitted instead of this affidavit. A child custody or visitation determination eligible for registration under Domestic Relations Law §77-d includes a judgment, decree, or other order of a court providing for the legal custody, physical custody, or visitation with respect to a child, including a permanent, temporary, initial and modification order, but not including an order relating to child support or other monetary obligations. See Domestic Relations Law §75-a (3). The order may have been entered in a proceeding for divorce, separation, neglect, abuse, dependency, guardianship, paternity, termination of parental rights, and protection from domestic violence, but does not include a juvenile delinquency, person in need of supervision or contractual emancipation enforcement proceeding or a proceeding to enforce an out-of-state custody or visitation order . See Domestic Relations Law §75-a (4)., one of the Justices of theCourt in Witness, Honorableday of, 20 County,(Attorney must sign above and type name below)Attorney(s) forOffice and P.O. AddressTelephone No.: Facsimile No.: E-Mail Address:Mobile Tel. No.:American LegalNet, Inc. www.USCourtForms.com