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Custody Affidavit Form. This is a Ohio form and can be use in Franklin County (Court Of Common Pleas).
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Tags: Custody Affidavit, Ohio County (Court Of Common Pleas), Franklin
IN THE COURT OF COMMON PLEAS OF FRANKLIN COUNTY, OHIO
DIVISION OF DOMESTIC RELATIONS AND JUVENILE BRANCH
CASE NO.
AFFIDAVIT/R.C. ยง3127.23
JUDGE
PLAINTIFF/PETITIONER
SOCIAL SECURITY NUMBER
ADDRESS
DEFENDANT/RESPONDENT
SOCIAL SECURITY NUMBER
ADDRESS
STATE OF OHIO
FRANKLIN COUNTY, SS:
, being first duly sworn, says that he/she is a party to the child
custody proceeding hereinabove set forth, concerning the following named child(ren):
1.
DOB
present
address
2.
DOB
present
address
3.
DOB
present
address
4.
DOB
present
address
5.
DOB
present
address
6.
DOB
present
address
Set forth below are the addresses at which said child(ren) resided during the preceding five (5) years, and the
name(s) and present address of the person(s) with whom the child resided:
From
to
With
At
Current address
Custody affidavit (4-2005)
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From
to
With
to
With
to
With
to
With
At
Current address
From
At
Current address
From
At
Current address
From
At
Current address
1.
Said Affiant (circle one) HAS/HAS NOT participated as a party, witness or in any other capacity in any
other proceeding concerning the allocation, between the parents of the same child, of parental rights and
responsibilities for the care of the child including any designation of parenting time rights and the
designation of the residential parent and legal custodian of the child or that otherwise concerned the
custody of or visitation with the same child. If Affiant has so participated, the court, case number and the
date of the child custody determination are stated below.
2.
Said Affiant (circle one) DOES/DOES NOT know of any proceeding that could affect the current
proceeding, including proceedings for enforcement of child custody determinations, proceedings relating to
domestic violence or protection orders, proceedings to adjudicate the child as an abused, neglected, or
dependent child, proceedings seeking termination of parental rights, and adoptions. If Affiant does know
of such a proceeding, the court, case number, and the nature of the proceeding are stated below.
3.
Said Affiant (circle one) KNOWS/DOES NOT KNOW of any person who is not a party to the proceeding
and has physical custody of the child or claims to be a parent of the child who is designated the residential
parent and legal custodian of the child or to have parenting time rights with respect to the child or to be a
person other than a parent of the child who has custody or visitation rights with respect to the child. If
Affiant knows of such a person, the names and addresses of those persons are stated below.
Said Affiant has the following knowledge regarding information set forth in paragraphs one through three above:
Each party has a continuing duty to inform the court of any child custody proceeding concerning the child in
this or any other state that could affect the current proceeding.
Said Affiant says that all the foregoing statements are true.
Affiant
Attorney
Notary Public
Address
Sworn to and subscribed by the affiant before me this
day of
, 20
Custody affidavit (4-2005)
.
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