COURT COUNTY . . . . . . . . . . . .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . : Domestic Relations IN THE Calendar No. COURT : JUDICIAL COUNTY, OHIO Plaintiff(s) Summit -against- : Index No. SUBPOENA : : Plaintiff / Petitioner Case No. : : : Judge: v. : Defendant(s) : ...................................................... INFORMATION FOR PARENTING PROCEEDING AFFIDAVIT (R.C. 3109.27) : THE PEOPLE OF THE STATE OF NEW YORK Defendant/Respondent/Petitioner : TO NOTE: By law, an affidavit must be filed and served with the first pleading filed by each party in every parenting (custody/visitation) proceeding in this Court, including a Petition for a Domestic Violence Civil Protection Order. Each party has a continuing duty while this case is pending to inform the Court of any parenting proceeding concerning the child(ren) in any otherGREETINGS: any other state. If more space is needed, attach an additional page. court in this or Affiant, 1. 2. WE COMMAND YOU, that all business and excuses beingstates as follows: each of you attend before , laid aside, you and , the Honorable at the Court located at County of The name, birth date, and Social Security Number [if any] of each child whose custody/visitation is at issue in this in room , on the day of , 20 , at o'clock in the noon, and at any recessed case is: or adjourned date, to testify and give evidence as a witness in this action on the part of the The present address of the child(ren) is: Address Confidential, State of OR 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. 3. The child(ren) currently reside(s) with what adult(s)? Witness, Honorable Court in County, 4. , one of the Justices of the day of , 20 All other places and dates where the child(ren) have lived during the last 5 years, and the names of all adult(s) with whom they lived at each address are as follows: (Attorney must sign above and type name below) Attorney(s) for 5. The name(s) and current address of all adults listed above are: Office and P.O. Address FORM 10.01-F INFORMATION FOR PARENTING PROCEEDING AFFIDAVIT Telephone No.: Facsimile No.: E-Mail Address: REVISED 6/1/02 Mobile Tel. No.:Discard all previous versions of this form American LegalNet, Inc. www.USCourtForms.com COURT COUNTY . . . . . . . . . . . .OF. . . . . . . . . . . . . . . . . . . . . . . .[Side. 2 of.Form .10.01-F]. . . . .. .. ... .... : : Index No. Calendar No. 6. Do you know of any litigation anywhere, past or present, which concerns the custody, visitation, or care of the : JUDICIAL SUBPOENA Plaintiff(s) child(ren)? 7. If the answer to #6 is “yes”, state any other information you have about any parenting proceeding concerning the child(ren) now pending in a court of this or any other state. Include the case number, the name of the court and : the address of the court. -against- : : Defendant(s) : ...................................................... 8. State the name and address of any person who is not a party to this proceeding: (A) who has physical possession of the child(ren); or (B) who claims to be a parent of the child(ren) and is either the residential parent and legal custodian, or has visitation rights with the child; or (C) who is a person other than a parent of the THE PEOPLE OF THE STATE OF NEW YORK child(ren) who has custody or visitation rights. TO 9. 10. Are you now, or have you ever been, a party to any civil or criminal case or any investigation concerning child abuse, child neglect, or domestic violence? If so, state each court, case name, case number, date, type of case GREETINGS: case: and result of the WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before , the Honorable at the Court located at County of Do you have any domestic violence protection orders or any other restraining orders issued against you, or on your in roomagainst any other person? If so, state each ,court, case name, case number, date,noon,of caseany recessed , on the day of 20 , at o'clock in the behalf type and at and or adjourned date, to testify and give evidence as a witness in this action on the part of the result of the case: 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. OATH OF AFFIANT , one of the Justices my knowledge. I I hereby swear orWitness,that the answers above are true, complete and accurate to the best of of the affirm Honorable understand that falsification County, document may result in20 contempt of court finding against me which could of this Court in day of , a result in a jail sentence and fine, and that falsification of this document may also subject me to criminal penalties for perjury under Ohio Revised Code 2921.11. (Attorney must sign above and type name below) AFFIANT Sworn to and subscribed before me on this NOTARY PUBLIC FORM 10.01-F INFORMATION FOR PARENTING PROCEEDING AFFIDAVIT Attorney(s) for day of , Office and P.O. Address Telephone No.: Facsimile No.: E-Mail Address: REVISED 6/1/02 Mobile Tel. No.:Discard all previous versions of this form American LegalNet, Inc. www.USCourtForms.com