Affidavit Regarding Minor Children

Page 1 of 3 DOARCCOSCPinal03.05.18 Use only most current version Name of Person Filing: Street Address: City, State, Zip Code: Telephone Number: Email Address: ATLAS Number (if applicable) Representing Self (No Attorney) or Represented by Attorney If Attorney, Bar Number: SUPERIOR COURT OF ARIZONA PINAL COUNTY CASE NUMBER: S1100DO2 Name of Petitioner AFFIDAVIT REGARDING MINOR CHILDREN Name of Respondent HONORABLE: NOTICE: This 223Affidavit Regarding Minor Children224 is required for all legal decision- making cases. You must fill out this Affidavit completely, and provide accurate information. Use additional paper if necessary. You must give copies of this Affidavit and all other required documents to the other party, and to the judge. 1.CHILDREN OF THE PARTIES WHO ARE UNDER 18 YEARS OLD. The following child(ren) are under age 18 and were born to, or adopted by, me and the other party: Name: Name: Birth Date: Age: Birth Date: Age: Name: Name: Birth Date: Age: Birth Date: Age: 2.INFORMATION REGARDING WHERE THE CHILDREN UNDER 18 YEARS OLD HAVE LIVED FOR THE LAST 5 YEARS: (Attach additional pages if necessary) Child222s Name: Dates: From To Address: Lived with: American LegalNet, Inc. www.FormsWorkFlow.com Page 2 of 3 DOARCCOSCPinal03.05.18 Use only most current version City, State: Relationship to Child: Child222s Name: Dates: From To Address: Lived with: City, State: Relationship to Child: Child222s Name: Dates: From To Address: Lived with: City, State: Relationship to Child: 3. COURT CASES IN WHICH I HAVE BEEN A PARTY/WITNESS THAT INVOLVED THE LEGAL DECISION-MAKING PARENTING TIME OF THE CHILD(REN): (Check one box) I have or I have not been a party/witness in court in this state or in any other state that involved the legal decision-making parenting time of the child(ren) named above. (If so, explain on separate paper. If not, go on.) Name of each child: Name of Court: Court Location: Court Case Number: Current Status: How the child is involved: Summary of any Court Order: 4. INFORMATION REGARDING PENDING COURT CASES RELATED TO THE LEGAL DECISION-MAKING OF THE CHILD(REN): (Check one box) I do have or I do not have information about a legal decision-making parenting time court case relating to any of the children named above that is pending in this state or in any other state. (If so, explain. If not, go on.) Name of each child: Name of Court: Court Location: Court Case Number: Current Status: How the child is involved: Summary of any Court Order: 5. LEGAL DECISION-MAKING OR PARENTING TIME CLAIMS OF ANY PERSON: (Check one box) I do know or I do not know a person other than the Petitioner or the Respondent who has physical legal decision-making or who claims legal decision-making or parenting time rights to any of the children named in this Affidavit. (If so, explain below. If not, go on.) American LegalNet, Inc. www.FormsWorkFlow.com Page 3 of 3 DOARCCOSCPinal03.05.18 Use only most current version Name of each child: Name of person with the claim: Address of person with the claim: Nature of the claim: OATH OR AFFIRMATION AND VERIFICATION: I swear or affirm that the information on this document is true and correct under penalty of perjury. Date Signature State of Arizona ) ) County of ) Subscribed and sworn (or affirmed) before me this day of , 20 (Day) (Month) (Year) by (Name of Signer) (Affix notary seal here) Notary Public (Notary222s Signature) American LegalNet, Inc. www.FormsWorkFlow.com