Custody Affidavit

<document>COURT COUNTY OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .IN THE COURT OF COMMON PLEAS OF FRANKLIN COUNTY, OHIO DIVISION OF DOMESTIC RELATIONS AND JUVENILE BRANCH:::::::Index No.Case No. AFFIDAVIT/R.C. §3109.27Calendar No.Judge JUDICIAL SUBPOENAPlaintiff(s) -against-Defendant(s) PLAINTIFF/PETITIONERSOCIAL SECURITY NUMBERADDRESS DEFENDANT/PETITIONER. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .SOCIAL SECURITY NUMBERADDRESSTHE PEOPLE OF THE STATE OF NEW YORK TO DATE OF MARRIAGEFAMILY FILE NUMBER, being first duly sworn, says that he/she is the plaintiff, defendant/petitioner in the cause hereinabove set forth, that the parties hereto are the natural/adoptive parents of the following named children: 1. DOB residing at GREETINGS: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 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 room2. DOB residing at 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. DOB residing at , one of the Justices of the4. DOB residing at Court in Witness, Honorableday of, 20 County,5. DOB residing at (Attorney must sign above and type name below)Attorney(s) for6. DOB residing at that said children resided for the five (5) preceding years at the address set forth below with names and parent addresses of persons with whom they resided: From to With At Current address Custody affidavit (4-2002)Office and P.O. AddressTelephone No.: Facsimile No.: E-Mail Address:Mobile Tel. No.:Page 1 of 2American LegalNet, Inc. www.USCourtForms.comCOURT COUNTY OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .From to With At Current address From to With At Current address From to With At Current address From to With At Current address :::::::Index No.Calendar No.JUDICIAL SUBPOENAPlaintiff(s) -against-Defendant(s). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .THE PEOPLE OF THE STATE OF NEW YORK TO1.GREETINGS: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 ofSaid Affiant (circle one) HAS/HAS NOT participated as a party, witness or in any other capacity in any other litigation in this or any other state, that concerned the allocation, between the parents of the same child, of potential rights and responsibilities for the care of the child and the designation of the residential parent and legal custodian of the child or that otherwise concerned the custody of the same child. 2.o'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 roomSaid affiant (circle one) HAS/DOES NOT HAVE information of any parenting proceeding concerning the child pending in the court of this or any other state. 3.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.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 visitation 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. 4.Said affiant previously (circle one)HAS/HAS NOT been convicted of or pleaded guilty to any criminal offense involving any act that resulted in a child being an abused child or a neglected child or previously has been determined, in a case in which a child has been adjudicated an abused child or neglected child, to be the perpetrator of the abusive or neglectful act that was the basis of the adjudication., one of the Justices of theCourt in Witness, Honorableday of, 20 County,(Attorney must sign above and type name below)Said affiant has the following knowledge regarding information set forth in paragraphs one through four above:Attorney(s) forSaid affiant says that all the foregoing statements are true.Office and P.O. Address AffiantAttorneyTelephone No.: Facsimile No.: E-Mail Address: Notary PublicAddress Sworn to and subscribed by the affiant before me this day of , 20.Mobile Tel. No.:American LegalNet, Inc. www.USCourtForms.comPage 2 of 2Custody affidavit (4-2002)</document>