Declaration Of Minor Under Age Of 17 Years {SCCA-464}

STATE OF SOUTH CAROLINA COUNTY OF _______________________ A JUVENILE A Child under Seventeen (17) Years of Age ) IN THE FAMILY COURT ) ____ JUDICIAL CIRCUIT ) ) ) ) DECLARATION OF MINOR ) UNDER THE AGE OF SEVENTEEN (17) ) YEARS ) ) ) Docket No. ____________________________ NOTICE TO THE CLERK OF COURT: A CERTIFIED COPY OF THIS DECLARATION, WITH THE FILE NUMBER NOTED ON IT, SHOULD BE GIVEN TO THE MINOR AFTER SHE SIGNS IT. THE ORIGINAL SHOULD IMMEDIATELY BE PLACED IN A SEALED ENVELOPE, WHICH SHOULD BE FILED UNDER SEAL AND KEPT UNDER SEAL AT ALL TIMES PURSUANT TO CODE SECTION 41-44-34(D). 1. My full name is________________________, and my address is ____________________________________________, South Carolina _____________. 2. I have filed a Petition under seal, under the name "Jane Doe." I declare, under penalty of contempt of court, that the foregoing is true and correct. Date: _____________________________ ____________________________, S.C. ____________________________________ Signature SCCA 464 (12/2009) American LegalNet, Inc. www.FormsWorkFlow.com