COURT COUNTY OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .:::::::Index No.Calendar No.IN THE COURT OF COMMON PLEAS, ASHLAND COUNTY, OHIO DOMESTIC RELATIONS DIVISION Plaintiff/PetitionerJUDICIAL SUBPOENAPlaintiff(s) -against-Defendant(s)CASE NO. vs.CHILD CUSTODY AFFIDAVIT Defendant/Petitioner. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .The , being first duly sworn according to law, states as follows concerning the custody of the minor child(ren) of the parties in the above-styled domestic relations action:THE PEOPLE OF THE STATE OF NEW YORK TOState the following information for each child of the parties:Addresses of the child within past 5 yearsDates at those addressesWho the child resided withNAMEDATE OF BIRTHGREETINGS: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 room(1)Have you participated as a party, witness or in any other capacity, in any other litigation concerning the custody of any of the above child(ren) in this or any other state or do you have any information about such a custody action?YESNOYour 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.(2)Do you know of anyperson who has physical custodyof anyof the aforenamed child(ren), or whoclaimsto have custody or visitation rights with respect to any of the child(ren), who is not a party to this case? YESNO(3)Has anypartyto these proceedings been convicted of or pled guiltyto anycriminal offense involving an act that resulted in a child being determined to be an abused or neglected child or to a violation of O.R.C. 2919.25, Domestic Violence?, one of the Justices of theCourt in Witness, Honorableday of, 20 County,YESNO(4)Do you understand that you have a continuing dutyto inform the court ofanycustodyproceedingconcerning the aforenamed child(ren) in this or any other state?(Attorney must sign above and type name below)NOYESIfyouanswerA YES@ toquestions1,2or3above,youmustattachanothersheettothisaffidavit explaining what informationAttorney(s) foryou have.Plaintiff/Defendant/PetitionerOffice and P.O. AddressSworn to and subscribed in my presence, this day of , 20. Notary PublicTelephone No.: Facsimile No.: E-Mail Address:Mobile Tel. No.:American LegalNet, Inc. www.USCourtForms.com
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