Colorado > Statewide > Protection Order
Affidavit Regarding Children Pursuant To Section 14-13-110 CRS JDF 404 - Colorado
| Affidavit Regarding Children Pursuant To Section 14-13-110 CRS Form. This is a Colorado form and can be used in Protection Order Statewide . |
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Municipal Court County Court District Court Denver Juvenile Denver Probate __________________________________ County, Colorado Couret Addrss: Plaintiff/Petitioner: ______________________ ________________ v. Defendant/Respondent: _________________________________ COURT USE ONLY Attorney or Party Without Attorney (Name and Address): Case Number: Phone Number: E-mail: Division Courtroom FAX Number: Atty. Reg. #: AFFIDAVIT REGARDING CHILDREN PURSUANT TO 14-13-209, C.R.S. I _______________________________ (name of party) submit the following information to the Court: 1. I request that I be permitted to omit the childrens address from this Affidavit because I fear that including the address will endanger the minor children. 2. The minor children are (list full name and date of birth): (Do not include address if number 1 above is checked.) Full Name of Child Date of Birth Current Address 3. The above-named children have lived with the following persons and in the following places within the last five years: (Give name and address of all persons the children have lived with within the last five years.) Name of Party Address (City/State/Zip Code) Time Period Relationship to (Month/Year) Child4. A legal action for Dissolution of Marriage, Legal Separation, Paternity, or Allocation of Parental Responsibilities (Decision-Making and Parenting Time) with the above-named children identified in the action has has not been filed. If such an action has been filed, complete the information below: County Where Case Has Been Filed Sta te Case Number Nature of Proceeding JDF 404 R7/04 AFFIDAVIT REGARDING CHILDREN PURSUANT TO 14-13-209, C.R.S. Page 1 of 2 American LegalNet, Inc. www.USCourtForms.com<<<<<<<<<********>>>>>>>>>>>>> 25. I have have not participated as a party or witness or in any other capacity in any other court proceeding concerning custody of, or visitation, or parenting time with the above-named children in this or any other state. If so, please provide the following information. County Where Case Has Been Filed State Case Number Date of Hearing 6. I do do not know of any court proceedings that could affect this proceeding, including proceedings concerning enforcement of prior orders, domestic violence/abuse, protective/restraining orders, termination of parental rights, or adoption. If so, please provide the following information. County Where Case Has Been Filed Sta te Case Number Nature of Proceeding 7. I do do not know of any person not a party to the proceeding who has physical custody or claims rights of parental responsibilities, legal cu stody, physical custody, visitation or parenting time with the above-named children. If yes, please provide the following information. Name of Person Address (Street, City, State, Zip Code) 8. I do do not understand that I have a continuing duty to inform the Court of any custody proceedings concerning the children in this or any other state when I obtain such information during this proceeding. 9. I am am not a Native American Indian and these children are are not subject to the provisions of the Indian Child Welfare Act. I swear or affirm under penalty of perjury that information contained in this Affidavit Regarding Children is true andcorrect. Date: ______________________________ ______________________________________ Plaintiff/Petitioner Defendant/RespondentSubscribed and affirmedo, or swrn to before me in the County of ______________________, State of ________________, this ___________ day of _______________, 20 _______. My Commission Expires: ________________________ ___________________________________ Notary Public/ Deputy Clerk JDF 404 R7/04 AFFIDAVIT REGARDING CHILDREN PURSUANT TO 14-13-209, C.R.S. Page 2 of 2 American LegalNet, Inc. www.USCourtForms.com
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