Maine > Statewide > District Court > Civil And Family Matters
Affidavit Concerning Child Custody CV-051 - Maine
| Affidavit Concerning Child Custody Form. This is a Maine form and can be used in Civil And Family Matters District Court Statewide . |
|
||||||
 Get this form for FREE as a print-only pdf |
|||||||
|
STATE OF MAINE SUPERIOR COURT DISTRICT COURT________________________, ss. Location __________________Docket No. _________________ Docket No. ________________________________________Plaintiff v. AFFIDAVIT CONCERNING CHILD CUSTODY ________________________Defendant 1. This proceeding involves a request for the court to determine the custody of_________________________________________________________________________Date of Birth___________________ _______________________________________________________Date of Birth___________________ _______________________________________________________Date of Birth___________________ _______________________________________________________Date of Birth___________________ 2. The present address of said child(ren) is_______________________________________________ _____________________________________________________________________________________ 3. The following is a complete list of the places where said child(ren) have lived within the past fiveyears, and the names and present address of all persons with whom said child(ren) have lived during thatperiod: Dates of Person with whom child(ren) have livedResidence Place (City and State) Name Present Address 4. The undersigned has not participated as a party, witness or in any other capacity in other litigationconcerning the custody of said child(ren), in this or any other State, except at follows:_____________________________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ THE UNDERSIGNED WILL ADVISE THE COURT OF ANY SUCH HEARING ARISING HEREAFTER. CV-051, Rev. 09/97 PAN <<<<<<<<<********>>>>>>>>>>>>> 2 There is no person, not a party to the present proceeding, what has physical custody of said child(ren),or claims to have custody or visiting rights with respect to said child(ren), except as follows:___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ The undersigned under oath and subject to the penalties of perjury, hereby declares that the statementsmade herein are true, upon the personal knowledge, information and belief of the undersigned, and so far as upon information and belief, that the undersigned believes them to be true. Signed___________________________________ Address___________________________________ ___________________________________ STATE OF MAINE _____________________County Personally appeared the above named ________________________________________________and signed and made oath to the foregoing affidavit, before me, Date:_________________________ _______________________________________ Notary Public / Attorney at Law
|
|||||||
