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Declaration Under Uniform Child Custody Jurisdiction Act CC13 - Nevada
| Declaration Under Uniform Child Custody Jurisdiction Act Form. This is a Nevada form and can be used in Family District Court Clark County . |
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1 CC13 2 3 4 5 DISTRICT COURT 6 CLARK COUNTY, NEVADA 7 8 9 Plaintiff(s) , 10 CASE NO. 11 -vs - DEPT. NO. 12 13 Defendant(s). 14 15 16 DECLARATION UNDER UNIFORM CHILD CUSTODY JURISDICTION ACT (NRS 125A.385) 17 1. There is/are child(ren) of the parties subject to this proceeding. The name, 18 place of birth, birth date and sex of each child, the present address, periods of 19 residence and places where each child has lived within the last five (5) years, 20 and the name(s), present address and relationship to the child of each person 21 with whom the child has lived during that time are listed in the table on the 22 following page: 23 . . . 24 . . . 25 . . . 26 . . . 27 . . . 28 Declaration Under Uniform Child Custody Jurisdiction Act {CC13}.doc/3/15/2005 American LegalNet, Inc. www.USCourtForms.com<<<<<<<<<********>>>>>>>>>>>>> 2 1 Childs Name Place of Birth Birth Date Sex 2 A. Period of Residence Address Person Child Lived With Relationship 3 (Name & Current Address) to present 4 to to 5 Childs Name Place of Birth Birth Date Sex 6 B. 7 Period of Residence Address Person Child Lived With Relationship (Name & Current Address) 8 to present t o 9 to 10 Childs Name Place of Birth Birth Date Sex C. 11 Person Child Lived With Relationship Period of Residence Address (Name & Current Address) 12 to present 13 to to 14 Childs Name Place of Birth Birth Date Sex 15 D. Period of Residence Address Person Child Lived With Relationship 16 (Name & Current Address) to present 17 to 18 to Childs Name Place of Birth Birth Date Sex 19 E. Period of Residence Address Person Child Lived With Relationship 20 (Name & Current Address) to present 21 to 22 to 23 24 NOTE: Attach information about additional children or additional information on children 25 listed above on attached sheet(s). Attached sheet(s) MUST be same size as this form. 26 2. I have have not (check one) participated as a party, witness, or in any other 27 capacity in any other litigation or custody proceeding in this or any other state 28 concerning custody of a child involved in this proceeding. 2 Declaration Under Uniform Child Custody Jurisdiction Act {CC13}.doc/3/15/2005 American LegalNet, Inc. www.USCourtForms.com<<<<<<<<<********>>>>>>>>>>>>> 3 1 If you checked have above, please supply the following information about the 2 other proceeding(s): 3 a. Name of each child involved: 4 b. Your role in other proceeding(s): 5 c. Court, state and case number of other proceeding(s): 6 d. Date of court order or judgment in other proceeding(s): 7 8 3. I do do not (check one) know of any proceeding that could affect the 9 current proceeding including proceedings for enforcement and proceedings 10 related to domestic violence, protective orders, termination of parental rights and 11 adoptions pending in a court of this or any other state concerning a child involved 12 in this proceeding other than that set out in item 1 above. 13 If you have checked do above, please supply the following information about 14 the other proceeding(s): 15 a. Name of each child involved: 16 b. Your role in other proceeding(s): 17 c. Court, state and case number of other proceeding(s): 18 d. Date of court order or judgment in other proceeding(s): 19 20 4. I do do not (check one) know of any person not a party to this proceeding 21 who has physical custody or claims to have custody or visitation rights with 22 respect to any child subject to this proceeding. 23 . . . 24 25 26 27 28 3 Declaration Under Uniform Child Custody Jurisdiction Act {CC13}.doc/3/15/2005 American LegalNet, Inc. www.USCourtForms.com<<<<<<<<<********>>>>>>>>>>>>> 4 1 If you checked do@ above, please supply the following information and check 2 appropriate boxes below: 3 a. Name and address of person(s): 4 Person named has physical custody of ( name of child) 5 Person named claims custody rights as to (name of child) 6 Person named claims visitation rights with (name of child) 7 NOTE: Attach additional sheet(s) same size as this form if more room is needed for 8 answers above. 9 I declare under penalty of perjury under the law of the State of Nevada that the 10 foregoing is true and correct. 11 EXECUTED this day of , 20 . 12 13 __________________________________________ Tab to here, enter Name 14 Tab to here, enter Address 15 Tab to here, enter City/State/Zip Tab to here, enter Telephone 16 17 18 19 20 21 22 23 24 25 26 27 28 4 Declaration Under Uniform Child Custody Jurisdiction Act {CC13}.doc/3/15/2005 American LegalNet, Inc. www.USCourtForms.com
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