Illinois > Local County > McHenry > Family Law
Declaration Under Uniform Child Custody Jurisdiction Act (UCCJA) CV-DEC1 - Illinois
| Declaration Under Uniform Child Custody Jurisdiction Act (UCCJA) Form. This is a Illinois form and can be used in Family Law McHenry Local County . |
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IN THE CIRCUIT COURT OF THE NINETEENTH JUDICIAL CIRCUIT McHENRY COUNTY, ILLINOIS IN RE THE MARRIAGE OF ___________________________________ Petitioner vs. Case Number_________________________ ___________________________________ Respondent DECLARATION UNDER UNIFORM CHILD CUSTODY JU RISDICTION ACT (UCCJA) 1. _____________________________________ Attorneys Name ________________________ 2. Number of minor children subject to this proceeding: __________________________________ Additional list attached. (Provide requested information for additional children on an attachment.) Insert the information requested below. The residence information must be given for the last five years. Child One Child Two Child Three Childs Name and Sex Date of Birth Place of Birth Childs Current Address and Length of Residence Name, Present Address and Relationship to Child of Person that lived at current address Childs Previous Address and Dates of Residence Name, Present Address and Relationship to Child st of Person that lived at 1 previous address Childs Previous Address and Dates of Residence Name, Present Address, and Relationship to Child nd of Person that lived at 2 previous address. Page 1 of 2 CV-DEC1 (new 9/03) American LegalNet, Inc. www.USCourtForms.com<<<<<<<<<********>>>>>>>>>>>>> 23. Have you participated as a party, witness or in some other capacity in another litigation or custody proceeding, either in Illinois or elsewhere, concerning custody of a child subject to the proceeding? Yes No If yes, please provide the following information: A. Name of each child: ______________________________________________________ B. Capacity of declarant: Party Witness Other (specify) _________________ C. Court of Proceedings: (Specify Name, State, Location) ___________________________ ________________________________________________________________________ D. Date of Final Order or Judgment _____________________________________________ 4. Do you have information about a custody proceeding pending in an Illinois court or any other court concerning a child subject to this proceeding, other than that stated in item 3? Yes No If yes, please provide the following information: A. Name of each child: ______________________________________________________ B. Nature of proceeding: Dissolution of Marriage Guardianship Adoption Other (Specify)________________________________________ C. Court of Proceedings: (Specify Name, State, Location) ___________________________ ________________________________________________________________________ D. Status of proceeding: ______________________________________________________ ________________________________________________________________________ 5. Do you know of any person who is not a party to this proceeding who has physical custody, or claims to have custody of, or visitation rights with any child subject to this proceeding? Yes No If yes, please provide the following information: Name and Address of Person Name and Address of Person Name and Address of Person Has physical custody Has physical custody Has physical custody Claims custody rights Claims custody rights Claims custody rights Claims visitation rights Claims visitation rights Claims visitation rights Name of each child Name of each child Name of each child I declare under penalty of perjury under the laws of the State of Illinois that the foregoing is true and correct. _____________________________________ ____________________________________________ (Type or print name) (Signature of Declarant) Date ________________________________ Page 2 of 2 CV-DEC1 (new 9/03) American LegalNet, Inc. www.USCourtForms.com
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