Affidavit Re Minor Children

Name: ___________________________________ Address: _________________________________ City, State, ZIP: ____________________________ Daytime Telephone No: ______________________ Representing Self, Without a Lawyer ARIZONA SUPERIOR COURT, PIMA COUNTY ______________________________________ Petitioner/Plaintiff and Case No. _________________ ______________________________________ Respondent/Defendant STATE OF ARIZONA County of Pima 1. ) ) ss. ) AFFIDAVIT RE: MINOR CHILDREN The nature of this action is: on 2. 3. either or both of the parties. 4. ness, or in any other capacity in any other prior litigation concerning custody of a child mentioned below, in this or any other state. (If you have, state the name of each child, the manner in which you participated, the court, the state & county or district, case number, and date of order or judgment, if any.) ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ 5. pending in a court of this or any other state. (If you do, state the name of each child, nature of the proceeding, the court, the state & county or district, case number, and the status of the proceeding.) ______________________________________________________________________________________ __________________________________________________________ _______________________ ______________________________________________________________________________________ 6. have custody or visitation rights with respect to any child mentioned below. (If you do have such knowledge, 1 paternitycomplaint-affidavit re minor children.form Revised 02.14.13 American LegalNet, Inc. www.FormsWorkFlow.com state the name and address of the person, whether that person has physical custody, is claiming custody rights, or is claiming visitation rights, and the name of the child involved.) ______________________________________________________________________________________ ______________________________________________________________________________________ 7. 8. 9. Mother's mailing address is: _______________________________________________________________ Father's mailing address is: _______________________________________________________________ a) The minor child(ren) affected or of this action are: NAME BIRTHDATE BIRTHPLACE ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ b) All the children have resided together at the following locations during the last five years: NAME AND PRESENT ADDRESS OF PERSON DATES OF ADDRESS OF CHILD HAVING PHYSICAL CUSTODY RELATION RESIDENCE DURING PERIOD DURING RESIDENCE PERIOD TO CHILD ___________________________________________________________________________________ ___________________________________________________________________________________ ___________________________________________________________________________________ ___________________________________________________________________________________ NOTE: If any of the children have lived separately, give specific information for that child on an additional page. ________________________________________ SUBSCRIBED AND SWORN to before me this _____ day by ___________________________________________________. , 20 __ My Commission Expires: ____________________ _________________________________________ Notary Public 2 paternitycomplaint-affidavit re minor children.form Revised 02.14.13 American LegalNet, Inc. www.FormsWorkFlow.com