Affidavit In Compliance With 3127.23 Ohio Revised Code - Hamilton County Juvenile Court

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HAMILTON COUNTY JUVENILE COURT
AFFIDAVIT IN COMPLIANCE WITH § 3127.23 OHIO REVISED CODE
IN RE:
CASE NUMBER:
Upon being duly sworn, the undersigning petitioner(s),
, herein
state the following:
1.
The child or children currently reside with
, at the address
of
Phone: (
)
(Complete Address)
2.
The child or children have lived with the following persons at the respective addresses during the past five years:
Name of Person lived with
Complete Address and Zip Code
Dates: From - To
3.
List the current address of each person listed above.
(
)
4.
he petitioner(s)
has, has not, have, have not
participated as a party, witness or in another capacity with any
T
other litigation concerning custody of this child or children either in this state or any other state.
Explanation:
(
)
5.
The petitioner(s)
has, has no, have, have no
information or knowledge of custody proceedings concerning this
child or these children, either in this or any other state. Explanation:
Child Custody Affidavit - Page 1 of 2
Form 551A 8/2006

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