Rsa 458-A, Uniform Child Custody Jurisdiction And Enforcement Act Affidavit
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2Instructions
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THE STATE OF NEW HAMPSHIRE
JUDICIAL BRANCH
Court Name:
Case Name:
Case Number:
(if known)
UNIFORM CHILD CUSTODY JURISDICTION
AND ENFORCEMENT ACT (UCCJEA) AFFIDAVIT
RSA 458-A
It is important that you answer these questions with as much detail and accuracy as possible. Lack of
adequate information could significantly delay orders being issued in your case.
There are several situations that might result in New Hampshire exercising jurisdiction over child/ren.
The continuous presence of the child/ren in New Hampshire for six (6) months is not the only basis
for jurisdiction. In some emergency situations, the court may be able to exercise jurisdiction on a
temporary basis.
1. List minor children born to or adopted by the parties:
Name
Date of Birth
Current Address
2 List the places where the minor child/ren of the parties has/have lived in the last five (5) years
and the names of the people they lived with at that time, if you know. Start with where the child lives
now and work backward in time.
Dates
Town/City, State
Parent(s)/Caretaker
Current Address/Contact
Which
From/To
Address of Parent/Caretaker
Child/ren
If more space is needed, attach Extra Page (Form NHJB-2656-FP).
I have attached Form NHJB-2656-FP because additional space was needed.
3. Are there any person(s), not a party to this proceeding, who have physical custody of the child/ren
or who claim to have custody, physical custody or parenting time rights?
Yes
No
If yes, list name(s) and address(es) of person(s):
NHJB-2660-DFP (12/01/2010)
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