Affidavit - Ohio Probate Court
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1PROBATE COURT OF ______________ COUNTY, OHIO
_________________, Judge
GUARDIANSHIP OF ____________________________________________________
CASE NO. _______________________
AFFIDAVIT
[R.C. 3127.23]
State of Ohio, County of ______________________________________________s.s.
(To be filed only when guardianship of the person of a minor is sought.)
Affiant being first duly sworn, deposes and says:
1. That the child's present address, the places where the child has lived within the
last five years, and the names and present addresses of the person(s) with whom the child
has lived during that period are:
2. That affiant has (not) participated as a party, witness, or in any other capacity
in any litigation concerning the custody of the child(ren) in this or any other state.
3. That affiant has (no) information of any custody proceeding concerning the
child(ren) pending in a court of this or any other state, except ______________________
_______________________________________________________________________.
4. That affiant has (no) knowledge of any person not a party to the proceedings
who has physical custody of the child(ren) or claims to have custody or visitation rights
with respect to the child(ren).
If 2, 3, or 4 is answered in the affirmative, and the space afforded is insufficient
for full explanation, please attach and incorporate herein any necessary information.
Affiant realizes that affiant has a continuing duty to inform the Court of any
custody proceedings concerning the child(ren) in this or any other state of which affiant
obtains information during the pendency of this proceeding.
____________________________________
Sworn to before me and subscribed in my presence this ________ day of
___________________, _________.
____________________________________
Notary Public
Print Form
FORM 16.1 - AFFIDAVIT
Eff. Date March 1, 2008
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