Affidavit Application For Registration Of A Custody Or Visitation Order - Uccjea
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2DRL §77-d
Form UCCJEA-14
Affidavit Application for Registration of an
Custody or Visitation Order – UCCJEA
8/2002
FAMILY COURT OF THE STATE OF NEW YORK
COUNTY OF
.................................................................................
In the Matter Of The Registration Of An
Out-Of-State G Custody G Visitation Order
AFFIDAVIT APPLICATION FOR
Under the Uniform Child Custody Jurisdiction
REGISTRATION OF AN
and Enforcement Act
OUT-OF-STATE G CUSTODY
G VISITATION ORDER– UCCJEA
Petitioner,
against
Respondent.
....................................................................
STATE OF NEW YORK
)
)ss.:
COUNTY OF
)
1. I [specify name]:
am the Petitioner in this application
to register the attached out-of-state order of [check applicable box(es)]: 9 custody 9 visitation,
that had been issued by [specify court, state or other jurisdiction and date]:
2. The child(ren) who (is) (are) the subject of the attached order (is) (are):
Name(s)
Date(s) of Birth
3. I reside at [specify address or, if ordered to be kept confidential pursuant to
Domestic Relations Law §§76-h, 254 or Family Court Act §154-b, the name and address of the
agent designated for service of process and papers]:
4. The Respondent [specify name]:
resides at [specify last-
known address or, if ordered to be kept confidential pursuant to Domestic Relations Law §§76-h,
254 or Family Court Act §154-b, the name and address of the agent designated for service of
process and papers]:
5. The name(s) and address(es) of any person(s) who were awarded custody or visitation
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in the order sought to be registered are as follows [specify]:
Name(s)
Relationship to Child(ren)
Address
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Do not include address if ordered to be kept confidential pursuant to Domestic Relations Law
§§76-h, 254 or Family Court Act §154-b. An application for address confidentiality, General Form 21,
available at
(Family Court forms), may be filed with this affidavit, if disclosure
would place the health or safety of a party or child unreasonably at risk.
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