Wcpc Form 18.01 Affidavit (R.c. 3127.23)
Download a blank fillable Wcpc Form 18.01 Affidavit (R.c. 3127.23) in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Wcpc Form 18.01 Affidavit (R.c. 3127.23) with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1IN THE WARREN COUNTY, OHIO COMMON PLEAS COURT
PROBATE DIVISION
Adoption of _____________________________________________________________________
(Name after Adoption)
Case No. _____________________
AFFIDAVIT
(R.C. 3127.23)
State of Ohio, County of _______________________________________ S.S.
Upon being duly sworn, __________________________________________________________________ does hereby
State the following:
1.
The child(ren) involved is/are ___________________________________________________________________
_
__________________________________________________________________________________________________________
2.
The child(ren)’s present address is/are ____________________________________________________________
__________________________________________________________________________________________________________
3.
The places where the child(ren) has/have lived the past five years are
__________
__________________________
__________________________________________________________________________________________________________
4.
The names and present addresses of the persons with whom the child(ren) has/have lived during that period is/are
__________________________________________________________________________________________________________
5. I have/have not participated as a party, witness, or in any other capacity or any other litigation concerning the
allocation of parallel rights and responsibilities of the same child(ren) or that otherwise concerned the custody in this or any other
State.
Yes
No
6. I have/have no information of any parenting proceeding concerning the child(ren) pending in a court of this or any of
other State.
Yes
No
7. I know/do not know person(s) not a party to the proceeding concerning the child(ren) or claims to be a parent of the
child(ren) who is designated the residential parent and legal custodian of the child(ren) or to have visitation rights with respect to
the child(ren) or any person other than a parent of the child(ren) who has custody or visitation rights with respect to the child(ren).
Yes
No
8. I have/have not been convicted of or pleaded guilty to any criminal offense involving any act that resulted in a child
being abused or neglected nor have I been the perpetrator of the abusive or neglectful act that was the basis of an adjudication that a
child is an abused or neglected child.
Yes
No
If your declarations in statements 5 through 8 are in the affirmative, state the case names(s), case number(s), date(s) and
nature of the cases(s) ________________________________________________________________________________________
__________________________________________________________________________________________________________
________________________________________
Affiant
Sworn to before me and subscribed in my presence this ________ day of __________________________, 20 _______.
________________________________________
Notary Public
Print Form
Reset Form
WCPC Form 18.01
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Legal