Form 35.1 Affidavit In Support Of Claim For Custody Or Access Page 5
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10Form 35.1:
Affidavit in Support of Claim for
(page 5)
Court file number
Custody or Access
Period(s) of Time with
Name(s) of Caregiver(s)
Child’s Name
Caregiver(s)
(if the child was in the care of a children’s aid society,
give the name of that children’s aid society)
(d,m,y to d,m,y)
10. My plan for the care and upbringing of the child(ren) is as follows:
a) I plan to live at the following address:
b) The following people (other than the child(ren) involved in this case) will be living with me:
Has this person been found
Has a child of this
guilty of a criminal offence (for
Full legal name and
person
Relationship
Birthdate
which he/she has not received a
other names this
ever been in the care of a
to you
pardon) or is he/she currently
(d, m, y)
person has used
children’s aid society?
facing criminal charges?
(if yes, give details)
(if yes, give details)
c) Decisions for the child(ren) (including education, medical care, religious upbringing, extra-curricular activities,
etc.) will be made as follows:
jointly by me and
(name(s) of person(s))
by me
by
(name(s) of person(s))
(If necessary, provide additional details below.)
FLR-35-1-E (2009/11)
Continued on next sheet
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