AFFIDAVIT IN SUPPORT OF REGISTRATION OF
OUT-OF-STATE CHILD-CUSTODY DETERMINATION (UCCJEA)
State of Michigan )
County of Cass )
I make the following affidavit under penalty of perjury:
1. My name is: ____________________________________________.
2. I am at least 18 years of age.
3. To the best of my knowledge and belief, the out of state Order(s) regarding
custody and/or parenting time attached to the Notice of Registration of Out-Of-
State Child-Custody Determination (UCCJEA) has/have not been modified,
changed, vacated or stayed and the Order(s) remain(s) in full force and effect.
I SWEAR OR AFFIRM THAT THE INFORMATION PROVIDED IN THIS
AFFIDAVIT IS TRUE AND ACCURATE.
Date:
Signature of Affiant
This form must be signed in front of a notary public.
Subscribed and sworn to before me, a Notary Public, by the above named Affiant on
___________________20__, in ______________ County, MI.
My commission expires: ____________________
Signature of Notary Public:_________________________________________
Printed name of Notary Public:
Notary Public, State of Michigan, County of ___________________________