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Saint Regis Mohawk Tribe Saint Regis Mohawk Tribal (St Regis Mohawk Tribe)

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SRMT CSEU Case No._____ ______________
SRMT Tribal Court Docket No.____________________
Page 1 of 5
Saint Regis Mohawk Tribe
Saint Regis Mohawk Tribal Court
______________________________
Petitioner
V
_____________________________
Respondent
1. Nature of Suit and Identification of children.
I, _______________________ , an enrolled member of the St. Regis Mohawk Tribe, currently residing at
, I am the petitioner in this action to
establish the duty of the respondent to pay child support [or to request an order modifying a child support order]
for the following children of whom I am the natural mother:
A.
Child’s Name: ______________________________________
Child’s Date of Birth: _________________________________
Child’s Tribal Affiliation: ________________________ _____
Paternity was established on _______ , through:
□ A signed birth certificate which is attached hereto.
□ An acknowledgement executed by the parties
□ By a judgment rendered by a court of competent jurisdiction and which is attached hereto
Currently, this child resides at , which □ IS / □ IS NOT the
same residence as the petitioner. (FSA Sec III 2B (vii)
B.
Child’s Name: _____________________________________
Child’s Date of Birth: _______________________________
Child’s Tribal Affiliation: ____________________________
Paternity was established on , through:
□ A signed birth certificate which is attached hereto.
□ An acknowledgement executed by the parties
□ By a judgment rendered by a court of competent jurisdiction and which is attached hereto
Currently, this child resides at , which □ IS / □ IS NOT the
same residence as the petitioner. (FSA Sec III 2B (vii)
PETITION FOR
CHILD SUPPORT
SRMT CSEU Case No._____ ______________
SRMT Tribal Court Docket No.____________________
Page 2 of 5
C.
Child’s Name: _____________________________________
Child’s Date of Birth: _______________________________
Child’s Tribal Affiliation: ____________________________
Paternity was established on , through:
□ A signed birth certificate which is attached hereto.
□ An acknowledgement executed by the parties
□ By a judgment rendered by a court of competent jurisdiction and which is attached hereto
Currently, this child resides at , which □ IS / □ IS NOT the
same residence as the petitioner. (FSA Sec III 2B (vii)
2. Order of Protection:
□ An Order of Protection was issued by _________________________________, a court of competent
jurisdiction against _______________________________________, who is also named in this petition(FSA
Sec III 2B (ii)).
□ An order of protection has not been issued.
3. Protection of Privacy:
□ The Petitioner requests that names and other personal/identifying information for the following child/children
be redacted from this petition: _____________________________________________________________
______________________________________________________________________________________
□ The Petitioner does not request redaction of information.
4. Current Information regarding the Respondent:
Name: ______________________________
Current Address: ________________________________________________________
DOB:________________ Tribal Affiliation: __________________ SRMT Enrollment No.____________
5. Respondent Prior History with the Saint Regis Mohawk Tribe and Territory:
□ Based on my knowledge, the respondent lived within the Tribe’s territory at (address)
____________________________________ from (dates) ____________ to _______________________.
□ Based on my knowledge, the Respondent worked within the Tribe’s territory at (address)
____________________________________ from (dates) ____________ to _______________________.
SRMT CSEU Case No._____ ______________
SRMT Tribal Court Docket No.____________________
Page 3 of 5
6. Respondent’s Participation in Child’s Birth and Support:
□ I hereby state that the father has contributed to the care of the child/children □ during the pregnancy
and/or □ after the child’s birth. Additional information: _______________________________________
_______________________________________________________________________________________
□ I hereby state that the respondent resided with me and my child/children at (address) ________________
__________________________, between (date)___________________and__________________________.
□ I hereby state that the respondent agreed that the child could live with me on the St. Regis Mohawk Tribe
territory. Additional information: ________________________________________________________
_______________________________________________________________________________________
□ I hereby state that I □ do □ do not solely make all decisions with respect to schooling, religion, or health care
for the children and that respondent □ participates □ does not participate in making such decisions.
If children DO visit respondent, those visitations usually occur:
□ Daily □ Weekly □ Monthly
And total visits are:
□ Less than 80 days per year
□ More than 80 days per year
□ I hereby state that the children □ DO / □ DO NOT visit the respondent.
7. Other Proceedings:
□ There has been a family court proceeding involving the child/children named in this petition.
as follows (FSA Sec II 2 vi)):
Type of Proceeding: Date of Proceeding: Name of Court:
□ There has not been a family court proceeding involving the child/children named in this petition.
8. Request for a Child Support Payment and Schedule:
A: Support. Petitioner requests that the court set the amount of child support at: $________________, which
shall be payable in installments, at a rate of $ per installment. This
amount is based on the guidelines set forth in the FSA and will be further established during this proceeding.
B: Medical and Health care. Petitioner has undertaken the costs of health care and medical cost and requests the
court to order that the children be provided healthcare coverage by: _ .(FSA Sec III 2B(iv).
C: Petitioner has outstanding medical bills in the amount of _______________, for the care of the children
named in this petition.
SRMT CSEU Case No._____ ______________
SRMT Tribal Court Docket No.____________________
Page 4 of 5
D: Petitioner has experienced extraordinary medical expenses for (name of child) ________________in the
amount of_________________.
E: □ Petitioner □ has □ has not experienced work related child care expenses in the amount of _________ and
□is□ is not requesting that the court order respondent to pay work related child care.(FSA Sec III 2B (v).
F: The petitioner □ is □ is not requesting that the respondent pay work related child care in the amount of
$ per .
9. Jurisdiction:
Based on the facts stated under oath herein, this court has jurisdiction over this petition and the respondent
because [CHECK ALL THAT APPLY]:
□ I am, □ my child is, or□ my children listed below are enrolled members of the Saint Regis Mohawk Tribe.
□ I reside or am domiciled, □ my child resides or is domiciled, or□ my children listed below reside or are
domiciled within the territory of the Saint Regis Mohawk Tribe. (See No. 7 below.)
□ The respondent is an enrolled member of the Saint Regis Mohawk Tribe.
□ The respondent resides or is domiciled within the territory of the Saint Regis Mohawk Tribe.
□ The respondent has had minimum contacts with the Tribe and its territory and is subject to this court’s
personal jurisdiction based on the facts alleged in this petition.
10. Allegation of Tribal Interest in Exercising Jurisdiction over a non-member:
□ Because the respondent is a non-member I further allege that this court has personal jurisdiction over the
respondent because the Tribe has an interest in the protection of its members. Under the standard set forth in
Montana v. United States, 450 U.S. 544 (1981), a tribe may regulate the activities of a non-member in two
circumstances—the nonmember has entered into a consensual relationship with the Tribe or with its members
by contract or other arrangements, or when the nonmembers conduct is “demonstrably serious and imperils the
political integrity, the economic security, or the health and welfare of the Tribe.” 450 U.S. at 565-566.
Congress has held that the welfare of Indian children is of utmost importance to a tribe, see Indian Child
Welfare Act, 25 U.S.C. § 1901(3), “there is no resource that is more vital to the continued existence and
integrity of Indian tribes that their children....”
The Saint Regis Mohawk Tribe has a vital interest in the health and welfare of that child and the exercise of
jurisdiction over the respondent for the establishment of paternity [and/or] child support falls well within the
Tribe’s authority over non-members under the second Montana exception. In this way the Tribe may protect
the health and welfare of the Tribe’s children. See Duncan v. Ross, 2006 WL 7137862 (Ft. Peck Ct. of Appeals
2006)(court had jurisdiction over paternity action under second Montana exception where one party a non-
Indian living off-reservation and one party non-member but Indian living on-reservation); Walker v. Tiger, 10
Okla Tribe 650, 2004 WL 7081139, *5 (S.Ct. Muscogee Nation 2004)(court may exercise jurisdiction over
child custody in a divorce proceeding because “protective orders for the welfare of tribal members is essential
SRMT CSEU Case No._____ ______________
SRMT Tribal Court Docket No.____________________
Page 5 of 5
to the political integrity, economic security, health and welfare of not only the Appellee and the minor child, but
also for every other tribal member or person eligible for tribal membership.”).
11. AFFIRMATION
I subscribe and affirm under penalty of perjury that this petition is made for the sole purpose(s) of establishing
paternity and/or obtaining child support from an individual who is (or may be) legally responsible for the
support of dependent child[ren]; and that statements made in this application or accompanying document(s)
have been examined by me and to the best of my knowledge and belief are true and correct.
Signature of Petitioner Date
Sworn to me this _________ day of _______________, 20_____
__________________________
Notary Public Signature
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Completed 20 July 2020

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