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Declaration of Custody

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Motion and Declaration for Temporary Nonparental Custody Order (MTAF)

Superior Court of Washington

County of

In re the Custody of:

Child(ren),

Petitioner(s),

and

Respondent(s),

No.

I. Motion

1.1 Custody

Based on the reasons set forth in the declaration below, the undersigned moves the court for a temporary order which grants the undersigned custody of the following children:

1.2 Other Relief

Does not apply.

Based on the reasons set forth in the declaration below, the undersigned moves the court for a temporary order which:

grants visitation for the mother as set forth in the attached proposed Residential Schedule, or as follows:

grants visitation for the father as set forth in the attached proposed Residential Schedule, or as follows:

orders child support as determined pursuant to the Washington State Support Schedule.

restrains or enjoins from disturbing the peace of the undersigned or of any child.

restrains or enjoins from going onto the grounds of or entering the home, work place or school of the other party, or the day care or school of the following named child(ren):

restrains or enjoins from knowingly coming within or knowingly remaining within (distance) of the home, work place or school of the other party or the day care or school of the following children:

restrains or enjoins from molesting, assaulting, harassing, or stalking .

restrains or enjoins from removing any of the children from the state of Washington.

(If This Box Is Checked, Clear and Convincing Reasons for This Request Must Be Presented in the Declaration Below.) requires to surrender any deadly weapon in his or her immediate possession or control or subject to his or her immediate possession or control to the sheriff of the county having jurisdiction of this proceeding, to his or her lawyer or to a person designated by the court.

requires to pay temporary attorney fees, other professional fees and costs in the amount of $ to:

appoints a guardian ad litem on behalf of the children.

Other.

1.3 Indian Child Welfare Act

The moving party requests that the court enter an order finding that:

Indian Child Status:

The child(ren) are Indian child(ren) as defined by the Indian Child Welfare Act, 25 USC § 1903, and notice of this action must be given in accordance with 25 U.S.C. § 1912(a).

None of the child(ren) are Indian child(ren) as defined by 25 U.S.C. § 1903.

Jurisdiction:

The child(ren) are Indian child(ren) as defined by the Indian Child Welfare Act, 25 USC § 1903, but are not domiciled or residing within the boundaries of an Indian reservation; and no Tribal Court has continuing jurisdiction over the child(ren); this court has jurisdiction under 25 USC § 1911.

The child(ren) are Indian child(ren) as defined by the Indian Child Welfare Act, 25 USC Sec 1903, and are domiciled or residing within the boundaries of an Indian reservation; or a Tribal Court has continuing jurisdiction over the child(ren).

Dated:

Signature of Moving Party or Lawyer/WSBA No.

Print or Type Name

II. Declaration

It is necessary that the court issue a temporary order granting the relief requested above for the reasons set forth below:

If the surrender of deadly weapons is requested, list reasons:

If the nonmoving party is not present and:

a) is on active duty and is a National Guard member or Reservist residing in Washington, or

b) is a dependent of a National Guard member or Reservist residing in Washington on active duty, list the reasons why this temporary order should be granted despite the absence of the other party:

I declare under penalty of perjury under the laws of the state of Washington that the foregoing is true and correct.

Signed at , on

Signature of Moving Party

Print or Type Name

Signed at , on

Signature of Moving Party

Print or Type Name

Do not attach financial records, personal health care records or confidential reports to this declaration. Such records should be served on the other party and filed with the court using one of these cover sheets:

1) Sealed Financial Source Documents (WPF DRPSCU 09.0220) for financial records

2) Sealed Personal Health Care Records (WPF DRPSCU 09.0260) for health records

3) Sealed Confidential Report (WPF DRPSCU 09.270) for confidential reports

If filed separately using a cover sheet, the records will be sealed to protect your privacy (although they will be available to all parties in the case, their attorneys, court personnel and certain state agencies and boards.) See GR 22(C)(2).

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What a Declaration of Custody Is

A Declaration of Custody is a written, sworn statement that identifies who currently has legal or physical custody of a person, property, or specific records. It functions as an affidavit or formal declaration for courts, agencies, or third parties that require proof of possession or care. Uses include family law custody determinations, temporary guardianship, chain-of-custody for evidence or records transfer, and custodial authority for medical or educational decisions. The document states factual details, dates, and the declarant’s relationship to the subject, and typically requires signature, date, and sometimes notarization to establish authenticity.

Why a Clear Declaration Matters

A clear Declaration of Custody provides documentary proof of possession or caregiving authority, reduces disputes, and supports administrative or legal requests. Properly executed declarations speed processing, clarify responsibilities, and help agencies, schools, or courts verify custody without lengthy hearings.

Why a Clear Declaration Matters

Who Prepares and Receives These Declarations

Parents, guardians, caregivers, attorneys, law enforcement, school administrators, and custodial agencies commonly prepare or receive Declarations of Custody.

  • Parents and guardians asserting legal physical custody for school or medical purposes.
  • Attorneys submitting affidavit evidence in family court or administrative hearings.
  • Custodial agencies, hospitals, and schools requesting documented authority to act on behalf of a person.

Choose the version and execution method required by the receiving organization or court to avoid rejection.

Essential Parts of a Professional Declaration of Custody

Core elements ensure the Declaration of Custody is complete, verifiable, and legally defensible across administrative and judicial settings and acceptable to schools, agencies, or courts.

Parties

Identify declarant, subject, and any other parties by full legal name, relationship, and contact information; include addresses and dates of birth where relevant to avoid ambiguity.

Custody Type

State whether custody is physical, legal, temporary guardianship, or custodial responsibility for records; describe scope, limits, and duration of the custody arrangement.

Effective Date

Specify the date custody began or will begin, using MM/DD/YYYY format; this anchors obligations and determines applicable deadlines and custody periods.

Facts and Basis

Provide concise factual narrative explaining how custody arose, relevant agreements, orders, transfers, or events supporting the declarant’s authority and possession.

Supporting Docs

List and attach corroborating records such as court orders, guardianship letters, transfer receipts, medical authorizations, school forms, or chain-of-custody logs.

Execution

Include signature block with printed name, date, and notary or witness lines if required; note any electronic signature method used and authentication level.

Required Fields and Core Data Elements

Full Legal Name: Exact name as on government ID
Date of Birth: Use MM/DD/YYYY format
Address: Street, city, state, ZIP
Custody Description: Physical or legal custody details
Effective Date: Use MM/DD/YYYY start date
Signature: Sign and date; notary if required

Step-by-Step: Prepare and Execute the Declaration

Follow these steps to prepare, verify, notarize (if required), and execute a Declaration of Custody correctly and consistently.

  • 01
    Gather Information: Collect names, dates, addresses, and supporting documents.
  • 02
    Draft Statement: Write concise factual basis and custody scope.
  • 03
    Attach Evidence: Include orders, receipts, authorizations, and records.
  • 04
    Execute Properly: Sign, date, notarize or e-sign per recipient rules.

Where and How Declarations Are Submitted

Typical routing and receipt options for submission and verification of the signed Declaration of Custody.

  • Send to Court: File with clerk per court filing rules.
  • Provide to School: Deliver to school registrar or administration office.
  • Share with Agency: Submit to social services or custodial agency.
  • Retain Copy: Keep original signed version and certified copies.

Technical Considerations for eSubmission

Electronic submission requires compatible formats, signer authentication, and secure transfer to meet legal and recipient requirements.

  • Formats: PDF or DOCX preferred
  • Authentication: Email link, SMS code, or two-factor
  • Integrations: Works with common storage and CRM

Consequences of Incorrect or Incomplete Declarations

Rejection by Court: Court may refuse unsupported electronic declarations
Delay in Services: Schools or agencies may delay enrollment
Criminal Liability: False statements risk perjury charges
Privacy Exposure: Improper identifiers may violate HIPAA
Benefit Impact: Custody-dependent services may be interrupted
Evidence Gaps: Missing attachments weaken chain-of-custody

Common Mistakes to Avoid

  • Using informal names or initials instead of full legal names can cause identity mismatches; recipients may reject the declaration or require supplemental affidavits to confirm identity.
  • Failing to attach supporting documents such as court orders, transfer receipts, or medical authorizations often leaves the declaration unsupported and may lead to administrative denial.
  • Signing without the required notarization, witnesses, or acceptable e-sign authentication causes delays or outright refusal by courts or institutions that demand wet-ink or RON.
  • Submitting outdated forms or versions not accepted by the receiving agency may necessitate resubmission and prolong disputes over custody or possession rights.

Timing Considerations and Typical Deadlines

Time-sensitive aspects depend on recipient; plan for verification, notarization, and agency filing deadlines when preparing the Declaration of Custody.

Provide upon official request without delay:

Deliver promptly to the requesting party to avoid service interruptions or administrative hold.

Observe local court filing and response deadlines:

Check clerk’s office for required forms, filing fees, and hearing dates.

Submit before school enrollment or program deadlines:

Provide documentation during registration to verify custody and emergency contacts.

Schedule notarization well ahead of submission:

Allow time for in-person or RON appointments and any identity proofing.

Retain original and update within statutory periods:

Amend and re-execute when custody changes; notify recipients promptly.

Illustrative Use Cases

Real-world examples illustrate how declarations speed verification across family law and records custody scenarios nationwide.

Family Court Example

A parent used a notarized Declaration of Custody to document temporary physical custody after an emergency relocation, providing schools and doctors immediate proof.

  • This avoided immediate interim hearings and service interruptions.
  • The declaration, accompanied by a certified copy of a court order and a hospital transfer record, satisfied administrative requirements so the child remained enrolled and received medical care while legal proceedings proceeded.

Evidence Chain Example

A lab used a Declaration of Custody to record transfer of biological samples from field collection to forensic analysis, creating a clear audit trail.

  • Signatures and timestamps documented custody.
  • Combined with chain-of-custody labels and laboratory accession logs, the declaration supported admissibility by linking each transfer to a signer, timestamp, and supporting receipt accepted by investigators in accordance with agency policies and laboratory accreditation.

Who Typically Signs a Declaration

Parent / Legal Guardian

A parent or legal guardian typically has authority to sign Declarations of Custody concerning minor children, unless a court order states otherwise. Include proof of relationship and identity; some institutions may require a certified court order for disputed custody.

Court-Appointed Guardian

A court-appointed guardian or conservator may sign declarations for wards when court documents confer custody or decision-making authority. Present the letters of guardianship or the court order; recipients frequently request notarized documents or certified copies for verification.

Frequently Asked Questions

Answers to common questions about preparing, signing, and submitting a Declaration of Custody, including authentication and supporting documentation.


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eSignature Pricing and Feature Comparison

Compare common eSignature pricing and feature criteria relevant when executing and managing Declarations of Custody across platforms.

signNow DocuSign Adobe Sign PandaDoc HelloSign
Starting Price $8/user/mo $15/user/mo $14/user/mo $19/user/mo $15/user/mo
Free Trial 7-day free trial Trial available Trial available Trial available Trial available
Bulk Send Yes Yes Yes Yes No
Audit Trail Yes Yes Yes Yes Yes
HIPAA Compliant Yes Yes Yes No No
Envelope Cap No cap 100 envelopes/user/year Varies by plan Varies by plan Varies by plan

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