UCCJEA Legal Document

UCCJEA JURISDICTIONAL AFFIDAVIT AND AGREEMENT

This Affidavit is executed on by Petitioner Name: residing at and Respondent Name: residing at .

RECITALS

WHEREAS, the parties are the parents or legal custodians of the following child(ren):

WHEREAS, the parties seek to establish, confirm or acknowledge the proper jurisdiction for child custody proceedings under the Uniform Child Custody Jurisdiction and Enforcement Act (UCCJEA) and to provide a written certification of facts relevant to jurisdiction and enforcement.

WHEREAS, the parties desire to reduce to writing the factual bases upon which jurisdiction is or is not claimed and to set forth agreed procedures for notice, enforcement, and venue in any future custody or enforcement proceedings.

NOW, THEREFORE, IT IS AGREED

1. Jurisdictional Facts. Each party certifies, under penalty of perjury, the following facts that form the basis for jurisdiction or non‑jurisdiction under the UCCJEA:
   Child's home state jurisdiction exists (child has lived with a parent in the state for at least six consecutive months immediately prior to the proceeding).
   Significant-connection jurisdiction exists (no home state but significant connections and substantial evidence in the state).
   Emergency jurisdiction is asserted due to present danger to child.
2. History of Proceedings. Identify all prior custody, protection, juvenile, or related proceedings concerning the child(ren). For each proceeding, describe the court, case number, country/state, nature of order, and the date entered:
3. Residency and Physical Custody Facts. The parties set forth the residence history for the child(ren) during the two years preceding the date of execution of this Affidavit. For each child, specify periods of residence and with which parent or custodian:
4. Admission of Evidence and Location of Records. Each party shall identify the location of substantial evidence relevant to the child's care, such as medical, school, and child welfare records, and shall consent to the use of records identified herein in any jurisdiction with proper notice:
5. Enforcement and Registration of Orders. The parties acknowledge that any custody order issued in a court of competent jurisdiction may be registered and enforced in other jurisdictions in accordance with the UCCJEA. The parties agree to cooperate in the registration process and to provide certified copies of orders upon request.
6. Representation of Accuracy. Each party represents that the facts set forth in this Affidavit are true and correct to the best of that party's knowledge, information, and belief. A party who knowingly provides false information may be subject to contempt, sanctions, or penalties as determined by a court of competent jurisdiction.

NOTICES

All formal notices required or permitted under this Affidavit shall be in writing and delivered to the addresses provided below. Notice given by certified mail, personal delivery, or other method reasonably calculated to provide actual notice shall be effective upon receipt.

MISCELLANEOUS PROVISIONS

Governing Law: This Affidavit shall be interpreted and enforced in accordance with the law of the state identified as the forum state in any petition or proceeding, except where the UCCJEA requires recognition of another state's order.

Entire Agreement: This Affidavit, together with any custody orders expressly incorporated herein, constitutes the entire written agreement of the parties with respect to the jurisdictional facts and procedures addressed herein, superseding all prior oral and written understandings, if any.

Severability: If any provision of this Affidavit is held to be invalid or unenforceable, the remaining provisions shall remain in full force and effect and be construed so as to achieve the intent of the parties to the fullest extent permitted by law.

Amendments: This Affidavit may be amended only by a written instrument signed by both parties and, where required, filed with the court.

Waiver: No waiver of any provision of this Affidavit shall be effective unless in writing signed by the waiving party. The failure to enforce any provision shall not constitute a waiver of future enforcement.

Counterparts: This Affidavit may be executed in counterparts, each of which shall be deemed an original and all of which together shall constitute one instrument.

ACKNOWLEDGMENT AND CERTIFICATION

Each party acknowledges that they have read this Affidavit, understand its contents, and certify under penalty of perjury that the statements contained herein are true and correct. Each party understands that the factual statements herein may be relied upon by a court in determining jurisdiction under the UCCJEA.

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