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Alaska Child Custody Jurisdiction Affidavit

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Alaska Child Custody Jurisdiction Affidavit
Alaska Child Custody Jurisdiction Affidavit
If you believe that disclosure of some of the information on this form would jeopardize your health,
safety or liberty or that of your children, you are not required to serve a copy of this form on the other
party. Instead, file this form with the court along with court form DR-151 (available at the clerk's
office). AS 25.30.380(e)
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DR-150 (3/03) (cs) AS 25.30.380
CHILD CUSTODY AFFIDAVIT
IN THE SUPERIOR COURT FOR THE STATE OF ALASKA
AT
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) CHILD CUSTODY JURISDICTION AFFIDAVIT
I, , say on oath or affirm under penalty of perjury that:
1. The following children are the subject of the present custody proceedings:
Child's Name Place of Birth Birthdate Sex
Present Address (since ): Who Has Custody Relationship
Prior Residences for past
5 years (dates)
City & State Person Child Lived With
(Name & Current Address)
Relationship
to
to
to
to
Child's Name Place of Birth Birthdate Sex
Present Address (since / / ): Who Has Custody Relationship
Prior Residences for past
5 years (dates)
City & State Person Child Lived With
(Name & Current Address)
Relationship
to
to
to
to
Alaska Child Custody Jurisdiction Affidavit
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