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The Affidavit Disclosing Care or Custody Proceeding

Produced by Attorney Jeffrey L. Wolf for MassLegalHelp
Last Updated July, 2017

The Affidavit Disclosing Care or Custody Proceeding is a form you have to file in court cases that involve a child.

The form tells the court if there are already any court orders about your child. It also tells the court if any judge is making decisions about your child now.

When you sign the form you swear that the information on it is true and complete as far as you know.

When do I have to file an Affidavit Disclosing Care or Custody Proceeding?

You do not need to file the Affidavit if the case is:

  • only for child support or
  • a delinquency case, like a complaint that claims the child has broken the law.

You do have to file the Affidavit in these cases if a child is involved:

  • Complaint for Divorce,
  • Joint Petition for Divorce
  • Complaint for Separate Support,
  • Complaint for Support-Custody-Visitation,
  • Complaint to Establish Paternity
  • Guardianship of Minor,
  • Abuse Prevention,
  • Care and Protection,
  • Grandparent Visitation,
  • Child Requiring Assistance,
  • Adoption,
  • Change of Name of Minor Child, and
  • Any other case that is about the care or custody of your child.

When do I have to file this Affidavit?

You must file this Affidavit at the same time you file the other forms in the case. For example, when you file

  • a complaint,
  • a petition,
  • an application for a Child Requiring Assistance,
  • an answer, or
  • an objection.

If any information has changed since the last Affidavit was filed, you must file a new, updated Affidavit.

Where do I file this Affidavit?

File it with the Clerk-Magistrate or Register of Probate at the court that is handling this case.You can file it in person or by mail.

What if it is not safe to put my or my children’s address on the Affidavit?

You do not have to put the children’s address on the Affidavit if:

  • The address is a shelter for victims of abuse and their children.
  • You believe that you or the children are in danger of physical or emotional abuse, or
  • You are filing a complaint for a 209A Abuse Prevention Order.

If it is not safe to put these addresses on the Affidavit for any of these reasons, you can ask the court to keep the addresses confidential.

To ask the court to keep your addresses confidential:

  1. Check the box in Section 3 of the Affidavit.
  2. Leave empty the boxes for addresses in sections 4 and 5 of the Affidavit, and
  3. Put the addresses in Sections 10 and 11 where it says ADDRESSES TO BE KEPT CONFIDENTIAL. These sections are on a separate page of the Affidavit so that the addresses can be kept confidential.

Do I have to give a copy of my Affidavit Disclosing Care or Custody Proceeding to anyone besides the court?

You have to give a copy only of the first page of the Affidavit to all other parties in the case.

How do I fill out this Affidavit?

Section 1

Put your name here. This section says that everything you put on this form is true as far as you know.

Section 2

Put the name of every child involved in the case next to a letter. Use another piece of paper and add more letters if more than 3 children are involved in this case.

Section 3

Check the box in this section if:

  • You are staying at a shelter for victims of abuse and their children.
  • You believe you or the children are in danger of physical or emotional abuse, or
  • You are filing a complaint for a 209A Abuse Prevention Order.

If you checked the box:

  • Go straight to section 6 - Skip Sections 4 and 5.
  • When you finish the first page of the Affidavit, fill out the page that has sections 10 and 11.

Section 4 – if you did not check the box in Section 3,

List the addresses of all the children involved in this case

Look at the letter next to each child’s name in Section 2.

Put each child’s address next to the same letter in Section 4 that is next to their name in Section 2.

If you have more than 3 children use the same paper you added the extra letters and names on for section 2.

top half of Affidavit Disclosing Care or Custody Proceeding form

Remember

If you check the box in Section 3 to ask that addresses be kept confidential, do not fill out Section 4 or 5.

Section 5

If you did not check the box in section 3, put in your address.

Section 6

Asks 2 things:

  1. Have you ever been the plaintiff or defendant in any care or custody case that involves a child you named on this form?
    • If your answer is ‘yes’, check the 1st box, I ☐ have
    • If you answer ‘no’, check the 2nd box, ☐ have not participated
  2. Do you know if any child named on this form was ever involved in a care or custody case? See the list of care or custody cases.
    • If you know a child on this form was involved in care or custody case check the 3rd box, I ☐ know.
    • If you do not know, check the 4th box, ☐ do not know.
    • If you are sure no child on the form was ever involved in a care or custody case, check the 4th box ☐ do not know

Section 7

List all the cases you know about that involve each child.

For each child, put

  • the letter from Section 2 that is next to the child’s name, like “Child A”
  • the name of the court and the docket number of the case that involved the child, and
  • in the status column write:
    • "custody awarded to" and write the name of the person the court gave custody to, and the date of the decision, If the court gave custody to DCF write in "DCF" and the date,  or
    • "no custody awarded" if the case was dismissed or the case was not about custody, like a name change case.

In the last column, put in the letter that shows your role in the case:

  • “W” for witness,
  • “P” for party, if you were the plaintiff or defendant.
  • “O” for other, or
  • “N” for none

Section 8

List

  • all the parties parties in care or custody cases that involved any of the children you listed in the last 2 years, and
  • all the people who claimed a legal right to any of your children in the last 2 years.

For each child, put:

  • the letter in Section 2 that is next to the child’s name, like “Child A” and
  • the name and address of the party or person

Do I have to file other papers with this Affidavit?

If there are other cases that involve a child on the Affidavit, you must also file certified copies of any:

  • complaint,
  • answer,
  • motion,
  • other pleading, and
  • decision made outside of Massachusetts.

Note

You do not need to file these other papers at the same time you file this Affidavit if

  • the court already has certified copies, or
  • a judge has given you an extension to file.

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