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6. Adults With Whom Children Have Lived:
During the past five years, the children have lived with the following adults:
Name of Person Person’s Current Address
____________________ ________________________________________
____________________ ________________________________________
____________________ ________________________________________
____________________ ________________________________________
____________________ ________________________________________
7. Prior Custody Determination: On ______________________________, the
____________________ Court of ____________________, County in the State of
____________________, Civil Action File Number ____________________
made a custody determination regarding custody of the minor children.
.
8. Other Proceedings That Could Affect Custody of Visitation in This Case:
[Check only one of these , either (a) or (b).]
__ (a) I do not have any information of any proceeding that could affect this case,
including proceedings for enforcement and proceedings relating to family
violence, protective orders, termination of parental rights, and adoptions in this
or any other state.
__ (b) I have information about a proceeding that could affect this case, including
proceedings for enforcement and proceedings relating to family violence,
protective orders, termination of parental rights, or adoptions in this or another
state. The court, the case number and the nature of the proceeding are as
follows:
____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
9. Others Claiming Custody or Visitation:
[Check only one of these, either (a) or (b).]
__ (a) I do not know of any person who is not a party to this case, who has
physical custody of the minor children or who claims to have custody or
visitation rights with respect to the children.
__ (b) I know of someone who is not a party to this case who has physical custody