uccjea affidavit

IN THE CIRCUIT COURT OF THE TWELFTH JUDICIAL CIRCUIT,
IN AND FOR MANATEE COUNTY, FLORIDA

Case No.: 123456
Division: family

SARAH KAREN ALLEN,
Petitioner,

and

JOHN FRANK ALLEN,
Respondent

UNIFORM CHILD CUSTODY JURISDICTION AND ENFORCEMENT ACT (UCCJEA) AFFIDAVIT

I, sarah karen allen, being sworn, certify that the following statements are true:

1. The number of minor children subject to this proceeding is three.. The name, place of birth, birth date, and sex of each child; the present address, periods of residence, and places where each child has lived within the past five (5) years; and the name, present address, and relationship to the child of each person with whom the child has lived during that time are:

THE FOLLOWING INFORMATION IS TRUE ABOUT CHILD #1:
Child's Full Legal Name: micheal raymond allenPlace of Birth: manatee countyDate of Birth: 04/10/2000Sex: Male micheal raymond allen's Residence for the past 5 years:
Dates
(From/to)Address (including city and state) where child livedName and present address of person child lived withRelationshipto child 04-10-2000-Present863 fairlawn boulevard starville, Florida 00012sara karen allen mother
863 fairlawn boulevard starville, Florida
00012

THE FOLLOWING INFORMATION IS TRUE ABOUT CHILD #2:
Child's Full Legal Name: kristen marie allenPlace of Birth: manatee countyDate of Birth: 08/03/2002Sex: Female kristen marie allen's Residence for the past 5 years:
Dates
(From/to)Address (including city and state) where child livedName and present address of person child lived withRelationshipto
Child
08-03-2002-Present863 fairlawn boulevard starville, Florida 00012sara karen allen mother
863 fairlawn boulevard starville, Florida
00012

THE FOLLOWING INFORMATION IS TRUE ABOUT CHILD #3:
Child's Full Legal Name: rachel jennifer allenPlace of Birth: manatee countyDate of Birth: 07/29/2005Sex: Female rachel jennifer allen's Residence for the past 5