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Hat your statement is true and sign it in front of a court clerk, a notary public, or an attorney who will also sign and date the affidavit. Judicial District of At (Town) Probate District name and number Plaintiff/Applicant (Last, first, middle initial) Court Use Only AFFACUS Docket number Defendant/Respondent (Last, first, middle initial) Information about the past five years for each child affected by this case is required. Provide information below. If more space is needed, use form.
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