Form 16.1 "Affidavit" - Ohio

What Is Form 16.1?

This is a legal form that was released by the Ohio Courts of Common Pleas - Probate Division - a government authority operating within Ohio. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on June 1, 2020;
  • The latest edition provided by the Ohio Courts of Common Pleas - Probate Division;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of Form 16.1 by clicking the link below or browse more documents and templates provided by the Ohio Courts of Common Pleas - Probate Division.

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Download Form 16.1 "Affidavit" - Ohio

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PROBATE COURT OF ______________ COUNTY, OHIO
_________________, Judge
GUARDIANSHIP OF ____________________________________________________
CASE NO. _______________________
STATEMENT
[R.C. 3109.27]
State of Ohio, County of ______________________________________________s.s.
(To be filed only when guardianship of the person of a minor is sought)
Affiant being first duly sworn, deposes and says:
1. That the child's present address, the places where the child has lived within the last
five years, and the names and present addresses of the person(s) with whom the child has
lived during that period are:
2. That affiant has (not) participated as a party, witness, or in any other capacity in any
litigation concerning the custody of the child(ren) in this or any other state.
3. That affiant has (no) information of any custody proceeding concerning the child(ren)
pending in a court of this or any other state.
4. That affiant has (no) knowledge of any person not a party to the proceedings who
has physical custody of the child(ren) or claims to have custody or visitation rights with respect
to the child(ren).
If 2, 3, or 4 is answered in the affirmative, and the space afforded is insufficient for full
explanation, please attach and incorporate herein any necessary information.
Affiant realizes that affiant has a continuing duty to inform the Court of any custody
proceedings concerning the child(ren) in this or any other state of which affiant obtains
information during the pendency of this proceeding.
____________________________________
The information above is true, complete, and accurate to the best of my knowledge. I understand
that knowingly providing false information in this document may result in a contempt of court
finding against me which could result in a jail sentence and fine, or criminal penalties under R.C.
2921.13.
____________________________________
Your Signature
FORM 16.1 - AFFIDAVIT
Temporarily Amended June 2020
PROBATE COURT OF ______________ COUNTY, OHIO
_________________, Judge
GUARDIANSHIP OF ____________________________________________________
CASE NO. _______________________
STATEMENT
[R.C. 3109.27]
State of Ohio, County of ______________________________________________s.s.
(To be filed only when guardianship of the person of a minor is sought)
Affiant being first duly sworn, deposes and says:
1. That the child's present address, the places where the child has lived within the last
five years, and the names and present addresses of the person(s) with whom the child has
lived during that period are:
2. That affiant has (not) participated as a party, witness, or in any other capacity in any
litigation concerning the custody of the child(ren) in this or any other state.
3. That affiant has (no) information of any custody proceeding concerning the child(ren)
pending in a court of this or any other state.
4. That affiant has (no) knowledge of any person not a party to the proceedings who
has physical custody of the child(ren) or claims to have custody or visitation rights with respect
to the child(ren).
If 2, 3, or 4 is answered in the affirmative, and the space afforded is insufficient for full
explanation, please attach and incorporate herein any necessary information.
Affiant realizes that affiant has a continuing duty to inform the Court of any custody
proceedings concerning the child(ren) in this or any other state of which affiant obtains
information during the pendency of this proceeding.
____________________________________
The information above is true, complete, and accurate to the best of my knowledge. I understand
that knowingly providing false information in this document may result in a contempt of court
finding against me which could result in a jail sentence and fine, or criminal penalties under R.C.
2921.13.
____________________________________
Your Signature
FORM 16.1 - AFFIDAVIT
Temporarily Amended June 2020