Commonwealth of Massachusetts The Trial Court Probate and Family Court Department
Division Docket No: Affidavit of Filing of Certified Copy of Child Custody Judgment Pursuant to M.G.L. C. 209B
I hereby certify under the penalties of perjury that the attached is a certified copy of the child custody judgment adjudicating the custody of issued by a court of competent jurisdiction in the State of I further certify that this judgment is currently in full force and effect.
(Signature)
(Print Name)
(Address)
NOTARIZATION SS Date:
Then personally appeared ______________________________________________________ to me known and made oath that the information contained in the foregoing statement is true to the best of his/her knowledge and belief. Before me,
Notary Public/Justice of the Peace My commission expires:
Certificate of Filing of Certified Copy of Child Custody Judgment Pursuant to M.G.L. c. 209B I hereby acknowledge that a certified copy of the child custody judgment adjudicating the custody of ______________________________________________issued by the _____________________Court, of the State of ____________________ has been filed at the Registry of Probate for the County of _________________ this ____________day of ____________________________, 20 _________. ______________________________________________ Register of Probate
Affidavit of Filing of Certified Copy of Child Custody Judgment c.g.f.