Child Care or Custody Disclosure Affidavit (Trial Court Rule IV)

Jurisdiction: Country: The United States | Province or State: Massachusetts

What is a Child Care or Custody Disclosure Affidavit (Trial Court Rule IV)?

A Child Care or Custody Disclosure Affidavit is a sworn statement you file in family cases involving a child. It tells the court about any other custody or care cases involving your child. It also lists where your child lived for the past five years and with whom. The goal is simple. The court must know if another court is already involved or has issued orders. This prevents conflicting orders and protects your child’s stability.

You sign the affidavit under the penalties of perjury. That means you swear the information is true. The court relies on your answers to decide if it can hear your case. Your answers also show whether another court is better placed to handle custody.

This affidavit is required at the start of any case that may affect custody or parenting time. It applies in divorce, custody complaints, paternity, guardianship, and parenting plan changes. You also use it in enforcement cases if custody or visitation is at issue. You may need it with restraining orders that include temporary custody. The court uses it to understand the full picture from day one.

Who Typically Uses This Form?

• Parents who are married, divorced, or never married.
• Legal guardians or proposed guardians.
• A caregiver seeking custody or visitation rights.
• A party asking to modify an existing custody or parenting order.
• Any party in a case that touches custody or parenting time.

Attorneys prepare it for clients. Many people also file it without a lawyer. Courts will not finalize custody orders without a complete affidavit.

Why Would You Need This Form?

You need this form because the court must check for other custody cases and orders. It must confirm it has the authority to decide custody. The affidavit makes that possible. It gives the judge your child’s residence history and any related court activity. It also alerts the court to safety concerns and potential risks.

If you do not file it, your case may be delayed. The judge may refuse to make custody or parenting orders until it is filed. If you file it with errors or omissions, it can cause problems. The court may question your credibility or impose sanctions. Accurate, complete answers keep your case moving.

Typical Usage Scenarios

You file this affidavit when you start a divorce with minor children. You also file it when you bring a stand-alone custody or paternity case. You file it when you ask to change custody or parenting time. You file it when you ask the court to enforce an existing order. If there is a protective order that awards temporary custody, you should file it. You may also need it in guardianship cases where custody is at stake.

You also use it if you are responding to any of the cases above. Each party must file their own affidavit. The court needs a complete record from both sides. If a case starts in another state, you still file it here. The judge will use your affidavit to coordinate with that other court if needed.

When Would You Use a Child Care or Custody Disclosure Affidavit (Trial Court Rule IV)?

You use this affidavit at the start of any case that could affect who has custody. That includes legal and physical custody. It also includes parenting time, visitation, and decision-making. In a divorce with children, you attach it to your first filing. In a custody complaint or paternity case, you file it with your complaint. If you are responding, you file it with your answer or soon after. In a motion to modify custody, file a new affidavit with your motion papers. Do the same for requests to relocate with a child.

If a restraining order seeks or grants temporary custody, complete this affidavit. The court must know if other courts have weighed in. This helps keep orders consistent and enforceable. If you are seeking guardianship of a minor, file it if custody or parental rights are involved. If you are asking the court to enforce custody terms, the affidavit still applies.

Parents, guardians, and caregivers use this form. So do parties with a claim to custody or visitation. For example, a parent who moved to Massachusetts should file it before asking for custody here. The court will review the child’s recent addresses. It must confirm whether Massachusetts is the child’s home state. Your affidavit provides that timeline.

You must also use the affidavit when there are other related cases. This includes juvenile matters, adoption cases, or child protection cases. If another court has issued an order, the judge needs to know. Your affidavit should name that court, the case number, and the status. You should also describe whether any orders are still in effect.

Finally, use this affidavit if safety is a concern. The form allows you to alert the court to risks. You can ask the court to keep addresses confidential if needed. You can also move to impound certain details for safety. The court can then tailor notice and service to protect the child and parties.

Legal Characteristics of the Child Care or Custody Disclosure Affidavit (Trial Court Rule IV)

This form is legally binding. You sign it under the penalties of perjury. That means false statements can lead to penalties. The court expects complete and truthful answers. The affidavit helps the court decide if it can hear the case. It also helps the court set safe and consistent orders. Because of that, your accuracy matters.

Enforceability comes from two places. First, your signature under oath. Second, the court’s reliance on your sworn information. The court may use your affidavit to contact other courts. It may obtain certified copies of orders from another state. If your affidavit omits a case, the judge may suspend action. The court may also order you to correct the record. In serious situations, it may impose sanctions.

The affidavit also establishes a record of the child’s residence. This is crucial for jurisdiction. The judge must know where the child has lived for the last five years. If your child recently moved, the court needs those dates. It must ensure it has the power to decide custody. If another state has an active case, the judge may coordinate with that court. Your affidavit makes that possible.

Privacy and safety also matter. The form allows you to limit address disclosure if there is a risk. You can ask the court to impound sensitive information. If approved, the court keeps that data confidential. If you need that protection, tell the clerk and follow the court’s process. The judge can allow alternative service and tailored disclosures.

You also have a duty to update. If a new case starts after you file, submit a new affidavit. If the child moves during the case, update the residence section. If a new order is issued elsewhere, disclose it right away. Courts expect you to keep this information current. That duty lasts while your case is pending.

Finally, attach supporting documents when you can. If you have a copy of a prior order, include it. If you lack details, say so. Do not guess at case numbers or dates. Write “unknown” if you do not know. Then try to get the missing information. The court values accuracy over speed.

How to Fill Out a Child Care or Custody Disclosure Affidavit (Trial Court Rule IV)

1) Confirm you have the right form.

Make sure your form title matches “Child Care or Custody Disclosure Affidavit.” Use the current version. If you are unsure, ask the clerk for the latest form.

2) Complete the case caption.

Enter the court name and division. Enter the county. If you have a docket number, add it. If not, leave it blank for the clerk. Put the case title, such as “Smith v. Jones.” List yourself as plaintiff/petitioner if you filed the case. List yourself as defendant/respondent if you are responding.

3) Identify the parties.

Write your full name, address, phone, and email. If you have a lawyer, include their name and contact information. Provide the same for the other party if known. If addresses must remain confidential for safety, note that and see step 13.

4) List each child covered by the case.

For each child, enter full legal name and date of birth. If the child uses a different last name, include it. Use the name on the birth certificate if possible.

5) Provide the child’s current address.

Enter the current physical address where the child lives. Include the street, city, state, and ZIP code. If disclosing the address is unsafe, see step 13 about confidentiality.

6) Provide the child’s residence history for five years.

List each place the child has lived for the last five years. Include start and end dates for each address. If the child is under five, list all addresses since birth. Use month and year if you do not recall exact days. Attach a separate page if needed.

7) Identify who lived with the child at each address.

For each address in step 6, list the names of people who lived with the child. Include their relationship to the child, such as parent or grandparent. Provide their current addresses if known. If you do not know an address, write “unknown.”

8) Disclose other custody or care cases involving the child.

State whether there are any custody, visitation, guardianship, or protection cases. Include past and present cases. List the court name, state, case number, and status. If you know the judge’s name, include it. Attach copies of recent orders if you have them.

9) Disclose your participation in related cases.

State whether you or the child have been part of any related cases. This includes paternity, support, juvenile, or protective order cases. Provide the court, case number, and outcome if known. Be clear if a case is pending.

10) Identify any person who may claim custody or visitation.

List anyone who claims custody or parenting time. Include anyone who may file for those rights. Give names and addresses if known. Note the relationship to the child. This can include a legal guardian or a current caregiver.

11) Note any existing orders affecting custody or safety.

If there is a restraining order or protective order, disclose it. Provide the court, case number, date, and whether it is active. Attach a copy if you have it. If you cannot safely share the address protected by that order, say so.

12) Add context if the court needs it to avoid conflict.

Use the space provided to explain overlapping cases. For example, note a pending case in another state. Explain whether that court issued any temporary orders. This helps the judge decide next steps.

13) Ask for confidentiality or impoundment if safety is at risk.

If sharing your address or the child’s address is unsafe, ask for protection. Check any confidentiality box on the form if present. File a motion to impound sensitive details if needed. Provide a short statement explaining the risk. Ask the clerk how to present this to the judge.

14) Use continuation sheets for extra space.

Do not cram details into small boxes. Use a separate page when needed. Label each page with the case caption and “Attachment to Affidavit.” Reference the section you are expanding. Number the pages.

15) Attach supporting documents.

Attach copies of court orders mentioned in the affidavit. Include any custody judgments, temporary orders, or protective orders. If you lack a copy, say so in the affidavit. Do not attach sensitive records without considering step 13.

16) Review for completeness and accuracy.

Check dates, addresses, and case numbers. Confirm the five-year history is complete. Verify the spelling of names. Make sure you answered every question. Do not leave blanks. Use “none” or “unknown” when appropriate.

17) Sign under the penalties of perjury.

Read the perjury statement above the signature block. Sign and date the affidavit. Print your name clearly. If there is a notary section, sign in front of a notary. Bring a photo ID if notarization is required.

18) Make copies for your records and for service.

Keep one complete copy for yourself. Make copies for each other party if service is required. If the court ordered confidentiality, follow those instructions. Ask the clerk about alternate service if addresses are impounded.

19) File the affidavit with the court.

File it with your initial complaint or answer. File it with any custody-related motion if not already on record. If you filed electronically, follow the filing system rules. If you filed in person, bring your copies for stamping.

20) Serve the affidavit if required.

Serve other parties as the court rules require. Use the same method as your complaint or motion. Keep proof of service. This may be a certificate of service or a return of service.

21) Update the affidavit if something changes.

File a new affidavit if the child moves. File one if a new case starts in any court. File one if a new order issues elsewhere. Do this promptly. The court needs current information.

22) Common mistakes to avoid.

Do not list only your addresses. List where the child lived. Do not forget short stays if they were significant. Do not omit other states. Do not guess at case numbers. If unknown, say “unknown” and then try to find them. Do not assume the court knows about a case. If it exists, disclose it.

23) Practical examples for clarity.

If you are filing for divorce with children, include the child’s five-year address history. List a past paternity case if there was one. If a protective order grants temporary custody, attach it. If your child lived with a grandparent for a year, list that address and the grandparent’s name.

24) If you are the responding party.

Complete the affidavit even if the other parent already filed one. Your view may add missing addresses or cases. The judge wants a full record from both sides. File it quickly to avoid delays.

25) If you recently moved states.

List the prior state addresses and dates. State if any case is pending there. If a case is active in another state, say so. Your affidavit helps the courts coordinate. It can prevent duplicate orders and confusion.

26) If you are seeking emergency orders.

File the affidavit with your emergency motion. Explain any safety issues and existing orders. Ask to impound addresses if there is a risk of harm. The judge may tailor notice and service to protect you and the child.

27) Final check before submission.

Ensure all pages are included and in order. Confirm attachments are labeled. Verify your contact information is correct or protected. Then file and serve as required.

By following these steps, you give the court a clear, complete record. You help the judge assess jurisdiction, safety, and next steps. You also prevent delays that come from missing or conflicting information. Fill it out carefully. Keep it updated. Your case will move more smoothly.

Legal Terms You Might Encounter

Affidavit means a written statement you sign under oath.

By signing this affidavit, you swear the information about the child’s care and custody is true to the best of your knowledge.

Care or custody proceeding means any court case that affects who has custody or parenting time.

This includes divorce, separate support, guardianship, adoption, and protection cases. You list any past or current cases in which the child’s care or custody was at issue.

Party means any person who has a legal role in a case.

On this form, parties include you, the other parent, and anyone else who claims custody or visitation, like a guardian or relative.

Home state is where the child has lived with a parent or caretaker for the last six months.

If the child is younger than six months, it means since birth. You use the home state to help the court understand whether it can make custody decisions.

Legal custody is the right to make major decisions for the child.

These decisions include education, health care, and religion. If a court has given someone legal custody, you note that here.

Physical custody is where the child lives day to day.

A person with physical custody provides daily care. If there is an order on physical custody, list it and attach details.

Parenting time is the schedule for when the child spends time with each parent.

Some people call this visitation. If a court has set a schedule, include that information on the form.

Jurisdiction is a court’s power to make custody orders.

The court uses the addresses, timelines, and other cases you disclose to decide if it has this power. Your accurate dates and places help the court decide.

Protective order means a court order to prevent harm or harassment.

Some orders limit contact between people. If any protective order affects the child or parties, you must disclose it.

Penalty of perjury means you can face legal consequences for false statements.

When you sign this affidavit, you confirm you understand this penalty. Be accurate and complete, or say if you do not know.

Confidential address means you are asking the court not to share a location.

You can request confidentiality if sharing an address would risk safety. The form lets you indicate safety concerns and ask the clerk about protections.

FAQs

Do you need to file this affidavit in every case with a child?

Yes. If your case involves child custody, parenting time, or placement, you file this affidavit. The court uses it to see if any other case might affect your case. If you are not sure, ask the clerk if your filing triggers the requirement.

Do you have to list every address the child has used?

List every address where the child has lived for the last five years. If the child is under five, list every address since birth. Include the dates lived at each address and the names of the people the child lived with at each address.

Do you include cases in other states or countries?

Yes. Disclose any care or custody case anywhere, past or present. Include the court location, case type, case number if known, and the judge if you know it. If you do not know a detail, state that you do not know.

Do you need to list people other than parents?

Yes. List anyone who claims custody or parenting time. This can include relatives, guardians, or other caretakers. If someone has cared for the child for a long time, include that information even if there is no order yet.

Do you have to disclose a protection order?

Yes. Disclose any order that limits contact among the parties or affects the child. The court needs to know about safety concerns when considering custody or visitation. If revealing an address is unsafe, ask the clerk about confidential filing.

Do you need to have the form notarized?

You sign under the penalties of perjury. Follow the signature block instructions exactly. Some courts require a notary or clerk to witness your signature. If the signature block requires it, sign in front of a notary or clerk.

Do you need to update the affidavit if something changes?

Yes. If another case starts, a case ends, or the child’s address changes, file an updated affidavit. File the update promptly so the court has correct information. Keep proof of your filing.

Do you need to serve the other party?

Yes, in most cases. After you file, provide a copy to the other party or parties. If there are safety or confidentiality protections, follow those instructions. Keep proof of service.

Checklist: Before, During, and After the Child Care or Custody Disclosure Affidavit (Trial Court Rule IV)

Before signing

• Gather the child’s full legal name and date of birth.
• Collect the child’s addresses for the last five years. If under five, list since birth.
• List everyone the child has lived with at each address, and the dates.
• Gather full names, current addresses, and contact details for each person listed.
• Make a list of all care or custody cases, past and present. Include case numbers, courts, and dates if known.
• Add any protection orders or no-contact orders involving the child or parties. Note the court and date.
• Identify any guardianship, adoption, or child protection cases involving the child.
• Confirm spellings of names, including prior names or nicknames that appear on records.
• Review any existing court orders. Have copies handy for accurate dates and terms.
• Prepare a statement if you need address confidentiality for safety.
• Confirm whether your signature must be notarized or witnessed by a clerk.
• Bring a government ID if notarization or in-person filing is required.

During signing

• Verify the child’s name and date of birth on the form.
• Check every address entry for accuracy and complete dates.
• Confirm names and contact details of all people the child lived with.
• Make sure you listed all open and closed custody-related cases.
• Verify case numbers and court locations, or note if unknown.
• Review any protective orders and confirm the dates and courts.
• Read the penalty of perjury statement carefully.
• Sign and date where indicated. Use blue or black ink if required.
• If notarization is required, sign only in front of the notary or clerk.
• Make sure every required field is complete. Write “unknown” rather than leaving blanks.
• Review any confidentiality requests and attach them if needed.

After signing

• Make at least two copies: one for you, one for the other party.
• File the original with the correct court for your case.
• Ask the clerk to stamp your copy “filed” for your records.
• Confirm if you must serve the other party and how to do it.
• Complete service and keep proof, like a return of service.
• If the court granted confidentiality, confirm how addresses will be handled.
• Store your filed copy with your other case documents.
• Calendar your next court date and any deadlines to update the affidavit.
• Update and refile if the child moves, a new case starts, or a case ends.
• Bring a copy of the filed affidavit to every hearing.

Common Mistakes to Avoid Child Care or Custody Disclosure Affidavit (Trial Court Rule IV)

• Leaving out a prior case.
• Consequence: The court may question your credibility or delay your case. Don’t forget even old or closed cases. List them and note that they are closed.

• Missing address history.
• Consequence: The court may lack jurisdiction information and postpone decisions. Do not guess. If you are unsure, say you are unsure and explain your efforts to find the address.

• Omitting non-parent caretakers.
• Consequence: The court may not contact a key person. List relatives or others who cared for the child, with dates and addresses.

• Failing to disclose protection orders.
• Consequence: The court might set unsafe contact or visitation. Always disclose orders, even if they seem unrelated to custody.

• Signing without reading the perjury warning.
• Consequence: False statements can lead to penalties. Review every entry, correct errors, and sign only when certain.

 What to Do After Filling Out the Form Child Care or Custody Disclosure Affidavit (Trial Court Rule IV)

File the affidavit with the court handling your case. Ask the clerk if any fee applies. Many courts do not charge for this affidavit, but you should confirm.

Provide a copy to every other party. Follow the court’s service method. Use personal service, mail, or e-service if allowed. If an order limits contact, follow that order when serving.

Keep proof of filing and proof of service. Stamp your copy “filed” and save any receipts or certificates. You may need them at a hearing.

Bring your filed copy to every court appearance. Judges often refer to these details during hearings. Having it handy saves time.

Update the affidavit if facts change. File an updated affidavit if the child moves, a case begins or ends, or a new protective order issues. Do this promptly to avoid delays.

Request confidentiality if needed. If sharing an address risks safety, ask the clerk about confidential filing. Follow any steps required to protect addresses or contact information.

Coordinate with other filings. If you file motions on custody or parenting time, make sure the affidavit is current. Judges rely on it when setting schedules.

Check your case docket. Confirm the affidavit appears on the docket. If not, ask the clerk to ensure it is uploaded or entered.

Prepare for questions at hearings. Be ready to explain timelines, addresses, and prior cases. Bring notes or documents that support your entries.

Store your records safely. Keep a clean copy of the affidavit, orders, and proof of service together. Use a folder or binder you can bring to court.

Consider how to correct errors. If you discover a mistake, file a corrected affidavit. Label it as corrected and explain what changed. Serve it on all parties.

Monitor for overlapping cases. If you learn about a new case elsewhere, file an updated affidavit immediately. This helps avoid conflicting orders.