Fillable AFFT Self-Represented DISTRICT COURT CLARK COUNTY, NEVADA (Family Law Self Help Center)

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AFFT Self-Represented DISTRICT COURT CLARK COUNTY, NEVADA (Family Law Self Help Center)

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© 2017 Family Law Self-Help Center Summary Disposition Affidavit (Custody)
1
AFFT
Your Name:
Address:
Telephone:
Email Address:
Self-Represented
DISTRICT COURT
CLARK COUNTY, NEVADA
________________________________
Plaintiff,
vs.
________________________________
Defendant.
CASE NO.: ____________________
DEPT: ____________________
AFFIDAVIT IN SUPPORT OF REQUEST FOR SUMMARY DISPOSITION OF DECREE
(Custody)
1. I, (your name) ____________________________________________________, am the
( check one) Plaintiff / Defendant in this case.
2. I live at (your street address) ________________________________________________
(city) ____________________________, (state) ____________, (zip) _____________.
3. I first moved to Clark County, Nevada on (date) __________________ which is more
than six weeks before I filed my Complaint/Counterclaim. I intend to live in Clark
County, Nevada for the foreseeable future.
4. I have read the ( check one) Complaint / Counterclaim filed in this case and can
testify that the allegations in that document are true and correct to the best of my
knowledge.
5. I request a final custody order from this court. The other parent and I have been separated
since (date of separation) ______________________.
© 2017 Family Law Self-Help Center Summary Disposition Affidavit (Custody)
2
6. Children. The other party and I have (number) ________ minor children together. The
provisions regarding custody, visitation, child support, and medical insurance outlined in
the proposed Decree are fair, are in the child(ren)’s best interest, and meets the
child(ren)’s financial needs.
7. Children’s Residence / Contact With Parents. For the last six months, the child(ren)
lived with ( check one) Me / The Other Parent / Both of Us / Someone
Else: (name) ___________________________
The child(ren) had the following contact with each parent in the last six months:
Me: (list how often you saw the children in the last six months)
__________________________________________________________________
__________________________________________________________________
Other Parent: (list how often the other parent saw the children in the last six months)
__________________________________________________________________
__________________________________________________________________
8. Other Parent’s Proposed Custody/Visitation. The final decree proposes the following
custody and visitation schedule for the other parent: (explain what contact the other
parent will have with the children if the decree is approved. If there will be no contact at
all or restricted/supervised contact, explain why)
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
9. I declare under penalty of perjury under the law of the State of Nevada that the foregoing
is true and correct.
DATED _____________________________, 20____.
Submitted By: (your signature)
(print your name)
/s/
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AFFT Self-Represented DISTRICT COURT CLARK COUNTY, NEVADA (Family Law Self Help Center)

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Completed 15 January 2021

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