COURT OF COMMON PLEAS

DIVISION OF DOMESTIC RELATIONS

HAMILTON COUNTY, OHIO

PRIVATE CUSTODY EVALUATOR ANNUAL COMPLIANCE STATEMENT

Name:

Date:

Attached to this statement is the following:

Updated resume with current contact information;

Proof of malpractice insurance;

Proof of attendance of at least six (6) hours of continuing education during the last year provided by the Supreme Court of Ohio or other provider that has received prior approval of the Supreme Court of Ohio and comprised of approved continuing education topics detailed in the Supreme Court of Ohio’s Custody Evaluator Training Guidelines.

By signature below, I certify that all the above information provided is accurate and I am unaware of any circumstances that would disqualify me from serving as a private custody evaluator.

Signature
Date