COURT OF COMMON PLEAS

DIVISION OF DOMESTIC RELATIONS

HAMILTON COUNTY, OHIO

Name:
Address
City, State Zip
-vs/and-
Name:
Address
City, State Zip

Enter:
Date:
Case No.
File No.
CSEA No.
Judge
Magistrate

Affidavit

Now comes and states the following:

(Your Signature)

Sworn to before me and subscribed in my presence this _____ day of _____________________________, 20 ____________.

________________________________________

Notary Public