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Posted: Fri May 26, 2006 5:19 pm
by Dazeemay
This is an excellent site on how to write your dec of facts: ... bbrev=/WA/


Double-space everything from the first number, down to the end, and indent paragraphs by ten spaces.





Declaration of Facts

I, ______________________________, state:
(Your Name)

1. I am the mother/father of three children: (Names of kids.)

2. This declaration is being written (state reason for writing the declaration of facts - for example, "in support of a motion to return children to mother" or "in support of a national class action lawsuit" or "to let the public know about the injustice done to us in (name of county) Superior Court".

3. This is in reference to (Case Name, Case Number, Date Filed and the name of the court.)

4. (Just state facts one at a time... I'll give some examples.) On June 2, 2002 I let my children go to school as usual and while they were there a CPS employee interviewed them without letting me know first.

5. My children were detained by the CPS employee and I was not notified by the school so by 4:30 when they didn't come home from school I was worried about them and called the school to find out if they knew anything.

6. When I called the school nobody wanted to talk to me and they handed the phone to three different people and put me on hold for fifteen minutes.

7. When the principal got on the line he told me that CPS took my three kids because my son, Johnny, had a bruise on his arm and said I did it.

8. The bruise happened because he climbed the apple tree and then got scared and couldn't get down. I climbed up there and grabbed him and had to lower him down by his arm and that's how he got bruised.

9. By the time I got off the phone with the principal of the school, it was only a few minutes before five PM so I called CPS but only got a recording and nobody would answer. It was Friday and I couldn't get through to them all weekend and even went to the office twice but it was closed. That was why I didn't check on them for two days - not because I didn't care which is what the worker, Judy Jones, made it sound like in court on Wednesday.

10. I haven't seen my children in three weeks because they say I'm a danger to them. This is not true. In fact most of what they say about me is not true which is why I'm contesting the charges and asking for a full trial to make them try to prove their untrue statements.

11. The CPS employees I talk to on the phone are extremely rude to me. They are Judy Jones and her supervisor, Mr. Smith. Judy Jones said very sarcastically: "You should never have had kids if you were going to hurt them. People like you make me sick." This woman, Judy Jones, won't believe this happened in the apple tree.

12. I am requesting a court order for the return of my children immediately.

[NOTE: This last part should state the exact words used, just change the date and place to match your circumstance.]

Executed June 28, 2002 at Yreka, California.

I declare under penalty of perjury that the foregoing is true and correct to the best of my knowledge.

(Your Name)

Here is a very excellent example of doing your DEC of FACTS by Marina.



Posted: Fri May 26, 2006 5:22 pm
by Dazeemay
Sample form created by: Linda J. Martin,

There's no word-wrap in this document - you must copy and paste to put it into a word processing program... then the lines will be easier to read.

This is a SAMPLE of a DECLARATION (also called AFFIDAVIT) to be used in objecting to the exaggerations, misstatements and multiple errors often put into CPS court documents by CPS caseworkers. It can be adjusted to use to object to psychologist reports, in which case it would be called "Objections and Corrections to the Report of the Psychologist" (if there's more than one psychologist, go ahead and name him). Attach as much evidence as you can to prove your side of the case. Evidence could be letters from professionals or affidavits from friends/family, tape recordings, etc. - but be sure to label them clearly "Exhibit A", "Exhibit B", etc.


Everything in brackets [ ] will need to be deleted and/or replaced with your information.

Number each page at bottom center: "Page 2 of 5" for example.

Put a header on each page stating "Objections and Corrections to the Report of the Child Welfare Caseworker" and underline that plus leave a few spaces to separate the header from the body of the document.

--- document starts here ---

[Parent's Name]
[Street Address]
[City, State Zip Code]
[Phone #]

[Change this next part to match the header information for your court case. You should be able to get this information from other paperwork already filed in your case. Try to make the header match what they have already done.]

[Center the next four lines and type in all caps:]



) Clerk No.
JOHNNY DOE, JR (DOB 4-5-1992) ) 33933 (get numbers from YOUR paperwork)
JANIE DOE (DOB 2-3-1996) ) 33637
Persons alleged to come ) Detention Date: March 21, 2000
within the provision of ) Disposition Date: June 2, 2000
the Juvenile Court Law ) Review Date: December 15, 2001

To the Honorable INSERT JUDGE'S NAME HERE IN CAPS, Judge of the [Superior] Court of the State of [California], in and for the County of [Los Angeles]:

[Double space the rest of the text. Indent paragraphs ten spaces.]

The Honorable Court above-named is hereby advised that the REPORT OF THE CHILD WELFARE CASEWORKER herein, as prepared and typed is ERRONEOUS AND INCORRECT in the following particulars, to wit:

[Here's where you get to be creative. Go through your caseworker's court paperwork and find every error, no matter how trivial. Even trivial errors show how incompetent the person is. You will list each error separately with corrections as in the sample. This sample is derived from an actual case I worked on in 1991. The names, dates, and some details were changed. The case I worked on was dismissed after similar paperwork was given to the judge. Remember to double space everything below. -- Linda]
1. Page One: JOHNNY DOE is not 8 years old. He was 10 as of April 5, 2002.

2. Page One: Mother's name is ELIZABETH SMITH, not Doe. Address given by caseworker is incorrect.

3. Page Two: COUNT 1: "On or about March 21, 2000, minors were found to be dirty." Minors were out playing in the yard, climbing trees to get fruit, and doing what most kids do when playing outside, getting dirty. There was nothing abnormal about their being dirty.

4. Page Two: COUNT 2: The caseworker erroneously stated, "Mother has recurrent mental problems that periodically render her unable to care for children." Mother's mental problem was temporary due to stress from her husband's deportation, her father's death, and the detention of her children by CPS. The problem is not recurrent and does not "periodically render her unable to care for the children" as suggested by the caseworker.

5. Page Three: "November 15, 2000" court date given by the caseworker is incorrect. The correct date is November 12, 2000.

6. Page Three: The Doe children were not taken after the mother was admitted to Bellview Mental Hospital. A caseworker arrived to detain the children from their grandmother's house and then advised the mother to allow herself to be admitted to Bellview because she was grieving and upset.

7. Page Three: On March 21, 2000 when Janie and Johnny were detained from their grandmother's home they were not injured, neglected, or abused in any way.

8. Page Three: Problems with police officer on November 1, 1999 occurred when police arrived to arrest Mr. John Doe, Sr. for deportation and the mother was cuffed and beaten by the arresting officer. This arrest does not affect or reflect on the stability of her current home life with her new husband, Mr. Thomas Smith.

9. Page Three: Mother quit her job on June 20, 2001, not "shortly after her marriage" as stated by the caseworker. The job is no longer needed for support of the family as her new husband is earning enough to support them and is willing to do so. Mother is needed at home to care for the children.

10. Page Three: Date of marriage to Thomas Smith is incorrect. The correct date is November 29, 2000.

11. Page Three: "Mrs.", not "Ms." - The caseworker knows that Mrs. Smith is not separated from her husband, but throughout the report she implies that Mr. and Mrs. Smith are not together.

12. Page Three: While her husband was visiting family in Nevada, Mrs. Smith called Dr. Hoar only twice for advice during a two week period, not "frequently" as stated by the caseworker, and those calls were only about Johnny's behavior, not about both children.

13. Page Three: Mrs. Smith has not only "largely complied" with the Reunification Plan, she has completely complied with all aspects of the plan.

14. Page Three: Mrs. Smith never told Dr. Hoar that she "couldn't handle Johnny anymore and wanted to give him up," as stated by the caseworker. What actually happened is that Dr. Hoar tried to talk Mrs. Smith into giving him up and putting him in a mental hospital. Mrs. Smith did not want to do that. During the session Mrs. Smith did not state that she had been upset.

15. Page Four: Janie does not have "sporadic behavior problems" in her home or at school as suggested by the caseworker. At home the mother has never seen indications of such problems and has received no such reports from Headstart. Attached please find "Exhibit A" - a letter from Headstart stating they have not observed or complained of any "sporadic behavior problems" from Janie.

16. Page Four: Johnny's behavior problems are only occasional and not a "continuous problem" as stated by the caseworker in her report. Attached please find "Exhibit B" - an evaluation of Johnny's behavior by Dr. Goodman in San Francisco, dated November 3, 2001.

17. Page Four: The improvement in Mrs. Smith's parenting has been going on for years, not just for the last few months. Attached please find "Exhibit C" and "Exhibit D" - certificates of completion provided by parenting class instructors in January 1997 and November 2000.

18. Page Four: There has been no "substantial, recent regression" due to a separation from Mr. Smith. Mr. and Mrs. Smith are still living together; he simply took a two week vacation to Nevada to visit his sick mother. Therefore this should not be used as a basis for the caseworker's request for another six months of services at taxpayers' expense.

19. Page Four: Dr. Hoar wants the case prolonged for another six months because once the case is dismissed the mother will find a different therapist, and Dr. Hoar will no longer be receiving CPS money for seeing her and her children. Therefore, Dr. Hoar's report should not be considered by the court. Mrs. Smith intends to find another therapist for the children when the case is dismissed as the children do not like seeing Dr. Hoar as therapist, and are even afraid to tell this to him. Under these circumstances, it is unlikely the children will progress adequately in therapy. For these reasons, Mrs. Smith's request to have Dr. Hoar removed from the case can hardly be called "an indication of poor judgement" as stated by the caseworker. She did so solely for the benefit of the children and with concerned regard for their psychological functioning.

20. Page Four: Recommendation that the minors be readjudged dependents of the Juvenile Court is inappropriate as the family has been functioning well during the last six months that they have been together. The case should be closed at this time.

21. Pages Four and Five: Recommendations 2, 4, and 5 are also inappropriate as the case should be closed.

22. Pages Six and Seven: Service Plan for mother and caseworker is inappropriate as the case should be closed.

Executed 10 December 2001 at Los Angeles, California.
I declare under penalty of perjury that the foregoing is true and correct to the best of my knowledge.

Elizabeth Smith

Posted: Sat May 27, 2006 9:22 pm
by Dazeemay

Forms for Documentation
Requests for Information
Petitions & Complaints
Answers & Affidavits
Appeals & Writs

Forms for Documentation

Sample Follow-up Documentation Letter to use after all verbal conversation, telephone calls, meetings and visitations
Preservation of Parental Rights letter to send to social worker
Preservation of Parental Rights letter to send to medical provider
Preservation of Parental Rights letter to send to teacher
Hatch Amendment Letter to send to school

Requests for Information

Requests for records or information under the Privacy Act of 1974
Requests for records or information under the Freedom of Information Act
Request form for using both the FOIA and PA

Petitions & Complaints

Petition for Restraining Order (to prevent removal of child to foster home outside vicinity of parent)
Petition for Leave to Appeal Order Committing Minor to Training School as a Delinquent

Answers & Affidavits

Answer to Petition
Answer with Affirmative Defenses


Motion General
Motion for More Frequent and Meaningful Visitation
Motion to Show Cause for Contempt (violating court orders)
Motion to Reconsider a Previous Order
Motion to Clarify an Order
Motion to Compel General
Motion to Compel Production (of records or manual)
Motion to Vacate - Change of Conditions
Motion to Proceed in Forma Pauperis (on appeal)
Informal Request for Discovery (use this one first)
Motion to Compel Discovery (then this one)
Notice of Motion to Dismiss Sham Proceedings (Based on False Allegations)
Notice of Motion to Dismiss for Failure to State a Cause of Action
Motion to Disqualify Judge Due to Bias or Prejudice
Opposition to a Motion (filed by another party)
Notice of Motion to Intervene
Motion to Intervene

Appeals & Writs

Notice of Appeal
Appellant's Brief
Motion to Proceed in Forma Pauperis
Request for Transcripts
Writ of Habeas Corpus
Writ of Mandamus
Writ of Prohibition
Writ of Certiorari


Certificate of Service
Notice of Hearing


NOTE: If you need a specific form and don't see it here, you may request it through our legal research form. (This only applies to forms pertaining to CPS matters and not divorce related matters.)
Legal Forms
Legal Research
Can I Sue?
Federal Law
State Law
Administrative Law


Contact Us

Examples of Declaration of Facts

Posted: Sun Jun 18, 2006 4:06 pm
by Marina
For examples of Declaration of Facts, see research thread in this section.


Posted: Wed Apr 28, 2010 3:49 pm
by Dazeemay
Marina, I found this on Research Resources and I felt it should come on this thread. It is more examples you gave of Dec of Facts etc.

Declaration of Facts - Examples
by Marina » Sun Oct 22, 2006 2:00 pm

Declaration of Facts - Examples ... risch1.htm

removal of 9 children from their parents due to a cut on a child's face, a one time situation which was described both by the child and the mother as an accident;

removal of children directly from school with no chance to say goodbye to parent, to get a reasonable explanation of the trauma of not being allowed to return home after school;

when the children failed to return home after school, the mother went to school to find out what happened, and was told her children were victims of child abuse and were being taken directly to foster homes;

the mother was taken by police with no attorney present, no records of the interrogation and pressured to admit that she had abused a child;

when she failed to come to work because she was in jail, she was fired;

the mother was put in jail for four days…although the children were already removed from her care;

the family secured an attorney and took their life savings (several hundred dollars) to pay a retainer;

there were numerous times when no interpreter was provided and in some cases, the interpreters may not have been familiar with court terminology and practice;

they had no funds to pay for a trial, so faced with the possibility of losing all their children in a trial, they chose to plea bargain to a lesser charge and their children were ordered to be retained in foster care. Having plea bargained, she never had a chance to deny that she had done anything to harm her children;

the family had some income supplements through food stamps and energy assistance, so when their children were removed, they became impoverished because the income supplements are based on the number of people in the family - they went from 11 to 2.
They couldn't move to a smaller house because they hoped to get their children back and would need the house.

while the probation worker was telling the family "don't yell at your children", the social workers were saying "you have to raise your voice at your children, otherwise they won't behave." You can imagine how difficult these rules were to this family.

in order to see their children, they had to travel to have supervised visitation with their children in various towns and locations; they had to meet with probation officers, social workers, lawyers. They were exhausted and anguished by what they had to do to get their family back together.

the mass production system of protective service meant that there were intake workers, then social workers, also case workers, family paraprofessionals, but none of them helped the family with tangible resources, claiming they had to go to other workers in other departments. Whenever there seemed to be a need, the social workers told them to see some other social worker or program. In one or two instances, they reapplied but were turned down…because their new family size did not qualify them. Some resources were promised, but never delivered.

In desperation to have enough income to get their children back, the mother went to work - nights - in Ripon. The social workers' response was; that's up to her if she wants to go back to work. There was no comprehensive plan to see if all the children were at home, would they requalify for benefits so that they could manage financially without her working. Considerable time was spent by the social workers to try to get the parents to ask family members to care for the children. I don't think the social workers ever considered that probably the incident that started this whole agony was because she was working to try to make enough money to provide additional money for the family.

Because of the confusion of what one social worker was doing and what others were doing, I asked the social workers if the parents could request a copy of their social service records. I was told emphatically that those records were not accessible to the parents. I, however, called the supervisor and was told of course the family members could have access to their own and their childrens' records.Marina

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Edit postDelete postReport this postInformationReply with quote Non-CPS Statement, but helps you visualize what to write
by Marina » Sun Oct 22, 2006 2:11 pm

Statement of Facts -- REALLY bad hair day

This is not a CPS case, but helps you visualize how to explain what happened.

Title: Texas Police Brutality

There is "previous article" and "next article" that explains more of the situation.Marina

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Edit postDelete postReport this postInformationReply with quote Statement of Fact -- Texas, Bruce Perkins
by Marina » Sun Oct 22, 2006 2:22 pm

Statement of Fact -- Texas, Bruce Perkins

Accused of sexual abuse, serving time, based on repressed memory syndrome.

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Edit postDelete postReport this postInformationReply with quote Truth Affadavit- Utah- Amanda Marie Simons
by Marina » Sun Oct 22, 2006 2:24 pm

Truth Affadavit- Utah- Amanda Marie Simons

"Now that I have established the facts from which to present my case I will proceed to do so.

FACT 21 - On September 8, 2004, I took my youngest daughter, Savannah, to Primary Children's hospital as a result of an emergency situation.

FACT 22 - I was told by The Division of Child and Family Services staff at Primary Children's Hospital that they considered the situation to be an accident and no action was contemplated by The Division of Child and Family Services. The doctors even suggested that her problem may be sleepwalking, which is something we had never considered because we had not confronted sleepwalking before. After our own investigation among other family members we find that many of the aunts, uncles, and cousins were prone to sleepwalking, sometimes even into their later lives.

FACT 23 - On the very next day, September 9, 2004, I was presented with a summons from the State of Utah concerning both of my children. This was in spite of what I was told the day before, and in spite of the fact that my older daughter was in not danger, and never had been. On its face, the summons was a threat against me while the State was holding my children hostage."Marina

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Edit postDelete postReport this postInformationReply with quote Statement of Facts- Maryland- Sandra Ann Craig
by Marina » Sun Oct 22, 2006 2:28 pm

Statement of Facts- Maryland- Sandra Ann Craig

"Statement of Facts

On an indictment returned by the Howard County Grand Jury which alleged no facts, and after a 14-day trial involving 29 State's witnesses and 43 defense witnesses, Mrs. Craig was convicted of child abuse, assault and related charges and received a 10-year sentence based essentially on testimony by Brooke Etze, almost seven..."Marina

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Edit postDelete postReport this postInformationReply with quote Statement of Facts- Texas- Case of Katie W.
by Marina » Sun Oct 22, 2006 2:38 pm

Statement of Facts- Texas- Case of Katie W.


This statement of facts is supported by the Affidavits of Edward David Wernecke and Michele Wernecke, found in the Appendix at Tabs 5(1) and 5(2). More-detailed facts are contained in those affidavits; the following is a brief summary of the facts germane to the mandamus.

In late 2004, Katie Wernecke, then a 12-year-old girl, became sick. On January 7, 2005, Katie was admitted to Driscoll hospital in Corpus Christi, Texas to determine what was wrong with her. A biopsy was performed, and by January 13, 2005, the doctors diagnosed Katie as having Hodgkin’s Disease.
Beginning on January 15, 2005, at the instance of her parents, Edward and Michele Wernecke, Katie began multiple rounds of chemotherapy for treatment of the cancer. Numerous CT and PET scans were also performed on Katie over the course of the next several months..."

Heartwrenching, read it all.Marina

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Edit postDelete postReport this postInformationReply with quote Affidavit - Ralph C. Underwager, Ph.D. Licensed Psychologist
by Marina » Sun Oct 22, 2006 2:50 pm

Affidavit of Ralph C. Underwager, Ph.D. Licensed Psychologist ... guilt.html

II treatment program requires an admission of guilt

III no scientific data supporting

III no justification for requiring such an admission

IV violation of the Fifth Amendment rights

V right to refuse treatment

VI unethical behaviors
Fifth and Eighth AmmendmentsMarina

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Edit postDelete postReport this postInformationReply with quote Example of Facts from federal complaint on domestic violence
by Marina » Thu Nov 02, 2006 2:56 pm

Example of Facts from federal complaint on domestic violence

This is an important federal class action complaint where women victims of violence had their children taken, and which resulted in a favorable ruling.

Notice that the first part of section V gives the State Statutory framework,

while the second part of V gives the Facts.


57. In January, 1999, plaintiff was living together with her children, the infant plaintiffs herein.

58. On January 27, 1999, Claude Barnett came to plaintiff's home and assaulted plaintiff, causing severe injuries.

59. Throughout said assault, infant plaintiff Destinee was asleep in another room, and infant plaintiff Kendell was at school.

60. Claude Barnett, the father of infant plaintiff Destinee, had separated from plaintiff prior to the birth of Destinee, and moved to another state.

61. Prior to January 27, 1999, Claude Barnett had never behaved violently toward plaintiff.

62. Claude Barnett has never behaved violently toward infant plaintiffs.

63. Immediately after assaulting plaintiff on January 27, 1999, Claude Barnett fled. Plaintiff called the police and Emergency Medical Services immediately.

64. Two police officers arrived shortly thereafter, followed by an Emergency Medical Service team.

65. The police officers interviewed plaintiff about the assault. They saw that plaintiff was bleeding profusely from a head wound, and that there was blood all over her apartment. They also saw that Destinee was asleep and that Kendell was not at home.

66. When the Emergency Medical Service team arrived, they wrapped bandages around plaintiff's head, put a collar around her neck to immobilize it, and strapped her onto a stretcher.

67. Plaintiff arranged for her neighbor to care for Destinee and to pick up Kendell from school, and was then taken to the hospital by ambulance.

68. Two other police officers came to the hospital and interviewed the plaintiff in the emergency room. The police asked plaintiff for the names of her relatives.

69. Plaintiff cooperated fully and explained that Claude Barnett had attacked her while Destinee was asleep and Kendell was at school.

70. Sometime during the evening of January 27, 1999, defendants Stropoli and Martin burst into the apartment of plaintiff's neighbor, with their guns drawn.

71. Defendants Stropoli and Martin searched the apartment, awakened Kendell and Destinee, and then announced that they were taking Kendell and Destinee away from the neighbor.

72. Defendants Stropoli and Martin brought Kendell and Destiny to the precinct house.

73. Upon information and belief, defendant Irizarry reported to the State Central Register of Child Abuse and Maltreatment (the child abuse hotline) that plaintiff had mistreated her children by engaging in domestic violence in their presence.

74. Said report was false, and defendant Irizarry knew or should have known that it was false.

75. Upon information and belief, said report was transmitted electronically to ACS, where the case was assigned to defendant Halstion for investigation.

76. Upon information and belief, while Kendell and Destinee were at the precinct house, plaintiff's cousin came to the precinct house and sought to take Kendell and Destinee to her home.

77. Upon information and belief, defendant Halstion instructed defendants Irizarry, Roe, and Doe not to release Kendell and Destinee to plaintiff's cousin, but rather to transport Kendell and Destinee to Halstion's office at ACS.

78. Upon information and belief, defendant Lopez transported Kendell and Destinee to ACS, and left Kendell and Destinee with defendant Halstion.

79. Upon information and belief, defendant Halstion placed Kendell and Destinee in a foster home.

80. On January 28, 1999, defendant Halstion telephoned plaintiff and told her that the City of New York had taken custody of her children. Defendant Halstion refused to tell plaintiff where her children were staying and refused to permit plaintiff to speak to Kendell and Destinee.

81. Upon information and belief, on or about January 28, 1999, agents of defendant Scoppetta transferred plaintiffs' case to defendant Clark for investigation.

82. Upon information and belief, defendant Scoppetta assigned defendants Degannes and Victorin to supervise defendant Clark. Upon information and belief, defendant Scoppetta assigned defendant Williams to supervise defendants Degannes and Victorin.

83. Upon information and belief, on February 2, 1999, defendant Clark, acting with the consent and pursuant to the directives of defendants Williams, Victorin, and Degannes, commenced child protective proceedings against plaintiff in the Family Court of the State of New York, Kings County.

84. Said defendants alleged that plaintiff had neglected both of her children by engaging in acts of domestic violence in front of infant plaintiff, Destinee and that the January 27 incident was only one of several such acts. Defendant also swore that Claude Barnett hit infant plaintiff Kendell on the mouth. Said allegations were false and defendants Clark, Victorin, Degannes, and Williams knew or should have known that the allegations were false.

85. Upon information and belief, on February 2, 1999, defendant Clark, acting with the consent and pursuant to the directives of defendants Williams, Degannes, and Victorin, obtained an order from the Brooklyn Family Court, ex parte, permitting defendants City and Scoppetta to retain custody of infant plaintiffs Kendell and Destinee.

86. Defendants detained Kendell and Destinee until February 18, 1999, when defendants finally released the infant plaintiffs to plaintiff. Plaintiff never consented to the detention of the infant plaintiffs.

87. During the three weeks that Kendell and Destinee were in defendants' custody, defendants failed to send Kendell to school.

88. After releasing the infant plaintiffs to plaintiff, defendants continued the Family Court proceedings against plaintiff for six more months, during which time plaintiff was required to appear in court on many occasions.

89. Upon information and belief, on March 15, 1999, defendant Clark, acting through the attorney for ACS and with the consent and pursuant to directives of defendants Williams, Victorin and Degannes, obtained a warrant from the family court for plaintiff's arrest.

90. Defendant Clark procured the warrant by providing false and misleading information to the Family Court.

91. Defendant Clark knew or should have known that her representations were false.

92. Agents of defendant Safir arrested plaintiff on April 7, 1999, pursuant to said warrant.

93. Plaintiff was held in custody for most of the day, and was finally released in the late afternoon or early evening.

94. Finally, on August 5, 1999, defendants Scoppetta, Williams, Clark, Victorin, and Degannes withdrew all charges against plaintiff.

95. Upon information and belief, defendants Scoppetta, Williams, Clark, Victorin, and Degannes, despite withdrawing all charges against plaintiff, made an administrative determination that plaintiff had neglected her children.

96. Upon information and belief, defendants Williams, Clark, and Degannes notified agents of defendant Johnson that plaintiff was a neglectful mother.

97. Agents of defendant Johnson accordingly placed plaintiff's name on their list of abusive and neglectful parents in the State Central Register of Child Abuse and Maltreatment.

98. Defendant Johnson and his agents will disseminate the information that plaintiff's name is on the List of abusive parents to any prospective employers in any field that involves working with children.

99. Plaintiff will be unable to obtain employment in any field that involves working with children as long as her name is on the List.

100. Plaintiff is entitled to an administrative hearing to clear her name.

101. Plaintiff requested such a hearing more than a year ago, and defendant Johnson still has not scheduled such a hearing.

102. Within ninety days after the claim herein sued upon arose, plaintiffs caused a notice of claim in writing to be served upon defendant City. Said claim has not been paid, and more than thirty days has elapsed since the service of the notice.Marina

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Edit postDelete postReport this postInformationReply with quote by Marina » Sun Nov 12, 2006 12:08 pm ... olumeID=52

(Plain Language in writing Legal Affadavits)

Writing to the Trial Judge

by Wayne Schiess

• Write a brief synopsis of the main point of the affidavit and identify the affiant.

• Keep the synopsis to 40 or 50 words.

• Put the synopsis up front, indented, and in boldface type.

A bold synopsis for the original affidavit might look like this:

This affidavit, by Kenneth Ivey’s supervisor Dennis Ragley, explains that Ivey was demoted because he missed his shift—after his cat had died—and because he did not find someone to cover his shift. Ivey was not demoted because he is a male.

This bold synopsis tells the reader, in a brief and forceful way, the critical point of the affidavit, right up front. Beginning affidavits this way benefits both the writer and the reader.

The writer benefits because creating the bold synopsis makes you think hard about what you’re asserting in the affidavit. The bold synopsis helps you to focus your writing on the critical point. It makes you articulate your point, succinctly.

Readers benefit because the bold synopsis allows them to quickly grasp the point of the affidavit even if they do not have time to read the whole thing. But for readers, the bold synopsis is more than just a time-saver. When readers scan the bold synopsis before reading the main text, it becomes easier to follow the story in the affidavit; the story makes sense the first time through. Plus, when the ending is spelled out up front, readers tend to fit the story to the ending—and that’s persuasion.


Use headings to ease the reader’s way

To make affidavits more readable, easier to follow, and more inviting to the eye, use headings.

• Put headings in boldface type so they stand out.

• Use some topic headings (one or two words each).

• Use some phrasal headings—cogent phrases that preview the factual assertions.
Headings in affidavits can be very effective. They cue the reader about content and organization. They break up long blocks of text. They make documents easier to skim.


In this revised affidavit, the reader gets

a bold-synopsis summary right up front,

highlighted headings to guide her through the story,

and a clutter-free document that is easy to read and understand.

This is an affidavit a judge can use.Marina

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Edit postDelete postReport this postInformationReply with quote by Marina » Wed Dec 13, 2006 11:40 am

Public Statements by Jack and Casey He and Their Supporters Regarding the Honorable Judge Robert Childers’ Ruling on Termination of Parental Rights ... ments.html


Posted: Sat Jun 04, 2011 2:51 pm
by dani89
thank you guys so much for these samples. i've been having so much trouble trying to type up an affidavit. if anyone is able to help me out furrther feel free to conact me.


Posted: Tue Jun 12, 2012 8:35 pm
by hearthurts
So this would be , not the right way to start this form right ?

thanks for examples , I will revamp the form !
Kevin ********
Shasta *** ,Ca. 96019
(530) 27*****

1500 Court St, Redding, California 96001-1685