On June 16, 2021 a
Party Statement
was filed
involving a dispute between
Ireland, Krysten,
and
Moro, Brandon,
for Paternity Managed
in the District Court of Berkshire County.
Preview
AFFIDAVIT DISCLOSING CARE [TRIAL COURT OF MASSACHUSETTS DOCKET NUMBER
OR CUSTODY PROCEEDINGS Krysten Brandon
Pursuant to Trial Court Rule IV _ Name of Case Ireland v. Moro AWOL aS
BMC District Court Juvenile Court Prob & Family Court Superior Court
Berkshire
Division Division _ | _ | Division Division Division
Section |, Krysten Irel and- ‘ hereby declare, to the best of my knowledge, information, and
1 belief that all the information on this form is true and complete:
Section | The name(s) of the child(ren) whose care or custody is at issue in this case are:
2 A. UTorhwefl, Ryder B. c,
(LAST, FIRST) (LAST, FIRST) (LAST, FIRST)
Use only the letter appearing in front of the child's name above when referring to that child when completing the remaining sections.
Section | The party filing this affidavit may request certain addresses to be kept confidential if the address is a shelter for battered
3 persons and their dependent child(ren), or the party filing this affidavit believes that he/she or the child(ren) are in
danger of physical or emotional abuse, or the party is filing an action under G.L.c. 209A. If you believe that this C
provision applies to you, check box at right, complete sections 10 and 11 on the reverse side of this page
and DO NOT complete sections 4 and 5 below.
Section | The address(es) of the above-named child(ren) whose care and custody is at issue in this case is/are:
4
Address(es): Address(es} During the Last 2 Years, if Different
CHILD A997 Acorn St., Pittsfield,MA01201
CHILD B.
CHILD C.
Section
5 My addressis: 97 Acorn St., Pittsfield, MA 01201
Section | (] havedX] have not participated in and | [1] knowsf3f do not know of other care or custody proceedings involving the above-named
6 child(ren) in Massachusetts or in any other state or country.
Certified copies of any pleadings or determinations in a care or custody proceeding outside of Massachusetts listed in sections 7 and 8
must be filed with this affidavit unless already filed with this court or an extension for filing these documents has been granted by this court.
Section | The following is a list of all pending or concluded proceedings | have participated in or know of involving the care or custody of
7
the above-named child(ren): [Wilitness [Party
Letter of Child Court Docket No. Status. [O]ther [NJone
CHILD N/A U1
CHILD T]
CHILD ]
Section | The names and addresses of parties to care or custody proceedings involving any of the above-named child(ren) or those
8 claiming a legal right to this these child(ren) during the last two years (not including myself} are:
Letter of Child Name of Party/Claimant Current (or last known) Address of Party/Claimant
CHILDSA BRandon Moro 45 Lois St., Lee, MA 01238
CHILD
CHILD
Section If the box at the right is checked, this affidavit discloses the adoption of one or more of the above-named Ol
9 child(ren} and | am requesting the court to impound this affidavit. See instructions.
This affidavit must be personaily signed by the party listed in section 1 above, unless he/she is under 18 years of age or has been adjudged
incompetent, in which case the attorney of record must sign. A revised affidavit must be filed with the court if new information is discovered
subsequent to this filing.
Ade 15th day of June ,287121 under the penalties of perjury.
5 Vr bawet— Krysten Ireland x
LX —
Siping Pr ran Ge ATTORNEY OF RECORD FOR SWENLETNGONPETENT PRINTED NAME OF PERSON SIGNING hn
wo
97 Acorn St., Pittsfield, MA 01201
ADDRESS OF ATTORNEY OF RECORD FOR INCOMPETENT/JUVENILE
THE PARTY FILING THIS AFFIDAVIT MUST FURNISH A COPY OF IT TO ALL OTHER PARTIES TO THIS ACTION.
OCAI-4 TRE IV (07/95) TurboLaw (800) 518-8726 cgi.
3
voz 9 HNAE
Document Filed Date
June 16, 2021
Case Filing Date
June 16, 2021
Category
Paternity Managed
For full print and download access, please subscribe at https://www.trellis.law/.