STATE OF SOUTH CAROLINA	)	IN THE FAMILY COURT
)	JUDICIAL CIRCUIT
COUNTY OF	)
)
)	APPLICATION AND AFFIDAVIT:
Petitioner,	)	REGISTRATION OF OUT-OF-STATE
)	CHILD CUSTODY ORDER
vs.	)
)	S.C. Code of Laws Ann. § 63-15-358(A)
)
Respondent.	)	Docket No.

This application must include two copies, with at least one copy being certified, of the child custody order sought to be registered.

I, (full name), request the County Family Court to register and confirm the attached child custody determination. My mailing address for purposes of service and notice is . (If your address is changed, you are responsible for notifying the court).

The name(s) and address(es) of any parent or person(s) acting as a parent who were awarded custody or visitation in the child custody determination sought to be registered are: .

I, (full name), do hereby swear and affirm under penalty of perjury that to the best of my knowledge and belief the attached order which I am seeking to register is in effect and has not been modified.

Sworn to before me this

______ day of _______________, 20___

_________________________________	______________________________________

Notary Public of South Carolina	Petitioner

My Commission expires: ____________

Name of Custodial Parent (if applicable):

SCCA 458A (1/2011)

STATE OF SOUTH CAROLINA

Carolyn W Yon

2011-01-28

drosengrant

SCJD