Form 10-504. Affidavit for ex parte custody order.

[For use with Rule 10-311 NMRA.] STATE OF NEW MEXICO COUNTY OF _______________ __________________ JUDICIAL DISTRICT IN THE CHILDREN’S COURT STATE OF NEW MEXICO ex rel. CHILDREN, YOUTH AND FAMILIES DEPARTMENT No. __________ In the Matter of _______________________________, (a) Child(ren), and Concerning _______________________________, Respondent(s). PARTE CUSTODY ORDER STATE OF NEW MEXICO ) ) ss. COUNTY OF ) I, ____________________, being duly sworn, under oath, state as follows: (1) This affidavit pertains to the child(ren) listed below: Child(ren) ________________________________ ________________________________ Date of Birth ________________________________ ________________________________ (2) I state the following facts to establish probable cause to believe _______________ (name(s) of child(ren)) has/have been [abused] [and] [neglected], that custody under the criteria set forth in Section 32A-4-18 NMSA 1978 is necessary, and that it would be contrary to the welfare of the child(ren) to remain in the home:1 ________________________________. (List facts supporting probable cause for each child) (3) I state that the Children, Youth and Families Department (CYFD) has made the following reasonable efforts to prevent the removal of the child(ren) from the home:2 ________________________________. (List the efforts made) (4) I state upon oath or affirm that the statements in this affidavit are true and correct to the best of my knowledge, information, and belief. ________________________________ Signature of CYFD representative SUBSCRIBED AND SWORN TO before me in the above county of the State of New Mexico this ______ day of ___________ (month), _______ (year). ________________________________ Notary Public My commission expires: ____________________