DECLARATION OF YOUR FULL NAME HERE IN CAPITALS

State of Your State 

County of Your County  

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(Your story goes below instead of the Sample text)

1. I, Firstname Lastname hereby state that on Month Day, Year, Ms. Case Worker of CPS came to my front door and told me "there had been a report". She said that she wanted to "help me get this cleared up".

2. I thought this OBVIOUSLY was a mistake and I felt I had nothing to hide, so I LET HER IN MY HOUSE and TALKED with her, being unaware of my Constitutional Rights (or in spite of my assertion of them). 

3. Ms. Case Worker immediately started walking though my house looking in my cupboards, pantry, the refrigerator, closets, bathroom, and every room in my house.

4. Ms. Case Worker left and returned a couple hours later with two policemen and snatched my child(ren) and said this was (whatever she accuses you of)

5. Detail what happened after that. 

6. Each new paragraph gets a new number

I declare under penalty of perjury that the foregoing is true and correct and that this Declaration was executed at Your Town, Your State.

Dated: The day, month, year you wrote it.

(You sign it here)
________________________________ 

Your Town, Your State
Your phone number

DO NOT forget to create the Certificate of Service! If you forget this, they will toss it out!
http://familyrightsassociation.com/bin/FORMS/certificate_of_service.htm

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