Exhibit C(1) Significant Impairment Unsworn Declaration
Texas · TexasLawHelp.org
This form is a declaration used to explain potential harm to a child. It is not meant to be filed by itself and must be used with a Petition in Intervention to describe the harm.
The court describes it as: Do not file form on its own. It is an exhibit. Use with Petition in Intervention to describe potential harm to the child.
Where this fits in a case
HearingStage: Hearing
This form is used when someone needs to show the court that a child's physical health or emotional development could be significantly harmed if certain custody orders are put in place.
Either party may file.
Common questions
- What is this form for?
- This form is an exhibit used to describe potential harm to a child. It must be used with a Petition in Intervention.
- Can I file this form by itself?
- No, the form states that it should not be filed on its own.
Revision history
No changes recorded since we started tracking this form on October 9, 2026.
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