FH-FM-CHILK-112TexasFillable

Exhibit C(1) Significant Impairment Unsworn Declaration

TexasLawHelp.org (Texas Supreme Court–approved and legal-aid forms) · Family Law

Verified current as of October 27, 2026

Unsworn declaration attached to a Texas petition in intervention stating that keeping the child with the parents would significantly impair the child's health or development.

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