GESTATIONAL SURROGACY COVER SHEET Form Approved for Mandatory Use L-2324 Rev. 12.11.25 Cal. Fam. Code § 7962 A. CONFIRMATION OF JURISDICTION Pursuant to Family Code

section 7620, if a child is conceived pursuant to an assisted reproduction agreement for gestational carriers, as defined in

Section and as described in

Section 7962, this court shall have jurisdiction over a proceeding to determine parentage of the child if any of the following conditions are satisfied: (Please check all that apply): ☐ A person entered into an assisted reproduction agreement for gestational carriers in this state with respect to a child who may have been conceived as a result of that assisted reproduction agreement (i.e., written gestational carriers agreement was entered into in this state). Fam. Code § 7620(a). ☐ Petitioner(

s) reside(

s) in this state or resided in this state at the time the assisted reproduction agreement for gestational carriers was executed. Fam. Code § 7620(b)(1). ☐ Respondent(

s) reside(

s) in this state or resided in this state at the time the assisted reproduction agreement for gestational carriers was executed. Fam. Code § 7620(b)(1). ☐ The medical procedures leading to conception, including in vitro fertilization or embryo transfer, or both, were carried out in this state. Fam. Code § 7620(b)(2). ☐ The child is/children are born in this state. Fam. Code § 7620(b)(3).

ATTORNEY OR PARTY WITHOUT ATTORNEY STATE BAR NUMBER: NAME: FIRM NAME: STREET ADDRESS: CITY: STATE: ZIP CODE: TELEPHONE NO.: EMAIL ADDRESS: ATTORNEY FOR (name): SUPERIOR COURT OF CALIFORNIA, COUNTY OF ORANGE Lamoreaux Justice Center: 341 The City Drive, Orange, CA 92868-3205 CASE NAME: GESTATIONAL SURROGACY COVER SHEET CASE NUMBER: B. CONFIRMATION OF VENUE Venue is proper before the Orange County Superior Court pursuant to the following sections of the Family Code because Orange County is the county where: (Please check all that apply): ☐ The child resides or is found. Fam.

Code § 7620(c)(1). ☐ The child is anticipated to be born. Fam. Code §§ 7620(c)(5) and 7962(e). ☐ The intended parent(

s) reside. Fam. Code §§ 7620(c)(5) and 7962(e). ☐ The assisted reproduction agreement for gestational carriers was executed. Fam. Code §§ 7620(c)(5) and 7962(e). ☐ The medical procedures pursuant to the assisted reproduction agreement for gestational carriers are to be performed. Fam. Code §§ 7620(c)(5) and 7962(e). C. CONFIRMATION OF COMPLIANCE WITH FAMILY CODE § 7962 (Please check all that apply): The parties signed the written assisted reproduction agreement for gestational carriers on . Fam. Code § 7962(a)(1). The assisted reproduction agreement for gestational carriers identifies the intended parent(s). Fam.

Code § 7962(a)(3). ☐ ☐ CASE NAME: CASE NUMBER: Form Approved for Mandatory Use L-2324 GESTATIONAL SURROGACY COVER SHEET Rev. 12.11.25 Cal. Fam. Code § 7962 I declare under penalty of perjury of the law of the State of California that the foregoing is true and correct. Signed: Date:___________________ ☐ The assisted reproduction agreement for gestational carriers discloses how the intended parents will cover the medical expenses of the gestational carriers and of the newborn or newborns. Fam.

Code § 7962(a)(4). ☐ Before signing the assisted reproduction agreement for gestational carriers, the parties to the agreement were represented by separate independent licensed attorneys of their choosing. Fam. Code § 7962(b). ☐ The assisted reproduction agreement for gestational carriers was signed in the presence of a notary or witnesses by the equivalent method of affirmation in the jurisdiction where the assisted reproduction agreement for gestational carriers executed . Fam.

Code § 7962(c). ☐ The parties to the assisted reproduction agreement for gestational carriers did not undergo an embryo transfer or commence injectable medication in preparation for an embryo transfer until after the agreement was fully executed as required by Family Code sections 7962(

b) and 7962(c). Fam. Code § 7962(d). ☐ A copy of the assisted reproduction agreement for gestational carriers has been lodged with this court. Fam. Code § 7962(e). ☐ The parties have attested, under penalty of perjury and to the best of their knowledge and belief, as to their compliance with Family Code

section in entering into the assisted reproduction agreement for gestational carriers. Fam. Code § 7962(e). D. MISCELLANEOUS What is the date the embryo(

s) were implanted into the intended surrogate? Month: _________ Day: _______ Year: _______ Have the parties previously filed for a surrogacy judgment related to this same surrogacy in another county? ☐ Yes ☐ No If yes, in what county? ________________________ What was the date of filing? ___________________ How many prior surrogacy judgments has either of the intended parents ever obtained? Has/have the Petitioner(

s) completed a criminal background check and submitted the same to the court? ☐ Yes ☐ No Is any party requesting a hearing? ☐ Yes ☐ No Are there any scheduling requests or issues of which the Court should be made aware? If so, what are they? ____________________________________ ____________________________________ ____________________________________ ____________________________________