For Court Use Only Superior Court Of California, County Of Street Address: Mailing Address: City And Zip

Cal. Form FL-105

California Superior Local Rules

Person child lived with (name and complete current address) Person child lived with (name and complete current address) Person child lived with (name and complete current address) Person child lived with (name and complete current address) Person child lived with (name and complete current address) Person child lived with (name and complete current address) Person child lived with (name and complete current address) Person child lived with (name and complete current address) Additional children are listed on form FL-105(A)/GC-120(A). (Provide all requested information for additional children.) FL-105/GC-120 FOR COURT USE ONLY SUPERIOR COURT OF CALIFORNIA, COUNTY OF STREET ADDRESS: MAILING ADDRESS: CITY AND ZIP CODE: BRANCH NAME: CASE NUMBER: DECLARATION UNDER UNIFORM CHILD CUSTODY JURISDICTION AND ENFORCEMENT ACT (UCCJEA) 1.

I am a party to this proceeding to determine custody of a child. 2. My present address and the present address of each child residing with me is confidential under Family Code

section as I have indicated in item 3. 3. There are (specify number): (Insert the information requested below. The residence information must be given for the last FIVE years.) a. Child’s name Place of birth Date of birth Sex Period of residence Address Relationship Confidentialto present to to to b.

Child’s name Place of birth Date of birth Sex Residence information is the same as given above for child a. (If NOT the same, provide the information below.) Period of residence Address Relationship Confidentialto present to to to Additional residence information for a child listed in item a or b is continued on attachment 3c.c. Family Code, § 3400 et seq.; Form Adopted for Mandatory Use Judicial Council of California FL-105/GC-120 [Rev.

January 1, 2009] DECLARATION UNDER UNIFORM CHILD CUSTODY JURISDICTION AND ENFORCEMENT ACT (UCCJEA) Probate Code, §§ 1510(f), 1512 minor children who are subject to this proceeding, as follows: www.courtinfo.ca.gov TELEPHONE NO.: FAX NO. (Optional): E-MAIL ADDRESS (Optional): ATTORNEY FOR (Name): ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address): PETITIONER: RESPONDENT: GUARDIANSHIP OF (Name): Minor OTHER PARTY: Child's residence (City, State) Child's residence (City, State) Child's residence (City, State) d.

Child's residence (City, State) Child's residence (City, State) Child's residence (City, State) (This

section applies only to family law cases.) (This

section apples only to guardianship cases.) Confidential Confidential Juvenile Delinquency/ Juvenile Dependency and provide the following information): 5. One or more domestic violence restraining/protective orders are now in effect. (Attach a copy of the orders if you have one a. Criminal b. Family d. Other Court State Case number (if known) County Orders expire (date) Court (name, state, location) Court order or judgment (date) Case status b. Guardianship c. Other Name of each child a. Family Case number Court (name, state, location) e.

Adoption Juvenile Delinquency/ Juvenile Dependency Case Number Your connection to the case CASE NUMBER:SHORT TITLE: Do you have information about, or have you participated as a party or as a witness or in some other capacity in, another court case or custody or visitation proceeding, in California or elsewhere, concerning a child subject to this proceeding?

Yes (If yes, attach a copy of the orders (if you have one) and provide the following information): Do you know of any person who is not a party to this proceeding who has physical custody or claims to have custody of or visitation rights with any child in this case? (If yes, provide the following information):Yes a. Name and address of person b. Name and address of person c.

Name and address of person Has physical custody Has physical custodyHas physical custody Claims custody rightsClaims custody rightsClaims custody rights Claims visitation rights Claims visitation rights Claims visitation rights Name of each child Name of each child Name of each child I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Date: (TYPE OR PRINT NAME) (SIGNATURE OF DECLARANT) 7. Number of pages attached: NOTICE TO DECLARANT: You have a continuing duty to inform this court if you obtain any information about a custody FL-105/GC-120 [Rev.

January 1, 2009] Page of 2DECLARATION UNDER UNIFORM CHILD CUSTODY JURISDICTION AND ENFORCEMENT ACT (UCCJEA) 4. 6. No proceeding in a California court or any other court concerning a child subject to this proceeding. No FL-105/GC-120 Proceeding Proceeding c. d.

Document details

Collection	California Superior Local Rules
Citation	Cal. Form FL-105
Type	court_rule
Language	en
Format	pdf
Source	CA_LOCAL
Identifier	be9cffa52b9f5086a79a2160ad6448927f937e5c

Source file is stored in the law ingest library (pdf).