Fillable ATTACHMENT FM-1025

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ATTACHMENT FM-1025

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ATTACHMENT FM-1025
FM-1025 REV 10/15/18
For Optional Use
DECLARATION FOR DEFAULT CUSTODY AND
VISITATION ORDERS
Family Law Local Rule 8B
Santa Clara County
Page 1 of 2
ATTORNEY OR PARTY WITHOUT AN ATTORNEY (Name and Address) TELEPHONE NO.:
FOR COURT USE ONLY
ATTORNEY FOR (Name):
SUPERIOR COURT OF CALIFORNIA, COUNTY OF SANTA CLARA
STREET ADDRESS:
201 North First Street, San José, CA 95113
MAILING ADDRESS:
191 North First Street
CITY AND STATE:
San José, California 95113
BRANCH NAME:
Family Justice Center
PLAINTIFF/PETITIONER:
DEFENDANT/RESPONDENT:
DECLARATION FOR DEFAULT CUSTODY AND
VISITATION ORDERS
CASE NUMBER:
Notice to the Respondent –
Please read both sides of this form
The other parent in your case (the “Petitioner”) has described
the custody and/or visitation order s/he is asking the Court to make in your case.
If you do not agree with the order you must take legal action.
If you do not take legal action, the Court may order what the Petitioner requested.
Talk with a private attorney or visit the Court’s Self-Service Center for more
Information about your legal rights and the legal process.
Petitioner – You should consider using this form, if:
You are asking for a default judgment in this case, and
You have children with the other parent in this case, and
You do not already have a custody and visitation court order that will be a part of your Judgment, and
You do not already have a Marital Settlement Agreement/Stipulated Judgment that will be a party of your
Judgment,
IMPORTANT: This form cannot help you ask for different custody and visitation orders than what you
asked for in your petition.
I, (your name) , am the Petitioner in this case.
1. Check one only:
I have attached form FL-311 to describe the custody and visitation schedule I want OR
Form FL-311 was attached to the petition I filed.
2. I am asking for the Custody Orders described on form FL-311 because:
ATTACHMENT FM-1025
FM-1025 REV 10/15/18
For Optional Use
DECLARATION FOR DEFAULT CUSTODY AND
VISITATION ORDERS
Family Law Local Rule 8B
Santa Clara County
Page 2 of 2
CASE NAME:
CASE NUMBER:
3. I am asking for the Visitation schedule described on form FL-311 because:
4. The child/ren has or have mainly lived with Mother Father Other:
During the last six months the other parent had the following contact with the child or children. Describe the
schedule, number of visits, length of visits:
I declare under penalty of perjury under the laws of the State of California that the foregoing is true and
correct.
Date: Petitioner’s Name:
Petitioner’s Signature:
Instructions for the Petitioner
1. Fill out this form completely.
2. Make two (2) copies.
3. File the original and copies with the Clerk’s Office at 201 North First Street, San José, CA 95113
4. Have someone else, NOT YOU, who is 18 years or older, personally deliver (“serve”) a copy of
this form to the other party. This must be done at least 15 calendar days before the Judgment is
submitted. The person who delivers (serves) this form must fill out a Proof of Service by Personal
Delivery (form FL-330).
5. You must file the Proof of Service by Personal Delivery form with the Court. Keep a file-stamped
copy for yourself.
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ATTACHMENT FM-1025

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Completed 27 June 2021

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