The children are
3. The court has jurisdiction over the respondent because the respondent
The action is brought in this county because (you must check one or more to file in this county):
Petitioner claims (check all that apply):
1.
PETITION TO ESTABLISH PARENTAL RELATIONSHIP
(Uniform Parentage)
Form Approved for Optional Use
Judicial Council of California
FL-200 [Rev. January 1, 2003]
6.
5.
4.
2.
FOR COURT USE ONLY
SUPERIOR COURT OF CALIFORNIA, COUNTY OF
CITY AND ZIP CODE:
BRANCH NAME:
PETITIONER:
RESPONDENT:
CASE NUMBER:
STREET ADDRESS:
MAILING ADDRESS:
ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, state bar number, and address):
FL-200
PETITION TO ESTABLISH PARENTAL RELATIONSHIP
a.
b.
c.
respondent is the child's mother.
respondent is the child's father.
parentage has been established by Voluntary Declaration of Paternity (attach copy).
a.
b.
c.
the mother.
the child or the child's personal representative (specify court and date of appointment):
Petitioner is
the father.
d.
other (specify):
a.
Child's name
Date of birth SexAge
b. a child who is not yet born.
a.
b.
c.
resides in this state.
had sexual intercourse in this state, which resulted in conception of the children listed in item 2.
other (specify):
a.
b.
the child resides or is found in the county.
a parent is deceased and proceedings for administration of the estate have been or could be started in this county.
d.
e.
respondent who is child's parent has failed to support the child.
(name): has furnished or is furnishing the following reasonable expenses
of pregnancy and birth for which the respondent as parent of the child is obligated:
Amount
Payable to For (specify):
g.
other (specify):
A completed Declaration Under Uniform Child Custody Jurisdiction and Enforcement Act (UCCJEA)) (form FL-105) is attached.
Child CustodyChild Support
Visitation Other (specify):
f.
public assistance is being provided to the child.
Family Code, § 7630
ATTORNEY FOR (Name):
TELEPHONE NO. (Optional): FAX NO. (Optional):
E–MAIL ADDRESS (Optional):
Page 1 of 2
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PETITION TO ESTABLISH PARENTAL RELATIONSHIP
(Uniform Parentage)
Petitioner requests the court to make the determinations indicated below.
CHILD CUSTODY AND VISITATION
PARENT-CHILD RELATIONSHIP
FL-200 [Rev. January 1, 2003]
CASE NUMBER:
PETITIONER:
7.
8.
Page 2 of 2
RESPONDENT:
a. b.
c.
Respondent Petitioner
is the parent of the children listed in item 2.
Other (specify):
a.
b.
Legal custody of children to
Physical custody of children to
Petitioner Respondent OtherJoint
Visitation of children:
Petitioner
d.
Facts in support of the requested custody and visitation orders are (specify):
(1)
None
c.
(2)
Reasonable visitation.
Visitation with the following restrictions (specify):
Contained in the attached declaration.
I request mediation to work out a parenting plan.
e.
CHILD SUPPORT
The court may make orders for support of the children and issue an earnings assignment without further notice to either party.
12.
REASONABLE EXPENSES OF PREGNANCY AND BIRTH:
9.
NAME CHANGE
11.
Children's names be changed, according to Family Code section 7638, as follows (specify):
FEES AND COSTS OF LITIGATION
10.
a.
b.
Attorney fees to be paid by
Expert fees, guardian ad litem fees, and other costs
of the action or pretrial proceedings to be paid by
I have read the restraining order on the back of the Summons (FL-210) and I understand it applies to me when this Petition is filed.
13.
I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
Date:
(SIGNATURE OF PETITIONER)(TYPE OR PRINT NAME)
A blank Response to Petition to Establish Parental Relationship (form FL-220) must be served on the Respondent with this Petition.
NOTICE: If you have a child from this relationship, the court is required to order child support based upon the income of
both parents. Support normally continues until the child is 18. You should supply the court with information about your
finances. Otherwise, the child support order will be based upon information supplied by the other parent.
Any party required to pay child support must pay interest on overdue amounts at the "legal" rate, which is currently
10 percent.
(3)
Petitioner
Respondent
Joint
Petitioner
Respondent Joint
Reasonable expenses of pregnancy
and birth be paid by
as follows:
Respondent should have the right to visit the children as follows:
(4)
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