Form Fl-015 - Petition For Grandparent Visitation Form - Superior Court Of California, County Of Stanislaus
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2ATTORNEY OR PARTY WITHOUT ATTORNEY (Name and Address)
Telephone Number
FOR COURT USE ONLY
SELF- REPRESENTED
ATTORNEY FOR (Name):
SUPERIOR COURT OF CALIFORNIA, COUNTY OF STANISLAUS
Street Address:
1100 I Street , Modesto, CA 95354
Mailing Address: Post Office Box 1098, Modesto, CA 95353
PETITIONER:
RESPONDENT:
CASE NUMBER:
PETITION FOR GRANDPARENT VISITATION
1. Petitioner’s relationship to minor child(ren) listed below:
grandmother
grandfather
my son [name] __________________________________ is the parent of the child(ren).
my daughter [name] __________________________________ is the parent of the child(ren).
Child’s Name
Birthdate
Currently living with
Other Parent’s Name
Relationship/in County
2. The parents of the child(ren)
:
[mark all boxes and fill in all spaces which apply]
a.
are currently married or have a domestic partnership and living together.
b.
are divorced. A Judgment of Dissolution of Marriage or Domestic Partnership was entered on:
__________________ , in _____________________ County,
____________________,
[Specify date]
[state]
Case No. _____________________.
c.
are currently involved in a divorce proceeding in _____________________ County, Case No.
_____________.
d.
are currently married or have a domestic partnership and one of the parents has been absent for more than
one month without the other parent knowing the whereabouts of the absent parent.
e.
have never been married or in a domestic partnership.
f.
are currently living separately and apart from each other on a permanent or indefinite basis.
g.
the
mother
father of the minor child(ren) is deceased.
h.
the child(ren) is/are not residing with either parent.
i.
The child(ren) has/have been adopted by a
stepparent
grandparent
other
[specify name and
: _____________________________________________________________.
relationship]
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PETITION FOR GRANDPARENT VISITATION
Approved for Optional Use
Family Code §§3102, 3103, 3104
FL-015 [January 2010]
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