Form Fl-015 - Petition For Grandparent Visitation Form - Superior Court Of California, County Of Stanislaus Page 2
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1
2CASE NAME:
CASE NUMBER
3. Describe the relationship between each child and the petitioner(s). Explain the reason why grandparent visitation is in
the best interest of each child:
continued in attached declaration
4. Describe the duration and frequency of visitation that is being requested:
continued in attached declaration
5. A completed declaration under the Uniform Child Custody Jurisdiction and Enforcement Act, form FL-105, is attached.
[Not required if the petition is filed within an open Family Law Case.]
6. Petitioner(s) requests that the court grant reasonable visitation with the above named child(ren), and such other relief
as the court may deem appropriate, pursuant to Family Code Sections 3100, 3102, 3103 and 3104.
I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
Dated:
Dated:
_________________________________
___________________________________
[Signature of Petitioner or Attorney]
[Signature of Petitioner or Attorney]
_________________________________
___________________________________
[Type or Print Name]
[Type or Print Name]
VERIFICATION
The statements in the above Petition are true of my own knowledge, except as to those matters that are therein stated on
my information and belief, and as to those matters I believe them to be true.
Signed at _______________________, California on ______________ _____
_____
[City or Town (Name)]
(Month)
(Date)
(Year)
I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
_________________________________
___________________________________
[Signature of Petitioner]
[Signature of Petitioner]
_________________________________
___________________________________
[Type or Print Name]
[Type or Print Name]
PARENT CONSENT TO PETITIONER’S REQUEST FOR GRANDPARENT VISIATION
Mother
Father hereby consents to and joins in this petition for Grandparent Visitation.
Dated:
_________________________________
___________________________________
[Type or Print Name]
[Signature of Parent of Minor Child(ren)]
Page 2 of 2
PETITION FOR GRANDPARENT VISITATION
Approved for Optional Use
Family Code §§3102, 3103, 3104
FL-015 [January 2010]
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