Form Np/sf Dp-1a - Confidential Declaration Of Domestic Partnership
Download a blank fillable Form Np/sf Dp-1a - Confidential Declaration Of Domestic Partnership in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Form Np/sf Dp-1a - Confidential Declaration Of Domestic Partnership with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1
2
3State of California
C
FILE NO:
____________________
Secretary of State
Confidential
Declaration of Domestic Partnership
This Space For Filing Use Only
IMPORTANT – Read instructions before completing this form.
We the undersigned, do declare that we have been living together as domestic partners and meet the requirements of Family
Code section 297, which are as follows:
Neither person is married to someone else or is a member of another domestic partnership with someone else that
has not been terminated, dissolved, or adjudged a nullity.
The two persons are not related by blood in a way that would prevent them from being married to each other in this
state.
Both persons are at least 18 years of age, OR if one or both persons are under 18 years of age, a certified copy of
the court order(s) granting permission to the underage person(s) to establish a domestic partnership is attached.
Both persons are members of the same sex, OR one or both of the persons is over 62 years of age and one or both
meet the eligibility criteria under Title II of the Social Security Act as defined in United States Code, title 42, section
402(a) for old-age insurance benefits or Title XVI of the Social Security Act as defined in United States Code, title 42,
section 1381 for aged individuals.
Both persons are capable of consenting to the domestic partnership.
Both persons consent to the jurisdiction of the Superior Courts of California for the purpose of a proceeding to obtain
a judgment of dissolution or nullity of the domestic partnership or for legal separation of partners in the domestic
partnership, or for any other proceeding related to the partners' rights and obligations, even if one or both partners
ceases to be a resident of, or to maintain a domicile in, this state.
The representations are true and correct, and contain no material omissions of fact to the best of our knowledge and belief.
Filing an intentionally and materially false Declaration of Domestic Partnership (Confidential) shall be punishable as a
misdemeanor. (Family Code section 298(c).)
PARTNER 1
PARTNER 2
___________________________________________________________
___________________________________________________________
Printed Name (Last)
(First)
(Middle)
Printed Name (Last)
(First)
(Middle)
___________________________________________________________
___________________________________________________________
Signature of Partner as Stated Above
Signature of Partner as Stated Above
OPTIONAL Name Changes:
OPTIONAL Name Changes:
New Last Name_______________________________________
New Last Name_______________________________________
New Middle Name _____________________________________
New Middle Name ____________________________________
Date of Birth (required for name change) ___________________
Date of Birth (required for name change) ___________________
Mailing Address
City
State
Zip
SEC/STATE NP/SF DP-1A (Rev 04/2015)
(Page 1 of 2)
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Legal