Form FL-105 (GC-120) "Declaration Under Uniform Child Custody Jurisdiction and Enforcement Act (Uccjea)" - California

What Is Form FL-105 (GC-120)?

This is a legal form that was released by the California Superior Court - a government authority operating within California. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on January 1, 2009;
  • The latest edition provided by the California Superior Court;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form FL-105 (GC-120) by clicking the link below or browse more documents and templates provided by the California Superior Court.

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Download Form FL-105 (GC-120) "Declaration Under Uniform Child Custody Jurisdiction and Enforcement Act (Uccjea)" - California

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FL-105/GC-120
ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address):
FOR COURT USE ONLY
To keep other people from
seeing what you entered on
your form, please press the
TELEPHONE NO.:
FAX NO. (Optional):
Clear This Form button at the
E-MAIL ADDRESS (Optional):
end of the form when finished.
ATTORNEY FOR (Name):
SUPERIOR COURT OF CALIFORNIA, COUNTY OF
STREET ADDRESS:
MAILING ADDRESS:
CITY AND ZIP CODE:
BRANCH NAME:
This section applies only to family law cases.)
(
PETITIONER:
RESPONDENT:
OTHER PARTY:
(This section apples only to guardianship cases.)
CASE NUMBER:
GUARDIANSHIP OF (Name):
Minor
DECLARATION UNDER UNIFORM CHILD CUSTODY
JURISDICTION AND ENFORCEMENT ACT (UCCJEA)
1. I am a party to this proceeding to determine custody of a child.
2.
My present address and the present address of each child residing with me is confidential under Family Code section 3429 as
I have indicated in item 3.
3. There are (specify number):
minor children who are subject to this proceeding, as follows:
(Insert the information requested below. The residence information must be given for the last FIVE years.)
a. Child’s name
Place of birth
Date of birth
Sex
Period of residence
Relationship
Address
Person child lived with (name and complete current address)
Confidential
Confidential
to present
Child's residence (City, State)
Person child lived with (name and complete current address)
to
Child's residence (City, State)
Person child lived with (name and complete current address)
to
Child's residence (City, State)
Person child lived with (name and complete current address)
to
b. Child’s name
Place of birth
Date of birth
Sex
Residence information is the same as given above for child a.
(If NOT the same, provide the information below.)
Period of residence
Address
Relationship
Person child lived with (name and complete current address)
to present
Confidential
Confidential
Person child lived with (name and complete current address)
Child's residence (City, State)
to
Child's residence (City, State)
Person child lived with (name and complete current address)
to
Child's residence (City, State)
Person child lived with (name and complete current address)
to
Additional residence information for a child listed in item a or b is continued on attachment 3c.
c.
Additional children are listed on form FL-105(A)/GC-120(A). (Provide all requested information for additional children.)
d.
Page 1 of 2
Form Adopted for Mandatory Use
Family Code, § 3400 et seq.;
DECLARATION UNDER UNIFORM CHILD CUSTODY
Judicial Council of California
Probate Code, §§ 1510(f), 1512
JURISDICTION AND ENFORCEMENT ACT (UCCJEA)
FL-105/GC-120 [Rev. January 1, 2009]
www.courtinfo.ca.gov
FL-105/GC-120
ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address):
FOR COURT USE ONLY
To keep other people from
seeing what you entered on
your form, please press the
TELEPHONE NO.:
FAX NO. (Optional):
Clear This Form button at the
E-MAIL ADDRESS (Optional):
end of the form when finished.
ATTORNEY FOR (Name):
SUPERIOR COURT OF CALIFORNIA, COUNTY OF
STREET ADDRESS:
MAILING ADDRESS:
CITY AND ZIP CODE:
BRANCH NAME:
This section applies only to family law cases.)
(
PETITIONER:
RESPONDENT:
OTHER PARTY:
(This section apples only to guardianship cases.)
CASE NUMBER:
GUARDIANSHIP OF (Name):
Minor
DECLARATION UNDER UNIFORM CHILD CUSTODY
JURISDICTION AND ENFORCEMENT ACT (UCCJEA)
1. I am a party to this proceeding to determine custody of a child.
2.
My present address and the present address of each child residing with me is confidential under Family Code section 3429 as
I have indicated in item 3.
3. There are (specify number):
minor children who are subject to this proceeding, as follows:
(Insert the information requested below. The residence information must be given for the last FIVE years.)
a. Child’s name
Place of birth
Date of birth
Sex
Period of residence
Relationship
Address
Person child lived with (name and complete current address)
Confidential
Confidential
to present
Child's residence (City, State)
Person child lived with (name and complete current address)
to
Child's residence (City, State)
Person child lived with (name and complete current address)
to
Child's residence (City, State)
Person child lived with (name and complete current address)
to
b. Child’s name
Place of birth
Date of birth
Sex
Residence information is the same as given above for child a.
(If NOT the same, provide the information below.)
Period of residence
Address
Relationship
Person child lived with (name and complete current address)
to present
Confidential
Confidential
Person child lived with (name and complete current address)
Child's residence (City, State)
to
Child's residence (City, State)
Person child lived with (name and complete current address)
to
Child's residence (City, State)
Person child lived with (name and complete current address)
to
Additional residence information for a child listed in item a or b is continued on attachment 3c.
c.
Additional children are listed on form FL-105(A)/GC-120(A). (Provide all requested information for additional children.)
d.
Page 1 of 2
Form Adopted for Mandatory Use
Family Code, § 3400 et seq.;
DECLARATION UNDER UNIFORM CHILD CUSTODY
Judicial Council of California
Probate Code, §§ 1510(f), 1512
JURISDICTION AND ENFORCEMENT ACT (UCCJEA)
FL-105/GC-120 [Rev. January 1, 2009]
www.courtinfo.ca.gov
FL-105/GC-120
SHORT TITLE:
CASE NUMBER:
4.
Do you have information about, or have you participated as a party or as a witness or in some other capacity in, another court case
or custody or visitation proceeding, in California or elsewhere, concerning a child subject to this proceeding?
Yes
No
(If yes, attach a copy of the orders (if you have one) and provide the following information):
Your
Court order
Court
Name of each child
Proceeding
Case number
connection to
or judgment
Case status
(name, state, location)
the case
(date)
a.
Family
b.
Guardianship
c.
Other
Proceeding
Case Number
Court (name, state, location)
Juvenile Delinquency/
d.
Juvenile Dependency
e.
Adoption
5.
One or more domestic violence restraining/protective orders are now in effect. (Attach a copy of the orders if you have one
and provide the following information):
Court
County
State
Case number (if known)
Orders expire (date)
a.
Criminal
b.
Family
Juvenile Delinquency/
c.
Juvenile Dependency
d.
Other
6.
Do you know of any person who is not a party to this proceeding who has physical custody or claims to have custody of or
Yes
No
(If yes, provide the following information):
visitation rights with any child in this case?
a. Name and address of person
b. Name and address of person
c. Name and address of person
Has physical custody
Has physical custody
Has physical custody
Claims custody rights
Claims custody rights
Claims custody rights
Claims visitation rights
Claims visitation rights
Claims visitation rights
Name of each child
Name of each child
Name of each child
I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
Date:
(TYPE OR PRINT NAME)
(SIGNATURE OF DECLARANT)
7.
Number of pages attached:
NOTICE TO DECLARANT: You have a continuing duty to inform this court if you obtain any information about a custody
proceeding in a California court or any other court concerning a child subject to this proceeding.
DECLARATION UNDER UNIFORM CHILD CUSTODY
FL-105/GC-120 [Rev. January 1, 2009]
Page 2 of 2
JURISDICTION AND ENFORCEMENT ACT (UCCJEA)
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