Declaration In Support Of Petition To Establish Fact Date And Place Of Marriage {MC-362A}

MC-362A ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address): FOR COURT USE ONLY TELEPHONE NO.: E-MAIL ADDRESS (Optional): ATTORNEY FOR (Name): FAX NO. (Optional): SUPERIOR COURT OF CALIFORNIA, COUNTY OF STREET ADDRESS: MAILING ADDRESS: CITY AND ZIP CODE: BRANCH NAME: IN THE MATTER OF (Names): CASE NUMBER: DECLARATION IN SUPPORT OF PETITION TO ESTABLISH FACT, DATE, AND PLACE OF MARRIAGE (Name of declarant): HEARING DATE AND TIME: DEPT.: declares as follows: 1. I make the statements in this declaration based on my personal knowledge or on the contents of the documents identified in item 5. ("Personal knowledge" of a fact is knowledge not gained from another person's statements to you about that fact.) 2. a. I am at least 18 years of age. b. I reside at (street address and city): County: 3. (Names) : were married on (date): a. City, town, township, or other (identify "other" if known): b. c. County: State or province: State: and at the following place: State (U.S.): Country: 4. Facts showing when and where the persons named in item 3 were married and explaining how I have personal knowledge of those facts are stated in the space below are stated in Attachment 4 to this declaration. (If you are relying solely on the contents of the documents identified in item 5, please advise in the space below.) Page 1 of 2 Form Adopted for Mandatory Use Judicial Council of California MC-362A [New July 1, 2012] DECLARATION IN SUPPORT OF PETITION TO ESTABLISH FACT, DATE, AND PLACE OF MARRIAGE (Miscellaneous) Health & Safety Code, §§ 103450­103490 www.courts.ca.gov American LegalNet, Inc. www.FormsWorkFlow.com MC­362A IN THE MATTER OF (Names): CASE NUMBER: 5. Attached are true and correct copies of the following documents (check each box that applies; statements of officiating persons and witnesses must be signed under oath, in an affidavit sworn before a Notary Public or with the following statement just above the signature: "I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct"): a. Marriage license* dated (date of each): * (A marriage license is required for a valid marriage in California. The procedure described in Health and Safety Code sec. 103450, et seq., cannot establish the validity of a California marriage if no marriage license was obtained.) b. c. Officiating person's statement dated (date of each): Witness statements dated (date of each): d. Other documents dated (describe and give the date of each document): Continued on Attachment 5d. is not is important to a court 6. The marriage of the persons named in item 3, or the date or place of the marriage case or proceeding that is now pending and described below. (If you selected "is," briefly describe the proceeding and provide the case name and number, the name and address of the court where the proceeding is pending, the names of all parties to the proceeding, and the names, addresses, and telephone numbers of their attorneys. Note: A court order made on a petition under Health and Safety Code section 103450, et seq., may not be effective against claims of persons or organizations not given notice of the petition for the order.) Continued on Attachment 6. 7. Number of pages attached: 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 OF DECLARANT) MC-362A [New July 1, 2012] (SIGNATURE OF DECLARANT) Page 2 of 2 DECLARATION IN SUPPORT OF PETITION TO ESTABLISH FACT, DATE, AND PLACE OF MARRIAGE (Miscellaneous)