Declaration In Support Of Request For Separate Mediation Sessions {1320}

SUPERIOR COURT OF CALIFORNIA COUNTY OF SOLANO FAMILY LAW AND PROBATE DIVISION Fairfield Branch 600 Union Avenue Fairfield, CA 94533 (707) 207-7340 Vallejo Branch 321 Tuolumne Street Vallejo, CA 94590 (707) 207-7340 In re the Matter of PETITIONER: ______________________________ and RESPONDENT: _____________________________ Case No. __________________ DECLARATION IN SUPPORT OF REQUEST FOR SEPARATE CHILD CUSTODY RECOMMENDING COUNSELING SESSIONS (CCRC) I declare that I am a victim of domestic violence as defined in Family Code §6211, to wit: __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ Child Custody Recommending Counseling (CCRC) having been ordered in this action, I hereby request that I be allowed to meet with the Child Custody Recommending Counselor (CCRC) separately and at a separate time, pursuant to the provisions of Family Code §3181. I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. DATE: __________________________ ____________________________________ SIGNATURE OF DECLARANT Form no. 1320 DECLARATION IN SUPPORT OF REQUEST FOR SEPARATE CCRC SESSIONS Rev. 01-12 American LegalNet, Inc. www.FormsWorkFlow.com Page 1 of 1