ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number and Address) FOR COURT USE ONLY TELEPHONE NO.: E-MAIL ADDRESS (Optional): ATTORNEY FOR (Name): SUPERIOR COURT OF CALIFORNIA, COUNTY OF AMADOR STREET ADDRESS: 500 ARGONAUT LANE MAILING ADDRESS: SAME CITY AND ZIP CODE: JACKSON, CA 95642 PHONE: 209-257-2603 PETITIONER: VS RESPONDENT: PETITION FOR JOINDER (Custody/Visitation) CASE NUMBER: Claimant alleges as follows: 1. Claimant is the (specify relationship) below: Child's name of the minor child(ren) outlined Sex Birthdate Age 2. Each minor child named in 1 is currently living with the Petitioner Respondent Other: in the following county (specify): Claimant requests that the court grant the following relief: a. reasonable visitation with the following child(ren) as determined by court. b. custody of the following child(ren) as granting custody to a parent will be detrimental to the child(ren) and that granting custody to the claimant (non- parent) is required to serve the best interest of the child(ren). c. Other: . 3. , , d. Such other relief as the court may deem appropriate. I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. DATED: CLAIMANT PETITION FOR JOINDER (Custody/Visitation)-(Rev. 06/19/12)-FCS-080 American LegalNet, Inc. www.FormsWorkFlow.com