ATTACHMENT FM-1051 ATTORNEY OR PARTY WITHOUT AN ATTORNEY (Name and Address): TELEPHONE NUMBER: FOR COURT USE ONLY ATTORNEY FOR (Name): SUPERIOR COURT OF CALIFORNIA COUNTY OF SANTA CLARA FAMILY DIVISION CASE NUMBER: DECLARATION OF RESIDENCE (For Family Law and Parentage Actions Only) This declaration must be filed with all new family law actions (including, but not limited to, dissolution, legal separation and nullity), and all new actions under started the Uniform Parentage Act (UPA) (including UPA actions filed simultaneously with a Domestic Violence Prevention Act case). Cases assigned to Department 101 (Domestic Violence Prevention Act that are not filed simultaneously with a UPA action, Civil Harassment, Elder Abuse, and Workplace Violence cases) and those filed by Department of Child Support Services (DCSS) are exempt from this requirement. I am the Petitioner in this case and declare under penalty of perjury that (check one of the boxes labeled 1, 2 or 3): 1. I live in Santa Clara County, and my residence is currently located in the zip code area checked below. OR I do not live in Santa Clara County, but the Respondent lives in the County and his or her residence is currently located in the zip code area listed below. If either box is checked above, please check the applicable county area and zip code below. Central County –Courthouse located at 170 Park Avenue, San José, CA 95113 95030 95033 95042 95101 95110 95111 95112 95113 95115 95116 95117 95118 95120 95121 95122 95123 95124 95125 95126 95127 95130 95131 95132 95133 95135 95136 95138 95139 95140 95148 95192 95193 North County – Courthouse located at 605 W. El Camino Real, Sunnyvale, CA 94087 94022 94024 94035 94040 94041 94043 94063 94085 94086 94087 94089 94301 94303 94304 94305 94306 95002 95008 95014 95032 95035 95050 95051 95053 95054 95070 95128 95129 95134 South County – Courthouse located at 301 Diana Avenue, Morgan Hill, CA 95037 95013 95020 95021 95037 95038 95046 95119 95141 OR 2. Neither I nor Respondent currently resides in Santa Clara County. OR 3. I have registered my address as confidential with the Secretary of State’s “Safe At Home” program and decline to provide the zip code for my residence. Date: Signature of Petitioner FM-1051 REV 7/01/10 DECLARATION OF RESIDENCE (For Family Law and Parentage Actions Only) Page 1 of 1 American LegalNet, Inc. www.FormsWorkFlow.com