FL-105(A)/GC-120(A) CASE NAME: CASE NUMBER: ATTACHMENT TO DECLARATION UNDER UNIFORM CHILD CUSTODY JURISDICTION AND ENFORCEMENT ACT (UCCJEA) Child's name Residence information is the same as given on form FL-105/GC-120 for child a. (If NOT the same, provide the information below.) Period of residence Present address Person child lived with (name and complete current address) Relationship Place of birth Date of birth Sex to present Confidential Child's residence (City, State) Confidential Person child lived with (name and complete current address) to Child's residence (City, State) to Child's residence (City, State) to Child's name Residence information is the same as given on form FL-105/GC-120 for child a. (If NOT the same, provide the information below.) Period of residence Address Person child lived with (name and complete current address) Relationship Place of birth Date of birth Sex Person child lived with (name and complete current address) Person child lived with (name and complete current address) to present Confidential Child's residence (City, State) Confidential Person child lived with (name and complete current address) to Child's residence (City, State) to Child's residence (City, State) to Child's name Residence information is the same as given on form FL-105/GC-120 for child a. (If NOT the same, provide the information below.) Period of residence Address Person child lived with (name and complete current address) Relationship Place of birth Date of birth Sex Person child lived with (name and complete current address) Person child lived with (name and complete current address) to present Confidential Child's residence (City, State) Confidential Person child lived with (name and complete current address) to Child's residence (City, State) to Child's residence (City, State) to Page____ of ____ Form Adopted for Mandatory Use Judicial Council of California FL-105(A)/GC-120(A) [New January 1, 2009] Person child lived with (name and complete current address) Person child lived with (name and complete current address) ATTACHMENT TO DECLARATION UNDER UNIFORM CHILD CUSTODY JURISDICTION AND ENFORCEMENT ACT (UCCJEA) Family Code, § 3400 et seq.; Probate Code, §§ 1510(f), 1512 www.courtinfo.ca.gov American LegalNet, Inc. www.FormsWorkFlow.com