ATTORNEY OR PARTY WITHOUT ATTORNEY (Name and Address): TELEPHONE NO.: FOR COURT USE ONLY ATTORNEY FOR (Name): SUPERIOR COURT OF CALIFORNIA, COUNTY OF STREET ADDRESS: MAILING ADDRESS: CITY AND ZIP CODE: BRANCH NAME: IN THE MATTER OF (NAME): Petitioner, a minor CASE NUMBER: DECLARATION OF EMANCIPATION OF MINOR AFTER HEARING 1. This proceeding came on for hearing as follows: Time: a. Date: Dept.: Div.: Room: b. Judge (name): c. Present in court: Petitioner Attorney (name): Father Attorney (name): Mother Attorney (name): Probation officer (name): Social worker (name): County counsel (name): District attorney (name): Other (name and relationship to minor): 2. THE COURT FINDS THAT: Notice was given as prescribed by the court. a. b. Warning has been given to the petitioner's mother father that a court may rescind the declaration of emancipation and the parents may become liable for the minor's support and medical coverage. c. The petitioner is a person described by Family Code section 7120. d. Emancipation is not contrary to the best interests of the petitioner. 3. THE PETITION IS GRANTED. THE PETITIONER IS DECLARED TO BE EMANCIPATED FOR THE PURPOSES SET FORTH IN FAMILY CODE SECTION 7050 ET SEQ. Date: (JUDGE OF THE SUPERIOR COURT) [SEAL] CLERK'S CERTIFICATE I certify that the foregoing is a true and correct copy of the original on file in my office. Date: Form Adopted by the Judicial Council of California MC-310 [Rev. July 1, 1994] Clerk, by DECLARATION OF EMANCIPATION OF MINOR AFTER HEARING , Deputy Family Code, § 7000 et seq. 2001 © American LegalNet, Inc.