Local form- revised 7/28/06 OPTIONAL FORM For Court Use Only In the Superior Court of the State of CaliforniaIn and for the County of Kings 1640 Kings County Drive Hanford, CA 93230 INSTRUCTIONS TO COUNSELOR:Please type or print legibly. Name of counselor: Title: Address: Telephone number: ( ) (street) (city) (state) (zip code) Name of male applicant: (first) (middle) (last) Address of male applicant: (street) (city) (state) (zip code) Age: Home telephone number: ( ) Message telephone number: ( ) Name of female applicant: (first) (middle) (last) Address of female applicant: (street) (city) (state) (zip code) Age: Home telephone number: ( ) Message telephone number: ( ) The above-stated applicants have received no less than three (3) hours of premarital counseling in at least two (2) counseling sessions concerning social, economic, and personal responsibilities incidental to marriage by the undersigned and have, in my opinion, the basic knowledge necessary to enter into matrimony as required by California State Law (Family Code Section 304).Dated on:// (Signature of Counselor) American LegalNet, Inc. www.FormsWorkFlow.com