Declaration Of Birth Mother
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Declaration Of Birth Mother Form. This is a California form and can be use in San Diego Local County.
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Tags: Declaration Of Birth Mother, JUV-249, California Local County, San Diego
FOR COURT USE ONLY
ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address):
TELEPHONE NO.:
FAX NO.(Optional):
E-MAIL ADDRESS (Optional):
ATTORNEY FOR (Name):
SUPERIOR COURT OF CALIFORNIA, COUNTY OF SAN DIEGO
CENTRAL DIVISION, JUVENILE COURT, 2851 MEADOW LARK DR., SAN DIEGO, CA 92123
NORTH COUNTY DIVISION, 325 S. MELROSE DR., SUITE 130,VISTA, CA 92081
IN THE MATTER OF THE PETITION OF
DECLARATION OF BIRTH MOTHER
CASE NUMBER
I, __________________________________________________, declare the following:
I am the biological mother of ____________________________, born on ____________ in _______________________.
I was married to _____________________________________ on __________________ in ______________________.
A dissolution of this marriage was final on or about _______________. I have not cohabited with _______________
since ________________________________________.
It is physically impossible for _______________________________ to be the father of ___________________________.
I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
Date:
Type or print name
SDSC JUV-249 (New 9/12)
Signature of Birth Mother
DECLARATION OF BIRTH MOTHER
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