Annual Declaration Under Penalty Of Perjury Parenting Without Violence
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Annual Declaration Under Penalty Of Perjury Parenting Without Violence Form. This is a California form and can be use in Santa Clara Local County.
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Tags: Annual Declaration Under Penalty Of Perjury Parenting Without Violence, FM-1085, California Local County, Santa Clara
FOR COURT USE ONLY
PARENTING WITHOUT VIOLENCE PROVIDER (Name and Address):
TELEPHONE NO:
FAX NO. (Optional):
E-MAIL ADDRESS (Optional):
SUPERIOR COURT OF CALIFORNIA, COUNTY OF SANTA CLARA
STREET ADDRESS:
170 Park Avenue
MAILING ADDRESS:
191 North First Street
CITY AND ZIP CODE:
BRANCH:
San Jose, California 95113
Park Avenue Courthouse – Family
ANNUAL DECLARATION UNDER PENALTY OF PERJURY
PARENTING WITHOUT VIOLENCE
I,
, do hereby declare under penalty of perjury that I and
Name of Professional Provider
everyone I employ as a provider of Parenting Without Violence agree to abide by the standards for structure and
content as published on September 16, 2008 by the Parenting Without Violence Curriculum Task Group, a
subcommittee of the DV Court Systems Committee. This publication is attached and available on the Court’s website at
www.sccsuperiorcourt.org.
Name of Provider:
Address of Provider:
Name of Signatory:
Signature of Signatory:
Date:
Please send completed original form to: Superior Court of California, County of Santa Clara
Attn: Family Court Services
191 North First Street, San Jose, CA 95113
FM-1085 REV 9/02/09
ANNUAL DECLARATION UNDER PENALTY OF PERJURY
PARENTING WITHOUT VIOLENCE
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