ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, state bar number, and address) TELEPHONE NO: ATTORNEY FOR (NAME): FOR COURT USE ONLY FAX NO: SUPERIOR COURT OF CALIFORNIA COUNTY OF YUBA 215 FIFTH STREET, SUITE 200 MARYSVILLE, CA 95901 (530) 749-7600 IN THE MATTER OF THE PETITION OF: TO ESTABLISH THE FACT OF MARRIAGE OF: and CASE NUMBER: PETITION TO ESTABLISH FACT OF MARRIAGE [H&S § 103450] The undersigned respectfully alleges: 1. Petitioner is a resident of the County of Yuba, State of California. 2. Petitioner seeks to establish the fact of marriage of ___________________________ and ___________________________, each to the other, said marriage having been solemnized on _______________ in the County of __________________________, State of __________________________ OR [ ] in the Country of ___________________________________. 3. Said marriage has not been registered in conformity with the provisions of law in effect at the time of said marriage, or such record has been lost or destroyed after having been filed. WHEREFORE, Petitioner prays that an order of the Court be made establishing the fact of marriage of _________________________ and _________________________, each to the other, which occurred as set forth hereinabove, and for such other relief as the Court deems proper. Dated: ____________________ ................................... ___________________________________ Type or Print Name Signature of Petitioner VERIFICATION I declare under penalty of perjury the laws of the State of California that the foregoing is true and correct. Dated: ____________________ ................................... ___________________________________ Type or Print Name Form Adopted for Mandatory Use Yuba County Superior Court Effective 7/1/03 Rev. 03/12/07 Signature of Petitioner PETITION TO ESTABLISH FACT OF MARRIAGE FL03009 [H&S § 103450] Appendix 2-A American LegalNet, Inc. www.FormsWorkflow.com