Order Establishing Fact Of Death
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Order Establishing Fact Of Death Form. This is a California form and can be use in Yuba Local County.
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Tags: Order Establishing Fact Of Death, PR05013, California Local County, Yuba
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 DEATH OF:
CASE NUMBER:
ORDER ESTABLISHING FACT OF DEATH
[H&S § 103450]
THE COURT FINDS as follows:
1.
Petitioner is a resident of the County of Yuba, State of California.
2.
_______________________ became deceased on ________________________________ [
] in the
County of __________________________, State of __________________________ or [
] in the
Country of ____________________________________.
3.
Said death was not registered in conformity with the provisions of law in effect at the time of said death,
or such record was lost or destroyed after having been filed.
THE COURT ORDERS that the death of _______________________ which occurred as set forth
hereinabove, is hereby verified and established by this Court.
Dated: ____________________
JUDGE OF THE SUPERIOR COURT
Yuba County Superior Court
Effective 8/10/05
ORDER ESTABLISHING FACT OF DEATH
[H&S § 103450]
PR05013
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