FILE NO._________________ State of California Secretary of State REVOCATION OF TERMINATION OF DOMESTIC PARTNERSHIP (Family Code section 299) Instructions: 1. Complete and mail to: Secretary of State P.O. Box 942870 Sacramento, CA 94277-2870 (916) 653-3984 2. There is no fee for filing this Revocation of Termination of Domestic Partnership. (Office Use Only) I, the undersigned, do declare that: I am revoking the termination of domestic partnership, notice of which was filed with the Secretary of State on ___________________. This revocation is being filed within six months of the date the (month/day/year) Notice of Termination was filed with the Secretary of State. I have sent the other party a copy of this notice of revocation by first-class mail, postage prepaid, at the other party's last known address. _________________________________ Signature ________________________________________________ Printed Name (Last) (First) (Middle) Partner's Name (Last) (First) (Middle) RETURN TO (Enter the name and the address of the person to whom a copy of the filed document should be returned.) NAME ADDRESS CITY/STATE/ZIP SEC/STATE NP/SF DP-3 (Rev 04/2015)