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Declaration Under Uniform Child Custody Jurisdiction and Enforcement Act (UCCJEA)

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California · With the petition.

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    What is FL-105?

    Mandatory attachment in any California family-law or probate case where custody, visitation, or guardianship of a minor child is at issue. The declarant lists each child's residences and caregivers for the past five years, plus any other ongoing custody, restraining-order, or non-party-claimant facts. The court uses the declaration to confirm California has jurisdiction under the UCCJEA (Family Code section 3400 et seq.).

    What happens if you miss the deadline: Without FL-105 the court cannot establish UCCJEA jurisdiction. Cases get continued until the declaration is filed; some clerks reject the petition at intake.

    How to file

    Filing fee
    No separate fee. FL-105 is filed with the underlying petition (FL-100, GC-210, etc.).
    Filing method
    in-person, mail, efile (county-specific)
    Filing deadline
    Filed with the first pleading involving custody. Family Code section 3429(a). The declarant has a continuing duty under section 3429(d) to inform the court of any proceeding in this or any other state that could affect the current proceeding, so an amended FL-105 is filed when needed.
    How to serve
    Served on the other party with the underlying petition (typically by personal service via FL-110 summons + the petition + FL-105). Documented on FL-115 (Family Law Proof of Service of Summons).
    Wet signature
    Yes, sign in pen after printing.
    Notarization
    No
    Original and copies
    1 original to the clerk plus 2 copies (1 for filer, 1 to be served).

    Common pitfalls

    Three highest-leverage checks for the AI review. (1) Item 2 children list: at least one child name + DOB + birthplace, matching what is named in the underlying petition (FL-100 item 4b). (2) Item 3 residence history: must cover 5 years with no gaps. The most common rejection cause is gaps between rows (e.g., row 1 starts 06/2023, row 2 ends 03/2023, leaving 4/2023-5/2023 unaccounted). (3) Item 6 non-party claimants: Family Code section 3429(a)(3) requires the filer to disclose any person not a party who has physical custody or claims rights of legal custody, physical custody, or visitation. Listing on FL-105 is a disclosure obligation; it does not by itself join or serve those non-parties. If their participation in the case is needed, the filer must follow the family-law joinder procedures (FL-371 Request for Joinder, governed by Cal. Rules of Court rule 5.24). The wizard should remind the filer to consult court self-help on joinder of a non-party custody claimant.

    Don't memorize the rules. Ezel walks you through FL-105 field by field, flags what the AI review treats as a blocker, and renders a court-ready PDF.

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    You'll likely also file

    Other Ezel-supported forms that commonly file alongside FL-105. Each one has its own guided fill, AI review, and PDF render.

    FL-100
    Petition (Marriage/Domestic Partnership)
    Petition (Marriage/Domestic Partnership). FL-105 is the mandatory companion to FL-100 whenever the marriage produced minor children (FL-100 item 4.b is checked) because Family Code section 3409(a) bars the court from making any custody or visitation order without the home-state and ongoing-proceedings facts FL-105 supplies under the Uniform Child Custody Jurisdiction and Enforcement Act. The petitioner files FL-105 at case opening alongside FL-100 + FL-110 so the respondent receives the UCCJEA declaration with the initial service packet under CCP 415.10 / 415.20(b) / 415.30; if FL-105 is missing at filing it can be filed later but no custody order can issue until it is on file and served, and entry of FL-180 dissolution judgment with minor children is held until FL-105 is current. The home-state inquiry under FC 3402(g) (lived with a parent for at least 6 consecutive months immediately before filing) decides whether California has initial jurisdiction; if another state qualifies as home state, the federal Parental Kidnapping Prevention Act (28 USC 1738A) preempts California's authority and the case must be filed there even if both parties prefer a California forum. FC 3424 emergency-jurisdiction findings (child present and either abandoned or threatened with mistreatment, abuse, or imminent harm) are reported in FL-105 item 7 and trigger immediate emergency custody orders even if California is not the home state. Each child needs a residence history for the past 5 years, capped at 4 children with 5 address rows on the base form; overflow uses FL-105(A) attachment, not MC-025 (the FC 3429 form-of-record requirement is specific to FL-105/FL-105(A)). FL-105 is signed under penalty of perjury per CCP 2015.5 and must be kept current; a parent who learns of a new proceeding (juvenile dependency under W&I 300, guardianship under PC 1500, sibling case in another county, out-of-state custody case, Hague abduction proceeding) must update FL-105 under FC 3429, and prior Hague Convention abduction proceedings under FC 3445 or pending FC 3441 inconvenient-forum motions belong on the supplemental disclosure too. FC 3404 unjustifiable conduct (parent who has hidden the child, fled California with the child, or otherwise gamed home-state qualification) can lead the court to decline jurisdiction even when statutorily available.
    FL-110
    Summons (Family Law)
    Summons (Family Law). When the FL-100 dissolution involves minor children, the petitioner attaches FL-105 to the FL-100 + FL-110 service packet so the respondent receives the petitioner's UCCJEA declaration with the initial papers, and the respondent's own UCCJEA disclosure duty under Family Code section 3429 begins to run from the same service moment. FL-105 and FL-110 carry independent jurisdictional functions: FL-110 is personal jurisdiction over the respondent (CCP 415.10 personal service, 415.20(b) substituted service, or 415.40 service outside California establish the respondent's appearance window and start the 30-day FC 2020 / CCP 412.20(a)(3) response clock), while FL-105 supplies the subject-matter jurisdiction facts that let the court make custody orders at all. FC 3409 bars the court from issuing any custody order until an FL-105 declaration is on file from the party raising custody; FC 3421 fixes home-state-of-the-child as the controlling subject-matter jurisdiction rule, and FC 3402(g) defines home state as the state where the child lived with a parent for at least 6 consecutive months immediately before the action. Filing FL-100 + FL-110 without FL-105 in a children case produces a properly opened dissolution but no power to enter custody orders until FL-105 is filed and served; the omission also voids the custody portion of any later FL-180 judgment for lack of subject-matter jurisdiction (FC 3402, 3421). The FL-110 ATROs under FC 2040 do, however, restrict child-relocation from the date FL-110 is served regardless of FL-105 status, because the ATROs are not custody orders within the meaning of FC 3409.
    FL-120
    Response (Marriage/Domestic Partnership)
    Response (Marriage/Domestic Partnership). When minor children are involved, the respondent who appears by FL-120 has the same UCCJEA disclosure duty the petitioner had at FL-100: under Family Code section 3409 the court cannot make any custody order without an FL-105 declaration on file from the party raising custody, and the UCCJEA chapter (FC 3400-3465) gives every party seeking custody orders an independent disclosure obligation. So the respondent attaches FL-105 to FL-120 either to start the home-state inquiry the petitioner never started (if FL-100 was filed without FL-105) or to put divergent facts in the file when the respondent's information differs from the petitioner's FL-105. The 'home state' anchor under FC 3402(g) (the state where the child lived with a parent for at least 6 consecutive months immediately before the action) is the single fact the court uses to decide whether California has subject-matter jurisdiction at all; if the respondent has been raising the child in another state during that window, the respondent's FL-105 may itself bar California jurisdiction under FC 3421 and force the petitioner to refile in the child's home state. The respondent's FL-105 must also disclose any pending custody / dissolution / DV proceeding in another state (FC 3429), any out-of-state custody order in force (FC 3443 enforcement), and any Hague Convention return application. If the petitioner already filed a full FL-105 and the respondent's facts match precisely, the respondent may agree-and-incorporate on FL-120 instead of refiling; any divergence on the 5-year address chain, persons with physical custody, or ongoing proceedings requires the respondent's own FL-105 (and FL-105(A) continuation for more than 4 children or 5 address rows).
    FL-300
    Request for Order
    Request for Order. FL-105 (or an updated FL-105 reflecting current child residence facts) is REQUIRED whenever FL-300 requests custody or visitation orders (boxes 1.a custody or 1.b visitation checked) and no current FL-105 is already on file in the case; without Uniform Child Custody Jurisdiction and Enforcement Act (UCCJEA) jurisdictional facts the court cannot make any custody order under Family Code section 3409(a) and 3421, even on an in-case motion in an otherwise valid FL-100 case, because subject-matter jurisdiction over custody is FACT-DEPENDENT (the child's home state, significant connections, ongoing custody proceedings in any state) and the FL-105 declaration is the court's primary evidence of those facts. FL-300 itself flags this requirement on page 1 with a fact-check item directing the moving party to attach FL-105 if custody / visitation is requested. An updated FL-105 is ALSO required when the children's residence has changed since the FL-105 originally filed with FL-100 or FL-120, even if a prior FL-105 covered jurisdiction at case opening: the UCCJEA continuing-jurisdiction analysis under FC 3422 turns on whether the children still have significant connections to California (i.e. whether the child OR the child + at least one parent still lives in California) and whether substantial evidence concerning the child's care, protection, training, and personal relationships is available in California; if the children moved to another state, the court may need to communicate with the foreign-state court under FC 3410 and decline modification jurisdiction under FC 3422(a)(1). FL-105 is filed at the same time as FL-300 and served on the responding party with the FL-300 packet under Cal. Rules of Court rule 5.92 (personal service under CCP 415.10 if the responding party has not yet appeared, or first-class mail under CCP 1013(a) plus 16-court-day notice under CCP 1005(b) if they have appeared and have not opted out of mail service). Missing FL-105 with an FL-300 custody motion is a near-automatic continuance for fact-finding, and the moving party loses the ex parte / accelerated calendar if requested.
    FL-191
    Child Support Case Registry Form
    Child Support Case Registry Form. Both forms are mandatory whenever the case involves minor children: FL-105 at the caption stage to confirm UCCJEA jurisdiction over the children under Family Code sections 3400-3465 (the Uniform Child Custody Jurisdiction and Enforcement Act, with the home-state rule defined at FC 3402(g)), and FL-191 at the support-order stage to register each parent's contact and employer information with the State Case Registry under Family Code section 4014 (mandatory attachment to every order or modification of child support, family support, or spousal support that involves a child). FL-191 is filed by each parent separately, not jointly, because the registry holds separate records for each obligor and obligee; FC 4014 specifically requires the obligor's employer information so the child-support order can be enforced through an income-withholding order under FC 5230 (automatic earnings assignment on every support order issued, modified, or renewed) and FC 5232 (employer must begin withholding within 10 days of receiving the order), feeding the actual wage withholding on a future FL-195 earnings assignment. The two forms share the same child-identification baseline: the children listed on FL-105 items 1.a, 2.a, 3.a, and 4.a are the same children whose names and dates of birth appear on FL-191 page 1 item 7, with Social Security numbers required for the State Case Registry under federal 42 USC 666(a)(13) (the federal IV-D mandate that states collect SSNs for support-order enforcement). Any discrepancy between the two filings is a clerk-rejection trigger because the State Case Registry tracks each child by the SSN / DOB combination that FL-105 already established, and the State Case Registry feeds the federal Parent Locator Service under 42 USC 653 for interstate enforcement of orders. FL-105 stays in force throughout the case (FC 3409 bars the court from making custody orders without an FL-105 on file from the party who first raised custody); FL-191 is updated whenever a parent's address, phone, employer, or health-insurance carrier changes, under FC 4014(b) (parents must notify the registry of changes within 10 days). FL-191 is confidential and held in the State Case Registry, not the public court file under FC 4014(a); only pages 1 and 2 are filed with the court (pages 3 and 4 are the parents' worksheets and stay with each parent for reference). For DV-protected parties, FL-191 includes a confidential-address election that keeps the protected party's residence from the other parent and from the public file, parallel to the Safe at Home address-confidentiality program under Gov. Code section 6206. Where a Local Child Support Agency (LCSA) is appearing under FC 17400, FL-191 plus a copy of FL-105 flow to LCSA under FC 17430, and LCSA uses the registry data to perform employer location and wage garnishment without separate discovery. Health-insurance orders required by FC 3751 also feed off FL-191 employer data because the order routes to the employer's group health plan administrator under FC 3760.
    POS-030
    Proof of Service by First-Class Mail (Civil)
    Proof of Service by First-Class Mail. The right service vehicle for FL-105 depends on whether the form rides with the initial FL-100 + FL-110 packet or arrives later. When FL-105 is served as part of the initial packet, the FL-110 personal-service rule under Code of Civil Procedure section 415.10 governs the whole packet (personal service on the respondent), and POS-030 is NOT used; the petitioner uses FL-115 (Proof of Service of Summons) or POS-010 (Proof of Personal Service, Civil) to prove personal service of the entire packet, with alternates CCP 415.20(b) substituted service and CCP 415.40 service outside California available when personal service is impractical. POS-030 first-class-mail service is appropriate only when FL-105 is filed or updated later in the case and the other party has already appeared, because under CCP 1013(a) any party who has appeared is served by mail rather than personal service. Common later scenarios: (a) an updated petitioner FL-105 served on the respondent before an FL-300 custody RFO when the child's residence facts have changed since the original filing, (b) a respondent's own FL-105 served on the petitioner with FL-120 when the respondent's UCCJEA facts diverge from the petitioner's earlier filing, (c) the petitioner's updated FL-105 served before FL-180 prove-up to refresh home-state and ongoing-proceedings facts that have shifted during the case. Family-law-specific FL-335 (Proof of Service by Mail) is preferred in many counties because the layout matches FL-110 / FL-115 sibling forms; POS-030 is the underlying CCP-side equivalent and is accepted statewide. CCP 1013(a) requires the server be 18 or older and not a party. The two-track distinction (personal at filing, mail thereafter) is the FC 215 rule that governs every later family-law motion paper.
    FL-180
    Judgment (Family Law)
    Judgment (Family Law). When FL-180 contains custody / visitation orders for minor children (item 4.j legal custody, item 4.k physical custody, item 4.l(1)-(4) visitation), FL-105 must be on file establishing the court's UCCJEA jurisdiction over those children under Family Code section 3409 (no custody order without an FL-105 declaration), section 3402(g) (home-state rule: the state where the child lived with a parent for at least 6 consecutive months immediately before the action), and section 3421 (initial child custody jurisdiction analysis). Custody orders entered without an FL-105 declaration on file are voidable for lack of UCCJEA jurisdiction and can be collaterally attacked under FC 3422 (continuing exclusive jurisdiction analysis). The children listed on FL-105 items 1.a, 2.a, 3.a, 4.a must match the children whose custody is being adjudicated on FL-180 letter for letter; a mismatch sends the judgment back. If the children's residence has changed in the 5-year address chain since the FL-105 was originally filed with FL-100 or FL-120 (a parent moved with the child, a child went to live with a grandparent, etc.), an updated FL-105 is filed before the FL-180 prove-up under FC 3429 so the judgment rests on current jurisdictional facts; the court records the change on the FL-180 judgment in item 4.k. Even where no party challenges jurisdiction, the FL-105 is mandatory: the judge cannot sign FL-180 with custody orders unless at least one party's FL-105 (current or properly amended) is in the file. Out-of-state-only contact is preserved through FC 3424 emergency-jurisdiction analysis when relevant; FL-105 item 5 carries that disclosure.
    FL-150
    Income and Expense Declaration
    Income and Expense Declaration. Cases involving minor children (the FL-105 trigger under Family Code section 3409) almost always involve child support, and FL-150 is required at any hearing where child support is set or modified under California Rules of Court 5.260(a)(1)-(3) and Family Code section 3552(a). Both parents file FL-150 if both ask the court to set support; the FL-150s plus the child-residence facts on FL-105 together drive the guideline child support calculation under FC 4055(a)-(b), the algebraic formula CS = K[HN - (H%)(TN)] where K is the income-adjusted factor from the FC 4055(b)(3) table, HN comes from the high earner's net disposable income computed under FC 4058 (gross income including employment, self-employment, and income from assets) and FC 4059 (deductions for taxes, mandatory union dues, health-insurance premiums, retirement contributions, and child or spousal support paid under a prior order), TN is the combined net disposable income of both parents, and H% is each parent's approximate timeshare with the children. The FC 4053(a)-(l) statutory factors (the parent's first and principal obligation to support; the support of children consistent with parents' station in life; both parents' mutually responsible support; etc.) frame the FC 4055 calculation; FC 4057(a) makes guideline support a rebuttable presumption and FC 4057(b) permits departure only on specific written findings; FC 4076(b) applies the low-income adjustment formula for obligors with net disposable below the floor; FC 4060 sets monthly timeshare conventions; and FC 4061-4063 add mandatory and discretionary add-ons (child-care related to employment under FC 4062(a)(1); uninsured health-care expenses for the children under FC 4062(a)(2); travel expenses for visitation under FC 4063). The FL-105 child-residence facts (items 1.a through 4.a listing residence over the last 5 years) feed the FL-150 page 1 item 3 timeshare percentage; mismatches between the two (for example FL-105 shows a child living with parent A for the last 18 months but FL-150 reports 50 / 50 timeshare) are flagged by DCSS and bench officers as the most common reason guideline support is recalculated downward from the requesting parent's number. FL-150 financial detail (W-2s, paystubs, last federal and state tax returns) is confidential under FC 3552(a) and stays in a sealed envelope under FC 3552(b), with copies delivered to the other party under FC 3553; FL-105 is part of the public court file because UCCJEA jurisdiction is an adjudicative fact. Both forms must be current at hearing: FL-150 within 90 days under CRC 5.260(a)(3); FL-105 must reflect any residence change within 30 days under FC 3429, with relocation specifically governed by FC 7501 and the Marriage of LaMusga (2004) 32 Cal.4th 1072 move-away factors. A stale FL-105 plus a stale FL-150 is the most common reason a first-appearance child-support hearing gets continued. Modification of an existing support order requires FL-300 plus a fresh FL-150 (and an updated FL-105 if residence facts changed); FC 3653(a) limits any modification's retroactive reach to the date of filing the FL-300 motion, so filing delay costs the moving party real money. Where the Local Child Support Agency is appearing under FC 17400, LCSA receives copies of both forms under FC 3553 and FC 17430 controls LCSA's filing protocols; LCSA can lodge FL-195 to assign the obligor's wages once the child-support order issues (FL-195 is the child-support wage assignment, distinct from FL-435 which is the spousal-support wage assignment under FC 5208). FL-191 (Child Support Case Registry) attaches to the FL-150 / FL-105 stack at the order hearing under FC 4014, separately from FL-105 itself but typically filed in the same packet for any hearing where child support is set or modified.
    DV-100
    Request for Domestic Violence Restraining Order
    Request for Domestic Violence Restraining Order. FL-105 (or DV-105 carrying the same UCCJEA facts in DV-specific form) is required whenever the DV-100 petitioner asks for child custody, visitation, or any other child-related order (the DV-105 Request for Child Custody and Visitation Orders, DV-140 child-related orders, DV-145 supervised visitation, and the custody provisions of any DV-130 final order all flow through the UCCJEA gate). The UCCJEA chapter at Family Code sections 3400-3465 governs subject-matter jurisdiction over child custody whether the order rides on a DV petition, a dissolution, a parentage case, or a stand-alone custody case, and FC 3409 bars the court from entering ANY custody order without a UCCJEA declaration on file from the party raising custody, regardless of how strong the violence findings on DV-100 items 4-7 are. The 'home state' rule at FC 3402(g) and FC 3421 controls: California has initial custody jurisdiction only if the child has lived with a parent in California for the 6 months immediately preceding the DV-100. If the child was just brought to California in the DV petitioner's flight from the abuser, the court may take emergency jurisdiction under FC 3424 (temporary order for abandoned, abused, or threatened children) based on the abuse findings while deferring to the home state for the permanent custody order; FL-105 documents the facts the court needs for both the 3421 / 3424 decision. File FL-105 (or DV-105) simultaneously with DV-100 when children are involved; without it the judge may decline to enter custody on DV-130 even when the violence findings support the rest of the restraining order, and the petitioner may have to file FL-105 later before custody can be added. FL-105(A) is the continuation for more than 4 children or 5 address rows.

    Field-by-field guidance

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    Your Name
    blocker

    Caption.

    • Filers list a nickname.
    • Filers omit middle name on a name that includes one.
    Firm Name
    none

    Attorneys only.

    • Pro se filers fill with employer.
    • Attorneys list lead partner only.
    Bar Number
    none

    Attorneys only.

    • Pro se filers fill with DL.
    • Out-of-state attorneys use home-state bar.
    Your Street
    blocker

    Caption street; can be confidential under Family Code 3429 in DV cases.

    • Filers list rental address.
    • Filers list P.O. Box only.
    Your City
    blocker

    Caption city.

    • Filers list county.
    • Filers abbreviate.
    Your State
    blocker

    Caption state.

    • Filers spell out California.
    • Filers use lowercase.
    Your Zip
    blocker

    Caption ZIP.

    • Filers paste ZIP+4 with dash.
    • Filers guess.
    Your Phone
    blocker

    Caption phone.

    • Filers list outdated phone.
    • Filers list work number.
    Your Email
    none

    Optional.

    • Filers paste rarely-checked email.
    • Pro se filers worry about leaving blank.
    Atty For
    blocker

    Identifies whom the filer represents.

    • Pro se filers leave blank.
    • Filers write the wrong role.
    Court County
    blocker

    Same county as underlying case.

    • Filers list county they live in.
    • Filers add 'County of'.
    Court Street
    blocker

    Court street.

    • Filers list courthouse name.
    • Filers use old address.
    Court Mailing
    none

    Optional, only if different.

    • Filers fill when same as street.
    • Filers paste their own P.O. Box.
    Court City Zip
    blocker

    Court city/ZIP.

    • Filers list only the city.
    • Filers use old courthouse ZIP.
    Court Branch
    blocker

    Branch name.

    • Filers leave blank in multi-branch counties.
    • Filers type informal name.
    Petitioner Caption
    blocker

    Petitioner from underlying case.

    • Filers shorten the petitioner's name.
    • Filers use a nickname.
    Respondent Caption
    blocker

    Respondent from underlying case.

    • Filers shorten the respondent's name.
    • Filers use a nickname.
    Other Party Caption
    none

    Other party in parentage or DCSS cases.

    • Filers leave blank when third party joined.
    • Filers fill when no third party.
    Juvenile Child Name
    none

    Required only in juvenile cases.

    • Filer leaves blank in juvenile cases.
    • Filer fills in non-juvenile cases.
    Guardianship Minor Name
    none

    Required only in probate guardianship cases.

    • Filer leaves blank in guardianship cases.
    • Filer fills in non-guardianship cases.
    Case Number
    none

    Blank when filed with original petition; clerk assigns. Required if filed later.

    • Filers leave blank.
    • Filers paste with extra spaces.
    Short Title P2
    warning

    Page 2 short title; auto-fillable from caption.

    • Filer leaves blank.
    • Filer types full caption when 'short title' is expected.
    Filer Role
    blocker

    Required: party OR authorized agency representative.

    • Filer marks the wrong role.
    • Filer leaves blank.
    Agency Name
    warning

    Required if filer_role == auth_rep.

    • Filer leaves blank when agency-affiliated.
    • Filer fills as a parent.
    Num Children
    blocker

    Number of minor children subject to this proceeding.

    • Filer counts only one child when multiple exist.
    • Filer guesses.
    Child1 Name
    blocker

    First child's full name. At least one child must be listed.

    • Filer uses nickname.
    • Filer omits middle name on legal documents.
    Child1 Dob
    blocker

    First child's date of birth.

    • Filer lists year only.
    • Filer guesses.
    Child1 Birthplace
    blocker

    City and state where the child was born.

    • Filer omits state.
    • Filer lists country when child born in U.S.
    Child2 Name
    warning

    Second child if any.

    • Filer leaves blank when 2+ children.
    • Filer combines names.
    Child2 Dob
    warning

    Second child DOB.

    • Filer lists year only.
    • Filer guesses.
    Child2 Birthplace
    warning

    Second child birthplace.

    • Filer omits state.
    • Filer lists country.
    Child3 Name
    warning

    Third child if any.

    • Filer leaves blank when 3+ children.
    • Filer combines names.
    Child3 Dob
    warning

    Third child DOB.

    • Filer lists year only.
    • Filer guesses.
    Child3 Birthplace
    warning

    Third child birthplace.

    • Filer omits state.
    • Filer lists country.
    Child4 Name
    warning

    Fourth child if any.

    • Filer leaves blank when 4+ children.
    • Filer combines names.
    Child4 Dob
    warning

    Fourth child DOB.

    • Filer lists year only.
    • Filer guesses.
    Child4 Birthplace
    warning

    Fourth child birthplace.

    • Filer omits state.
    • Filer lists country.
    More Children Attachment
    none

    Check if 5+ children; use Attachment 2 / FL-105(A).

    • Filer marks without attaching FL-105(A).
    • Filer leaves blank when 5+ children.
    Residence Pattern
    blocker

    Required: single child or all-together (3a) vs separated (3b uses FL-105(A)).

    • Filer marks 'lived together' when children moved between parents.
    • Filer leaves blank.
    Addr1 From
    warning

    Current residence start date. Required if residence_pattern == together.

    • Filer lists end date in 'from' field.
    • Filer guesses date.
    Addr1 Residence
    warning

    Current residence (City, State).

    • Filer lists current address only when 5-year history requires more.
    • Filer omits unit number.
    Addr1 Person
    warning

    Person child currently lives with (name + complete address).

    • Filer leaves blank.
    • Filer lists role only without name.
    Addr1 Relationship
    warning

    Relationship to that person.

    • Filer uses informal language.
    • Filer leaves blank.
    Addr1 Confidential Residence
    none

    Optional confidential-residence flag.

    • Filer marks unnecessarily.
    • Filer leaves blank when DV concerns warrant confidentiality.
    Addr1 Confidential Person
    none

    Optional confidential-person-address flag.

    • Filer marks unnecessarily.
    • Filer leaves blank when DV concerns warrant confidentiality.
    Addr2 From
    none

    Address 2 start.

    • Filer's addr2_from does not equal addr1_from end.
    • Filer guesses.
    Addr2 To
    none

    Address 2 end.

    • Filer leaves blank when there's a defined end date.
    • Filer fills with future date.
    Addr2 Residence
    none

    Address 2 residence.

    • Filer lists current.
    • Filer omits unit number.
    Addr2 Person
    none

    Address 2 person.

    • Filer leaves blank.
    • Filer lists role only.
    Addr2 Relationship
    none

    Address 2 relationship.

    • Filer uses informal language.
    • Filer leaves blank.
    Addr3 From
    none

    Address 3 start.

    • Filer's addr3_from does not align with addr2_to.
    • Filer guesses.
    Addr3 To
    none

    Address 3 end.

    • Filer leaves blank.
    • Filer fills with future date.
    Addr3 Residence
    none

    Address 3 residence.

    • Filer lists current.
    • Filer omits unit number.
    Addr3 Person
    none

    Address 3 person.

    • Filer leaves blank.
    • Filer lists role only.
    Addr3 Relationship
    none

    Address 3 relationship.

    • Filer uses informal language.
    • Filer leaves blank.
    Addr4 From
    none

    Address 4 start.

    • Filer's date does not align.
    • Filer guesses.
    Addr4 To
    none

    Address 4 end.

    • Filer leaves blank.
    • Filer fills future date.
    Addr4 Residence
    none

    Address 4 residence.

    • Filer lists current.
    • Filer omits unit number.
    Addr4 Person
    none

    Address 4 person.

    • Filer leaves blank.
    • Filer lists role only.
    Addr4 Relationship
    none

    Address 4 relationship.

    • Filer uses informal language.
    • Filer leaves blank.
    Addr5 From
    none

    Address 5 start.

    • Filer's date does not align.
    • Filer guesses.
    Addr5 To
    none

    Address 5 end.

    • Filer leaves blank.
    • Filer fills future date.
    Addr5 Residence
    none

    Address 5 residence.

    • Filer lists current.
    • Filer omits unit number.
    Addr5 Person
    none

    Address 5 person.

    • Filer leaves blank.
    • Filer lists role only.
    Addr5 Relationship
    none

    Address 5 relationship.

    • Filer uses informal language.
    • Filer leaves blank.
    More Addresses Attachment
    none

    Check if more than 5 addresses; use Attachment 3a.

    • Filer marks without attaching.
    • Filer leaves blank when 6+ addresses in 5 years.
    Other Cases Yn
    blocker

    Required Yes/No.

    • Filer marks 'no' to avoid disclosure.
    • Filer leaves blank.
    Case4a Family
    none

    Family case number. Required if other_cases_yn == yes and a family case applies.

    • Filer leaves blank when family case exists.
    • Filer fills when no family case.
    Case4a Court
    none

    Family case court.

    • Filer leaves blank when case4a_family.
    • Filer lists county only without court.
    Case4a Order Date
    none

    Family case order date.

    • Filer leaves blank when case4a_family.
    • Filer guesses.
    Case4a Child Names
    none

    Family case child names.

    • Filer leaves blank.
    • Filer lists nicknames.
    Case4a Your Role
    none

    Family case your connection.

    • Filer uses informal language.
    • Filer leaves blank.
    Case4a Status
    none

    Family case status.

    • Filer leaves blank.
    • Filer marks both pending and closed.
    Case4b Probate Case No
    none

    Probate guardianship case number.

    • Filer leaves blank when probate exists.
    • Filer fills when no probate.
    Case4b Probate Court
    none

    Probate guardianship court.

    • Filer leaves blank when case4b filled.
    • Filer lists county only.
    Case4c Other Case No
    none

    Other case number.

    • Filer leaves blank when other case exists.
    • Filer fills when no other case.
    Case4c Other Court
    none

    Other case court.

    • Filer leaves blank when case4c filled.
    • Filer lists county only.
    Case4d Juvenile Case No
    none

    Juvenile case number.

    • Filer leaves blank when juvenile case exists.
    • Filer fills when no juvenile case.
    Case4d Juvenile Court
    none

    Juvenile case court.

    • Filer leaves blank when case4d filled.
    • Filer lists county only.
    Case4e Adoption Case No
    none

    Adoption case number.

    • Filer leaves blank when adoption case exists.
    • Filer fills when no adoption case.
    Case4e Adoption Court
    none

    Adoption case court.

    • Filer leaves blank when case4e filled.
    • Filer lists county only.
    Dvro In Effect
    none

    Boolean: any restraining/protective orders in effect.

    • Filer marks 'no' to avoid disclosure.
    • Filer leaves blank.
    Ro5a County
    none

    Criminal RO county.

    • Filer leaves blank when DVRO exists.
    • Filer lists state only.
    Ro5a State
    none

    Criminal RO state/tribe.

    • Filer leaves blank.
    • Filer spells out state.
    Ro5a Case No
    none

    Criminal RO case number.

    • Filer leaves blank.
    • Filer guesses.
    Ro5a Expires
    none

    Criminal RO expiration.

    • Filer leaves blank.
    • Filer types 'permanent'.
    Ro5b County
    none

    Family RO county.

    • Filer leaves blank when 2+ ROs exist.
    • Filer lists state only.
    Ro5b State
    none

    Family RO state/tribe.

    • Filer leaves blank.
    • Filer spells out state.
    Ro5b Case No
    none

    Family RO case number.

    • Filer leaves blank.
    • Filer guesses.
    Ro5b Expires
    none

    Family RO expiration.

    • Filer leaves blank.
    • Filer types 'permanent'.
    Ro5c County
    none

    Juvenile RO county.

    • Filer leaves blank when 3+ ROs exist.
    • Filer lists state only.
    Ro5c State
    none

    Juvenile RO state/tribe.

    • Filer leaves blank.
    • Filer spells out state.
    Ro5c Case No
    none

    Juvenile RO case number.

    • Filer leaves blank.
    • Filer guesses.
    Ro5c Expires
    none

    Juvenile RO expiration.

    • Filer leaves blank.
    • Filer types 'permanent'.
    Ro5d County
    none

    Other RO county.

    • Filer leaves blank when 4+ ROs exist.
    • Filer lists state only.
    Ro5d State
    none

    Other RO state/tribe.

    • Filer leaves blank.
    • Filer spells out state.
    Ro5d Case No
    none

    Other RO case number.

    • Filer leaves blank.
    • Filer guesses.
    Ro5d Expires
    none

    Other RO expiration.

    • Filer leaves blank.
    • Filer types 'permanent'.
    Other Persons Yn
    blocker

    Required Yes/No.

    • Filer marks 'no' to avoid disclosure.
    • Filer leaves blank.
    Person6a Name
    warning

    Required if other_persons_yn == yes.

    • Filer leaves blank when other person exists.
    • Filer uses nickname.
    Person6a Role
    warning

    Required if person6a_name is filled.

    • Filer uses informal language.
    • Filer leaves blank.
    Person6a Children
    warning

    Required if person6a_name is filled.

    • Filer leaves blank.
    • Filer lists role only.
    Person6b Name
    none

    Optional second non-party.

    • Filer leaves blank when 2+ others exist.
    • Filer uses nickname.
    Person6b Role
    none

    Optional.

    • Filer uses informal language.
    • Filer leaves blank.
    Person6b Children
    none

    Optional.

    • Filer leaves blank.
    • Filer lists role only.
    Person6c Name
    none

    Optional third non-party.

    • Filer leaves blank when 3+ others exist.
    • Filer uses nickname.
    Person6c Role
    none

    Optional.

    • Filer uses informal language.
    • Filer leaves blank.
    Person6c Children
    none

    Optional.

    • Filer leaves blank.
    • Filer lists role only.
    Pages Attached
    info

    Number of attachment pages.

    • Filer leaves blank when attachments exist.
    • Filer undercounts.
    Verification Date
    blocker

    Date of declaration under penalty of perjury.

    • Filer post-dates.
    • Filer signs before completing.
    Verification Name
    blocker

    Printed name of declarant.

    • Filer prints nickname.
    • Filer leaves blank.

    Ezel is a self-help tool. Ezel is not a law firm and does not provide legal advice. You are the filer. Review the form carefully before submitting it to the court, and consult a licensed attorney if you have questions about your case. For free legal help, contact your local legal aid office or court self-help center.

    Sources

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