Merced — MSC-FL-031

Source: https://www.merced.courts.ca.gov/system/files/forms-and-filings/msc-fl-031-cover-page-confidential-records-ada-comp.pdf

MSC-FL-031

ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address): FOR COURT USE ONLY

TELEPHONE NO.: FAX NO. (Optional):

E-MAIL ADDRESS (Optional):

ATTORNEY FOR (Name):

SUPERIOR COURT OF CALIFORNIA, COUNTY OF MERCED STREET ADDRESS: 2260 N Street st MAILING ADDRESS : 627 W. 21 Street CITY AND ZIP CODE: Merced, CA 95340 BRANCH NAME: Family Law

PLAINTIFF/PETITIONER:

DEFENDANT/RESPONDENT:

CASE NUMBER:

COVER PAGE FOR CONFIDENTIAL RECORDS

I, , declare as follows:

I am the Petitioner Respondent Other Parent in this case.

Attached hereto arc true and correct copies of the following confidential incident reports in connection with

Petitioner's Respondent's Other Parent's

Request for Order Request for Domestic Violence Restraining Order Mediation.

1. Report of Police Department dated .

2. Report of Police Department dated .

3. Report of Police Department dated .

4. Report of Police Department dated .

5. Report of Police Department dated .

I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.

Date:

SIGN

(TYPE OR PRINT NAME) (SIGNATURE OF DECLARANT)
Attorney for Plaintiff Petitioner Defendant
Respondent Other (Specify):

For Optional Use COVER PAGE FOR Page 1 of 1 MSC-FL-031 [Rev. Jul. 1, 2019] CONFIDENTIAL RECORDS