San Bernardino — 16-6477-356

Source: https://sanbernardino.courts.ca.gov/system/files/16-6477-356petitionforconciliation.pdf

Attorney or Party without Attorney ( Name, Address and Telephone number) For Court Use Only

SUPERIOR COURT OF CALIFORNIA, COUNTY OF SAN BERNARDINO

STREET ADDRESS

MAILING ADDRESS

CITY AND ZIP CODE

BRANCH NAME

Plaintiff(s):

Defendant(s): PETITION FOR CONCILIATION CASE NUMBER:

To the Conciliation Court:

Name of Petitioner or Petitioner(s)

Allege . . . as follows: (a) That a controversy exists between the parents herein, and request the aid of said Court to effect a reconciliation or an amiable settlement of the controversy.

(b) That the name and age of each minor child whose welfare may be affected by the said
controversy is as follows:
Name: Age:
Name: Age:
Name: Age:
Name: Age:

(c) That the name and address of each petitioner is as follows:
Name: Address:
Name: Address:
Name: Address:
Name: Address:

(d) That the (husband) (wife) of the petitioner is:
Name: Address:
Telephone Number: ; and that said (husband) (wife) is named as
respondent.

(e) That whose address is
has a relation to said controversy within the meaning of Section 1763, Code of Civil Procedure,
(Statues 1939, Chap. 737) and is hereby also named as respondent herein.

Dated: by:

PETITION FOR CONCILIATION

16-6477-356 Rev. 04-2014