Mendocino — EM-100

Source: http://www.courts.ca.gov/documents/em100.pdf

EM-100 ATTORNEY OR PARTY WITHOUT ATTORNEY STATE BAR NUMBER: FOR COURT USE ONLY NAME: FIRM NAME: STREET ADDRESS: CITY: STATE: ZIP CODE: TELEPHONE NO.: FAX NO.: E-MAIL ADDRESS: ATTORNEY FOR (name): SUPERIOR COURT OF CALIFORNIA, COUNTY OF STREET ADDRESS: MAILING ADDRESS: CITY AND ZIP CODE: BRANCH NAME:

IN THE MATTER OF (name): Petitioner, a minor PETITION FOR DECLARATION OF EMANCIPATION OF MINOR CASE NUMBER: ORDER PRESCRIBING NOTICE ORDER DENYING PETITION DECLARATION OF EMANCIPATION

1. My name: My address: I am a resident of or temporarily domiciled in this county.
2. I request that the court declare me to be emancipated.
3. a. I am at least 14 years of age and my date of birth is: b. I am willingly living separate and apart from my parents or legal guardian, with the consent of my parents or legal guardian. I have been living apart from them since (date): c. I am managing my own financial affairs. I have completed my declaration of income and expenses on form EM-115 and attached it to this petition. d. No part of my income comes from any activity that is a crime under the laws of the State of California or of the United States.
4. My mother's name is: Her address is: Her consent to my emancipation is attached. Notice to her should not be required because (state reasons):
5. My father's name is: His address is: His consent to my emancipation is attached. Notice to him should not be required because (state reasons):

6. I have a legal guardian.

My guardian's name is: My guardian's address is: My guardian's consent to my emancipation is attached. Notice to my guardian should not be required because (state reasons): 7. Other person entitled to notice. This person's name is: This person's address is: This person's consent to my emancipation is attached. Notice to this person should not be required because (state reasons): 8. I am a dependent child [probation] ward of the Juvenile Court of County. Case number (if known): My social worker probation officer is (name): His / her consent is attached. I declare under penalty of perjury that the foregoing is true and correct and that this declaration is executed at (place): , California. Date: (SIGNATURE)

Form Adopted for Mandatory § 7000, et seq. Use PETITION FOR DECLARATION OF EMANCIPATION OF MINOR, Family CodeJudicial Council of California www.courts.ca.gov. EM-100 [Rev. September 1, 2018] ORDER PRESCRIBING NOTICE, DECLARATION OF EMANCIPATION, AND ORDER DENYING PETITION

EM-100 NAME OF MINOR CASE NUMBER:

ORDER PRESCRIBING NOTICE

9. The court finds that a. All persons entitled to notice of this proceeding have consented to the emancipation and waived notice of hearing. b. The addresses of the following are unknown. (1) Father (2) Mother (3) Legal guardian c. Notice to the following persons cannot or should not be given: d. Other (specify):
10. IT IS ORDERED that notice of this proceeding a. is not required. The declaration of emancipation may proceed without hearing. b. is required to the following persons: (1) Father (4) Juvenile Court of County (2) Mother for service on social worker or probation officer (3) Legal guardian (5) Legal guardian c. This matter is set for hearing on (date): at (time): in (dept.):

Date: (JUDGE OF THE SUPERIOR COURT)

DECLARATION OF EMANCIPATION WITHOUT HEARING (Only if the court has ordered item 10a above.)

The court finds that the petitioner is a person described by Family Code section 7120. All notice requirements have been met or waived by the court. Emancipation is not contrary to the best interests of the child. THE PETITION IS GRANTED. THE PETITIONER IS DECLARED TO BE EMANCIPATED FOR PURPOSES SET FORTH IN FAMILY CODE SECTION 7050 ET SEQ.

Date: (JUDGE OF THE SUPERIOR COURT)

ORDER DENYING PETITION

The court finds that the petition on its face fails to establish that the petitioner is a person described by Family Code section 7120. THE PETITION IS DENIED.

Date: (JUDGE OF THE SUPERIOR COURT)

[SEAL] CLERK'S CERTIFICATE
(Of Declaration of Emancipation)
I certify that the foregoing is a true and correct copy of the original on file in my office.

Date: Clerk, by , Deputy

EM-100 [Rev. September 1, 2018] PETITION FOR DECLARATION OF EMANCIPATION OF MINOR, Page 2 of 2 ORDER PRESCRIBING NOTICE, DECLARATION OF EMANCIPATION, AND ORDER DENYING PETITION For your protection and privacy, please press the Clear This Form button after you have printed the form. Print this form Save this form Clear this form