San Bernardino — SB-11292

Source: https://sanbernardino.courts.ca.gov/system/files/sb-11292.pdf

Attorney or Party Without An Attorney (Name, State Bar No. & Address) For Court Use Only

Telephone No. Attorney for: Superior Court of California, County of San Bernardino

Petitioner:

Respondent:

CASE NUMBER

PETITION FOR FAMILY VISITATION

1. Parent ____________________________ of the below-listed minor child(ren) is deceased. Petitioner is related to the
   deceased parent as follows:

   child of deceased parent sibling of deceased parent grandparent of deceased parent

   Name of Child Birthdate Identify Person Living With Other Parent’s Name & County of Residence

2. Describe the relationship and the bonding between each child and the petitioner(s). Explain the reason why family
   visitation is in the best interest of each child: See attachment

   ---

   SB-11292 Petition for Family Visitation Page 1 of 2
   03/12/13 rev. optional use Family Code, Section 3102

Petitioner: Case Number

Respondent:

3. Describe the duration and frequency of visitation that is being requested: See attachment

4. A completed Declaration under the Uniform Child Custody Jurisdiction and Enforcement Act (Form FL-105) is attached, as there is no existing Family Law Case and this Petition shall start a new matter.

5. Petitioner(s) request that the court grant reasonable visitation with the above-named child(ren), and such other relief as
   the court may deem appropriate, pursuant to Family Code Section 3102. A Request for Order is being concurrently
   filed in order to request a hearing date on the request for visitation.

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

Date:

---

(Type or Print Name Here) (Sign Name Here)

---

(Type or Print Name Here) (Sign Name Here)

_______________________________________________________________________
SB-11292 Petition for Family Visitation Page 2 of 2
03/12/13 rev. optional use Family Code, Section 3102