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PETITIONER: CASE NUMBER: RESPONDENT:

5. The parents of the child(ren) have never been married.
6. The mother of the minor child(ren) is deceased.
7. The father of the minor child(ren) is deceased.

8. Each child named above is currently living with _______________________________
(name), ____________________ (relationship to child(ren), in ___________________
County, ________________________ (state), _________________________(country).

9. I agree to the visitation schedule requested on page 3 of the Petition for Grandparent
Visitation (FL-15).

10. Respondent objects to Petitioner’s request for visitation rights with the minor child(ren)
because:
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________

11. Visitation is not in the best interest of the children because there is not a preexisting
relationship between the Petitioner and the grandchild(ren).

12. A completed Declaration Under Uniform Child Custody Jurisdiction & Enforcement
Act – Judicial Council Form (FL-105) is attached.

13. PARENTAL OBJECTION TO PETITIONER’S REQUEST FOR GRANDPARENT
VISITATION: I object to the Petition for Grandparent Visitation.

Date: ___________ ______________________________________
Signature of Parent of Minor Child(ren)

______________________________________
Print Name of Parent of Minor Child(ren)

14. Respondent(s) request(s) that the court deny Petitioner’s request for visitation and for
such other relief as the court deems just.

I declare under penalty of perjury, under the laws of the State of California, that the

foregoing is true and correct, and that this declaration was signed at_______________________, California.

Date: _________________ ____________________________________
Signature of Respondent

____________________________________
Print Name

Form Approved for Mandatory Use Page 2 of 3 FL-16 (Adopted 01/01/11, Revised 07/01/19) RESPONSE TO PETITION FOR GRANDPARENT VISITATION