San Francisco — Declaration Re: Contact With Consulting Attorney, Mediator, OR Legal Document Preparer or Assistant

Source: https://sf.courts.ca.gov/system/files/forms-and-filings/local-form-1114.pdf

1 Name: Address: 2 Phone Number: Email Address: 3

4 SUPERIOR COURT OF CALIFORNIA, COUNTY OF SAN FRANCISCO 5

6 _____________________, Case No.: _________________________ 7 Petitioner, 8 vs. DECLARATION RE: CONTACT WITH 9 CONSULTING ATTORNEY, MEDIATOR, OR _____________________, LEGAL DOCUMENT PREPARER OR ASSISTANT 10 Respondent 11 I, _________________, am the Petitioner / Respondent in this matter and hereby declare as follows: 12 1. _________________ has worked with me as my Consulting Attorney / Mediator / Legal Document 13 Preparer / Legal Document Assistant (Choose One) to prepare the proposed Judgment package. 14 2. The Court or any of its personnel may communicate directly with ______________________ in person, by 15 telephone, via email, or via mail about the filing of the Judgment package submitted in this case. 16 3. ________________________’s contact information is: 17 Address: 18 Phone Number: Email Address: 19

20 4. If I should ever wish to withdraw this consent, I will promptly file a paper entitled “Withdrawal of

21 Consent.”

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

23

24 Date: _________________ ___________________________

25 Name:

26 Petitioner / Respondent

27 DECLARATION RE: CONTACT WITH CONSULTING ATTORNEY, MEDIATOR, OR LEGAL DOCUMENT 28 PREPARER OR ASSISTANT SFUFC FORM 11.14-A