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JV-505

Statement Regarding Parentage

Clerk stamps date here when form is filed.

Child's name: _____________________________________________

a.

b.

c.

I am not the parent of this child. I do not wish to participate in 
juvenile court proceedings about this child. I understand that:

I will receive no further notices of hearings in this matter.

I will not get a chance for custody of this child or court-ordered 
visitation with this child.

If the child cannot be returned to a custodial parent or guardian, 
it is possible that all parental rights will be terminated and the 
child will be adopted.

d. This denial applies only to the juvenile court proceedings and 

does not prevent the local child support agency from seeking to 
have another court determine that I am the child’s parent for 
purposes of support of the child. If that occurs, I will have the 
right to a court trial, to confront and cross-examine witnesses 
and present evidence on my behalf, and to be represented by a 
lawyer who may be appointed if I cannot afford to hire one.

I know I can have an attorney for this.

a.

b.

I want the judge to appoint an attorney for me.
or
I give up my right to an attorney.

Fill in court name and street address:

Superior Court of California, County of

Fill in case number if known:
Case Number:

I do not know if I am the parent of the child and I 
determine whether or not I am the biological parent. I understand that: 
a.

consent to    

If I am judged to be the parent of the child, I will have to support the child until the child reaches the age of 
18 and has completed high school, or completes high school between the ages of 18 and 19, or reaches the 
age of 19, whichever comes first.

request   

blood or DNA testing to 

b.

If I do not support the child when I have the money to do so, I may be charged with a crime under Penal 
Code section 270 and, if convicted, could be sentenced to pay a fine of up to $2,000 and spend up to one year 
in county jail, or one year and a day in state prison.

I believe I am the child’s parent and request that the court enter a judgment of parentage. I understand that:
a.

If I am judged to be the parent of the child, I will have to support the child until the child reaches the age of 
18 and has completed high school, or completes high school between the ages of 18 and 19, or reaches the 
age of 19, whichever comes first.

b.

If I do not support the child when I have the money to do so, I may be charged with a crime under Penal 
Code section 270 and, if convicted, could be sentenced to pay a fine of up to $2,000 and spend up to one year 
in county jail or one year and a day in state prison.

IMPORTANT NOTICE ON PAGE 4. READ BEFORE SIGNING.

Judicial Council of California, www.courtinfo.ca.gov 
Revised January 1, 2008, Mandatory Form
Family Code, §§ 7540, 7541, 7611, 7611.5, 7612, 8612, 
8714, 8714.5, 8902, 8912, 9000

Statement Regarding Parentage
(Juvenile) 

JV-505, Page 1 of 4

I have already established parentage of the child by (if known):
a.
A voluntary declaration signed by me on (date):
A copy is attached.
A court judgment of parentage on (date):
A copy is attached.

b.

I am married to the child's parent. Date of marriage: _____________________

Case Number:

in (county):

Your name:

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I believe I am the parent of the child and request that the court find that I am the presumed parent of the child.
a.
b.

The child lived with me from                        to                        and from                         to                       .
I have told the following people that the child is mine:

Check here if you need more space. Attach a sheet of paper and write “JV-505, Item 8b—People I 
Have Told the Child Is Mine” at the top. Number of pages attached: ____

c.

I have participated in the following activities with the child (for example, school, daycare, sports):

Check here if you need more space. Attach a sheet of paper and write “JV-505, Item 8c—Child’s 
Activities” at the top. Number of pages attached: ____

Revised January 1, 2008

JV-505, Page 2 of 4

Statement Regarding Parentage
(Juvenile)

Your name:

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d.

I have given the following money or things to the child:

Case Number:

Check here if you need more space. Attach a sheet of paper and write “JV-505, Item 8d—Things 
Given to Child” at the top. Number of pages attached: ____

e.

The child has spent the following time with my family:

Check here if you need more space. Attach a sheet of paper and write “JV-505, Item 8e—Other 
Information” at the top. Number of pages attached: ____

f.

Other information I want the court to know is:

Check here if you need more space. Attach a sheet of paper and write “JV-505, Item 8f—Other 
Information” at the top. Number of pages attached: ____

Date:

Date:

Type or print your name

Sign your name

Type or print your attorney’s name

Signature of your attorney

Revised January 1, 2008

JV-505, Page 3 of 4

Statement Regarding Parentage
(Juvenile)

•
       As the child’s alleged parent, you will not get services to help you get your child back. You
       will not automatically get the child to live with you or your relatives.

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       If the judge finds that you are the child’s parent, the judge may order services to help you get the child 
       back, but does not have to order services for you.

       If you say that you are not the child’s parent and will not take a test to find out if you are the parent, and do
       not want services to help you get the child back, you can fill out this form and not be a part of this case. 

       You can have a trial and ask the judge to decide if you are the child’s parent. You can pay a lawyer to be at 
       the trial. If you cannot afford a lawyer, the judge may appoint one for you for free. At a trial, you can ask
       witnesses questions and give evidence to the judge.  

       If you want the court to decide if you are the child’s parent, fill out this form. 

• •

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Your name:

 To the alleged parent of the child:

Case Number:

Revised January 1, 2008

Statement Regarding Parentage
(Juvenile)

JV-505, Page 4 of 4