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Here is the text we could read:

CASE NAME:

FL-105(A)/GC-120(A)

CASE NUMBER:

ATTACHMENT TO 
DECLARATION UNDER UNIFORM CHILD CUSTODY JURISDICTION AND ENFORCEMENT ACT (UCCJEA)

Place of birth

Date of birth

Sex

Child’s name

Residence information is the same as given on form 
FL-105/GC-120 for child a. (If NOT the same, provide the 
information below.)

Period of residence

Present address

Person child lived with (name and complete current  address)

Relationship

to present

Confidential

Confidential

Child's residence (City, State)

Person child lived with (name and complete current  address)

Child's residence (City, State)

Person child lived with (name and complete current  address)

Child's residence (City, State)

Person child lived with (name and complete current  address)

Child’s name

Residence information is the same as given on form 
FL-105/GC-120 for child a. (If NOT the same, provide the 
information below.)

Place of birth

Date of birth

Sex

Period of residence

Address

Person child lived with (name and complete current address) Relationship

to present

Confidential

Confidential

Child's residence (City, State)

Person child lived with (name and complete current address)

Child's residence (City, State)

Person child lived with (name and complete current address)

Child's residence (City, State)

Person child lived with (name and complete current address)

Child’s name

Residence information is the same as given on form 
FL-105/GC-120 for child a. (If NOT the same, provide the 
information below.)

Place of birth

Date of birth

Sex

Period of residence

Address

Person child lived with (name and complete current address)

Relationship

to present

Confidential

Confidential

Child's residence (City, State)

Person child lived with (name and complete current address)

Child's residence (City, State)

Person child lived with (name and complete current address)

Child's residence (City, State)

Person child lived with (name and complete current address)

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     Form Adopted for Mandatory Use         

Judicial Council of California 
FL-105(A)/GC-120(A)  
[New January 1, 2009]

ATTACHMENT TO  
DECLARATION UNDER UNIFORM CHILD CUSTODY JURISDICTION 
AND ENFORCEMENT ACT (UCCJEA)

Page____ of ____

Family Code, § 3400 et seq.;
Probate Code, §§ 1510(f), 1512
www.courtinfo.ca.gov

Attachment to Declaration Under Uniform Child Custody Jurisdiction and Enforcement Act (UCCJEA)

This info page is part of the LIT Lab's Form Explorer project. It is not associated with the California state courts. To learn more about the project, check out our about page.

Downloads: You can download both the original form (last checked 2023-03) and the machine-processed form with normalized data fields.

About This Form:

Sourced from selfhelp.courts.ca.gov (2023-03)
Page(s): 1
Fields(s): 85
Average fields per page: 85
Reading Level: Grade 6
LIST Grouping(s): FA-00-00-00-00.

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Identified Data Fields:

We have done our best to automaticly identify and name form fields according to our naming conventions. When possible, we've used names tied to our question library. See e.g., user1_name. If we think we've found a match to a question in our library, it is highlighted in green. Novel names are auto generated. So, you will probably need to edit some of them if you're trying to stick to the convention.

Here are the fields we could identify.

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The Legal Innovation & Technology Lab's Form Explorer Beta @ Suffolk Law School Last updated 2023-04-02

Attachment to Declaration Under Uniform Child Custody Jurisdiction and Enforcement Act (UCCJEA)

About This Form:

Identified Data Fields:

Create an Interactive Version of this Form:

The Legal Innovation & Technology Lab's Form Explorer ^Beta @ Suffolk Law School Last updated 2023-04-02