Fl 103 Form PDF Details

Form Fl-103 is a document used in the state of Florida to report the involuntary commitment of a person. The form is also used to provide information on the patient, such as name and age, as well as the reason for commitment. The form must be filed within five days of the involuntary commitment. failure to do so may result in criminal penalties. The Fl-103 form can be submitted to the clerk of court in the county where the patient was committed or to any law enforcement agency. It is important to file this form promptly, as it can help protect both the patient and others from harm.

QuestionAnswer
Form NameFl 103 Form
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namespetition domestic partnership form, petition maeeiage domestic partnership, fl 103, fl 103 form

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ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address):

TELEPHONE NO. :

FAX NO. (Optional):

E-MAIL ADDRESS (Optional):

 

ATTORNEY FOR (Name):

 

FL-103

FOR COURT USE ONLY

SUPERIOR COURT OF CALIFORNIA, COUNTY OF

 

 

STREET ADDRESS:

 

 

 

 

 

 

 

 

 

 

 

MAILING ADDRESS:

 

 

 

 

 

 

 

 

 

 

 

CITY AND ZIP CODE:

 

 

 

 

 

 

 

 

 

 

 

BRANCH NAME:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DOMESTIC PARTNERSHIP OF

 

 

MARRIAGE OF

 

 

 

 

 

 

 

 

PETITIONER:

 

 

 

 

 

 

 

 

 

 

 

RESPONDENT:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PETITION FOR

 

 

 

 

 

AMENDED

CASE NUMBER:

 

 

 

Domestic Partnership

 

 

 

 

 

Dissolution of

 

 

 

 

 

 

 

Marriage

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Legal Separation of

 

 

 

 

Domestic Partnership

 

 

 

Marriage

 

 

 

 

Nullity of

 

 

 

Domestic Partnership

 

 

 

Marriage

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NOTICE: If petitioner and respondent are of the same sex, use this form. If petitioner and respondent are of the opposite sex and are NOT also domestic partners, use form FL-100.

1. STATISTICAL FACTS

 

 

 

 

a.

 

 

 

 

 

 

(1)

Registration date of domestic partnership with the California Secretary of State or other state equivalent:

 

 

(2)

Date of separation:

 

 

 

 

 

(3)

Time from date of registration of domestic partnership to date of separation (specify):

Years

Months

b.

 

 

 

 

 

(2) Date of separation:

 

 

 

(1)

Date of marriage:

 

 

 

(3)

Time from date of marriage to date of separation (specify):

Years

Months

 

 

2.RESIDENCE (check all that apply)

a. Our domestic partnership was established in California. Neither of us has to be a resident or have a domicile in California to dissolve our partnership here.

b.

 

 

Our domestic partnership was established in a place other than California.

 

 

Petitioner

 

 

Respondent

has

 

 

 

 

 

 

 

 

 

 

been a resident of the state of California for at least six months and of this county for at least three months immediately

 

 

 

 

 

preceding the filing of this Petition.

 

 

 

 

 

 

 

 

 

c.

 

We are the same sex and are married.

 

We are the opposite sex and are married. We are also domestic partners.

 

 

 

 

 

 

 

 

Petitioner

 

Respondent

has been a resident of the state of California for at least six months and of this

 

 

 

 

 

 

 

 

 

 

 

county for at least three months immediately preceding the filing of this Petition.

 

 

 

 

 

 

d.

 

 

 

We are the same sex and were married in California but are not residents of California. Neither of us lives in a state or

 

 

 

 

 

 

 

 

 

nation that will dissolve the marriage. This case is filed in the county in which we married.

 

 

 

 

 

 

 

 

Petitioner's residence (state or nation):

 

Respondent's residence (state or nation):

 

3.DECLARATION REGARDING MINOR CHILDREN (include children of this relationship born or adopted prior to or during this

domestic partnership or marriage)

 

 

 

a.

 

There are no minor children.

 

 

 

b.

 

The minor children are

 

 

 

 

 

 

 

 

 

Child’s name

Birthdate

Age

Sex

Continued on Attachment 3b.

c.If there are minor children of the petitioner and respondent, a completed Declaration Under Uniform Child Custody Jurisdiction and Enforcement Act (UCCJEA) (form FL-105) must be attached.

NOTICE: You may redact (black out) social security numbers from any written material filed with the court in this case other than a form used to collect child or partner support.

 

 

Page 1 of 2

 

 

 

Form Adopted for Mandatory Use

PETITION—DOMESTIC PARTNERSHIP/MARRIAGE

Family Code, §§ 297, 299, 2320, 2330

Judicial Council of California

www.courts.ca.gov

FL-103 [Rev. January 1, 2013]

(Family Law)

 

FL-103

Petitioner:

Respondent:

CASE NUMBER:

4.DECLARATION REGARDING SEPARATE PROPERTY AS CURRENTLY KNOWN

a. There are no such assets or debts subject to disposition by the court in this proceeding.

b.

 

All such assets and debts listed are listed in

 

Property Declaration (form FL-160)

 

Attachment 4b

and should be confirmed as petitioner's or respondent's separate property as indicated in form FL-160 or Attachment 4b.

5.DECLARATION REGARDING COMMUNITY AND QUASI-COMMUNITY ASSETS AND DEBTS AS CURRENTLY KNOWN

a. There are no such assets or debts subject to disposition by the court in this proceeding.

b.

 

All such assets and debts are listed in

 

Property Declaration (form FL-160)

 

Attachment 5b

 

 

and should be divided between petitioner and respondent as indicated in form FL-160 or Attachment 5b.

6.Petitioner requests

a.

b.

c.

dissolution of the

 

 

 

domestic partnership

 

 

marriage

based on

(1)

 

irreconcilable differences. (Fam. Code, § 2310(a).)

 

(2)

 

incurable insanity. (Fam. Code, § 2310(b).)

legal separation of the

 

 

domestic partnership

 

 

marriage

based on

 

 

 

 

(1)

 

irreconcilable differences. (Fam. Code, § 2310(a).)

 

(2)

 

incurable insanity. (Fam. Code, § 2310(b).)

 

 

 

 

 

 

nullity of void

 

 

domestic partnership

 

marriage

based on

 

 

 

 

(1)

 

 

incest. (Fam. Code, § 2200.)

 

 

(2)

 

 

bigamy. (Fam. Code, § 2201.)

d.

 

nullity of voidable

 

domestic partnership

 

marriage

based on

 

 

 

 

 

 

(1)

 

 

petitioner’s age at time of registration of domestic

(3)

 

 

unsound mind. (Fam. Code, § 2210(c).)

 

 

 

 

 

 

 

 

 

 

 

 

 

partnership or marriage. (Fam. Code, § 2210(a).)

(4)

 

 

fraud. (Fam. Code, § 2210(d).)

 

 

 

 

 

 

 

 

(2)

 

 

prior existing marriage or domestic partnership.

(5)

 

 

force. (Fam. Code, § 2210(e).)

 

 

 

 

 

 

 

 

 

 

(Fam. Code, § 2210(b).)

 

 

(6)

 

 

physical incapacity. (Fam. Code, § 2210(f).)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

7. Petitioner requests that the court grant the above relief and make injunctive (including restraining) and other orders as follows:

 

 

 

 

 

 

 

 

 

 

Petitioner Respondent

Joint Other

a.

Legal custody of children to

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

....................................................................................

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

b.

...............................................................................Physical custody of children to

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

.......................................................................................c. Child visitation granted to

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

As requested in form:

 

FL-311

 

FL-312

 

FL-341(C)

 

FL-341(D)

 

 

 

FL-341(E)

 

Attachment 7c.

 

 

 

 

 

 

 

 

 

d.

 

Determination of parentage of any children born to the petitioner and respondent prior to the domestic partnership or

 

 

 

marriage.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

e.

........................................................................Attorney fees and costs payable by

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

f. Partner or spousal support payable to

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

g.

 

Terminate the court’s jurisdiction (ability) to award partner or spousal support to respondent.

 

 

 

 

 

 

 

 

 

 

 

h.

 

Determine property rights.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

i. Restore petitioner’s former name (specify):

j. Other (specify):

Continued on Attachment 7j.

8.Child support: If there are minor children who were born to or adopted by the petitioner and respondent before or during this domestic partnership or marriage, the court will make orders for the support of the children on request and submission of financial forms by the requesting party. An earnings assignment may be issued without further notice. Any party required to pay support must pay interest on overdue amounts at the “legal” rate, which is currently 10 percent.

9.I HAVE READ THE RESTRAINING ORDERS ON THE BACK OF THE SUMMONS, AND I UNDERSTAND THAT THEY APPLY TO ME WHEN THIS PETITION IS FILED.

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)

Date:

(SIGNATURE OF PETITIONER)

(TYPE OR PRINT NAME)

(SIGNATURE OF ATTORNEY FOR PETITIONER)

NOTICE: Dissolution or legal separation may automatically cancel the rights of a domestic partner or spouse under the other domestic partner’s or spouse’s will, trust, retirement plan, power of attorney, pay-on-death bank account, survivorship rights to any property owned in joint tenancy, and any other similar thing. It does not automatically cancel the right of a domestic partner or spouse as beneficiary of the other partner’s or spouse’s life insurance policy. You should review these matters, as well as any credit cards, other credit accounts, insurance polices, retirement plans, and credit reports, to determine whether they should be changed or whether you should take any other actions. However, some changes may require the agreement of your partner or spouse or a court order (see Fam. Code, §§ 231–235).

FL-103 [Rev. January 1, 2013]

PETITION—DOMESTIC PARTNERSHIP/MARRIAGE

Page 2 of 2

 

 

(Family Law)

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