FL-511 Ex Parte Application for Order for Nondisclosure of Address

EX PARTE APPLICATION FOR ORDER FOR
NONDISCLOSURE OF ADDRESS AND ORDER
EX PARTE APPLICATION FOR ORDER FOR
NONDISCLOSURE OF ADDRESS AND ORDER
(UIFSA)
Family Code, § 4977
www.courtinfo.ca.gov
CASE NUMBER:
(Name):
for nondisclosure of the address or other identifying information of (name):
in the pleadings and other documents to be filed in the UIFSA action.
The following is the mailing address for service of process on (name):
Date:
(SIGNATURE OF DECLARANT)
Form Adopted for Mandatory Use
Judicial Council of California
FL-511 [Rev. January 1, 2003]
3.
FOR COURT USE ONLY
SUPERIOR COURT OF CALIFORNIA, COUNTY OF
STREET ADDRESS:
MAILING ADDRESS:
CITY AND ZIP CODE:
BRANCH NAME:
FL-511
TELEPHONE NO.:
GOVERNMENTAL AGENCY (under Family Code, §§ 17400, 17406)
or ATTORNEY OR PARTY WITHOUT ATTORNEY (Name,
state bar number, and address):
(Party appearing without an attorney should enter in this space the same address listed in item 3, below.)
ATTORNEY FOR (Name):
FAX NO.:
1.
2.
PETITIONER:
RESPONDENT:
OTHER:
The local child support agency acting on behalf of (name): applies for an order
4.
applies for an order for nondisclosure of the
address or other identifying information of (name):
in the pleadings and other documents to be filed in this action.
Facts in support of this application (state facts that demonstrate that the health, safety, freedom of movement, or physical or
emotional well-being of the applicant or the applicant's child may be unreasonably put at risk by the disclosure of the applicant's
address or other identifying information):
contained in the attached declaration
I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
(TYPE OR PRINT NAME)
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