Declaration of Petitioner - Child Custody and Visitation Request for Order (Free Form Template)

Sep 16, 2026

Uploaded by Rowan

Free, fillable family-court declaration form for a petitioner in California child custody and visitation cases. The template guides the requester to identify the parties and the minor child, state personal knowledge of the facts, and optionally respond to an opposing request for order. It includes sections to list the specific orders being requested, explain why the proposed orders serve the child’s best interests, and provide supporting facts or example exhibit formatting, ending with a perjury declaration and execution details.

LanguageEnglish

CategoryForms

FormatPDF

Pages2

Reading Time1 min

AccessFree to download

Declaration of Petitioner - Case Details

Parties, Child Information, and Personal Knowledge

Optional Response to a Request for Order

Requested Orders and Best-Interest Reasons

Supporting Facts and Exhibit Format

Perjury Statement and Execution

1 2 3 4 5 6 7 8 17 18 19 20 21 22 23 24 25 26 27 | Free template courtesy of Talkov Law:
2900 Adams St Ste C225 Riverside, CA 92504 Phone: (951) 888-3300
Email: [Info@talkovlaw.com](Info@talkovlaw.com) | | | --- | --- | | NAME
ADDRESS
TELEPHONE NUMBER
EMAIL
Notice: Please contact an attorney to advise you of your rights upon an assessment of the facts in your case before using this template declaration. It is strongly advised that you contact a family law attorney or a child custody attorney to consider all of your options.
Attorneys for Petitioner
SUPERIOR COURT FOR THE STATE OF CALIFORNIA
COUNTY OF [COUNTY] | | | [Name of Mother or Father],
Petitioner, v.
[Name of Mother or Father], Respondent. | CASE NO.
DECLARATION OF PETITIONER,[NAME], IN SUPPORT OF REQUEST FOR ORDER [OR RESPONSIVE DECLARATION TO REQUEST FOR ORDER] | | I, [NAME], hereby declare as follows:
1. I am the Petitioner in this matter, and the Mother/Father of the minor child, [CHILD’S NAME], born [CHILD’S DOB](currently [CHILD’S AGE] years old) . The facts set forth herein are of my own personal knowledge and if sworn I could and would testify competently thereto.
2. [INCLUDE THIS PORTION ONLY IF RESPONDING TO A REQUEST FOR ORDER. IF YOU ARE FILING A REQUEST FOR ORDER, REMOVE THIS PORTION AND PROCEED DIRECTLY TO ⁋ 4] I have received and read the Request for Order re child custody and visitation, filed on [DATE OF FILING] by Respondent, [NAME OF RESPONDENT](“Mother/Father”). I hereby respond as follows:
3. I am not in agreement with the orders requested by Mother/Father. | | | DECLARATION OF PETITIONER, [NAME], IN SUPPORT OF REQUEST FOR ORDER [OR RESPONSIVE
DECLARATION TO REQUEST FOR ORDER]
1 | | 1 2 3 4 5 6 7 8 17 18 19 20 21 22 23 24 25 26 27 | Free template courtesy of Talkov Law:
2900 Adams St Ste C225 Riverside, CA 92504 Phone: (951) 888-3300
Email: [Info@talkovlaw.com](Info@talkovlaw.com) | | | --- | --- | | 4. I respectfully request the court make the following orders:
a. LIST REQUESTED ORDERS HERE
b. LIST REQUESTED ORDERS HERE
c. LIST REQUESTED ORDERS HERE
5. I believe the orders I am requesting would be in the best interest of [NAME OF CHILD] for the following reasons:
6. Include all relevant facts supporting your requests and follow the list of tips provided in this article.
7. EXAMPLE EXHIBIT FORMAT: Father sent me a text message on August 4, 2020 indicating that he was “too drunk to drive”(Please see true and correct screenshot of text message from Father to Mother, dated August 4, 2020, attached herein as ‘Exhibit 1’) .
I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
Executed on [DATE], at [CITY, STATE] . | | | [NAME] | | | DECLARATION OF PETITIONER, [NAME], IN SUPPORT OF REQUEST FOR ORDER [OR RESPONSIVE
DECLARATION TO REQUEST FOR ORDER]
2 | |

FAQs

What information does the declaration template require at the start?

It requires the petitioner’s name, respondent’s name, the court header details, and the minor child’s identifying information such as birth date and age placeholders.

Can I use the same template to respond to a request for order?

Yes. The template includes an optional section that is used only when responding to a request for order; otherwise, that portion should be removed.

What sections must be completed to request specific court orders?

You must list the requested orders in the designated section and provide reasons showing why the requested orders are in the child’s best interest, including relevant supporting facts.

Sep 16, 2026

Uploaded by Rowan