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SF Dpterm

This document is a Notice of Termination of Domestic Partnership filed with the California Secretary of State. It provides instructions for filing the notice and requires the former domestic partners to declare that their partnership is terminated, provide their file number, and indicate if the termination was due to death or marriage. It must be signed, notarized, and mailed to the Secretary of State.

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40 views1 page

SF Dpterm

This document is a Notice of Termination of Domestic Partnership filed with the California Secretary of State. It provides instructions for filing the notice and requires the former domestic partners to declare that their partnership is terminated, provide their file number, and indicate if the termination was due to death or marriage. It must be signed, notarized, and mailed to the Secretary of State.

Uploaded by

Eric1201
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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State of California FILE NO: _______________________

Kevin Shelley
Secretary of State
NOTICE OF TERMINATION OF DOMESTIC PARTNERSHIP
(Family Code Section 299)

Instructions:

1. Complete and send by CERTIFIED mail to:


Secretary of State
P.O. Box 942877
(Office Use Only)
Sacramento, CA 94277-0001
(9l6) 653-3984

2. There is no fee for filing this Notice of Termination

I, the undersigned, do declare that:

Former Partner:_____________________________________________ and I are no longer Domestic Partners.


(Last ) (First) (Middle)

Secretary of State File Number: _________________________________.

If termination is caused by death or marriage of the domestic partner please indicate the date of the death or the
marriage: ______________________.
(month/day/year)

This date shall be the actual termination date for the Domestic Partnership as provided in Family Code Section
299.

_______________________________ ______________________________________________
Signature (Last) (First) (Middle)

__________________________________________________________________________________
Mailing Address City State Zip Code

NOTARIZATION IS REQUIRED
State of California
County of _____________________________

On , before me, , personally appeared

personally known to me (or proved to me on the basis of satisfactory evidence) to be the person whose name is subscribed to the
within instrument and acknowledged to me that he/she executed the same in his/her authorized capacity, and that by his/her
signature on the instrument the person executed the instrument.

Signature of Notary Public [PLACE NOTARY SEAL HERE]

SEC/STATE LP/SF DP-2 JAN 2003)

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