Free Microsoft Word - EXPART~2.DOC - California

NAME, ADDRESS, AND TELEPHONE NUMBER OF ATTORNEY OR PARTY WITHOUT ATTORNEY:

STATE BAR NUMBER

Reserved for Clerk's File Stamp

ATTORNEY FOR (Name):

SUPERIOR COURT OF CALIFORNIA, COUNTY OF LOS ANGELES
STREET ADDRESS: MAILING ADDRESS: CITY AND ZIP CODE: BRANCH NAME:

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Matter of: Decedent
CASE NUMBER:

EX PARTE PETITION FOR COURT ORDER TO RELEASE THE REMAINS OF A DECEDENT THIS EX PARTE PETITION IS ONLY TO REQUEST RELEASE OF THE REMAINS OF THE DECEDENT AND DOES NOT CONTAIN ANY REQUEST TO ADMINISTER THE ESTATE OF DECEDENT. 1. Petitioner _____________________________________ requests an order from the Court
(Your Name)

authorizing him/her to claim the remains of the decedent ____________________________________.
(Decedent's Name)

2. Decedent died on: _______________________ at: ___________________________________
(Date) (Location)

Decedent was a resident of the County of Los Angeles and his/her remains are in the
custody of the Los Angeles County Coroner.

Decedent was NOT a resident of the County of Los Angeles and his/her remains are in the
custody of the Los Angeles County Coroner.

3. Street address, city, and county of decedent's residence at time of death (specify):

4. Petitioner's relationship to the decedent is: __________________________________. If you are not related to the decedent by either blood or marriage, indicate how long you have known the decedent and how you met (work, church, neighbor, etc.) :

EX PARTE PETITION FOR COURT ORDER TO RELEASE THE REMAINS OF A DECEDENT
PRO 017 0407 Page 1 of 3 Health & Safety Code § 7105

Matter of: Decedent

CASE NUMBER:

5. To the best of my knowledge, Decedent is survived by (check all that apply): a. spouse b. registered domestic partner c. child(ren), natural or adopted d. grandchild(ren) e. parent or parents f. brothers or sisters g. grandparents h. aunts or uncles i. cousins j. no next of kin 6. If you checked any box in item 5 other than box j, please provide their name, relationship, approximate age, address and phone number (add attachment 6 if needed):

7. Describe your efforts to contact the person(s) listed in item 6 to inform them of your request to claim the decedent's remains.

EX PARTE PETITION FOR COURT ORDER TO RELEASE THE REMAINS OF A DECEDENT
PRO 017 0407 Page 2 of 3 Health & Safety Code § 7105

Matter of: Decedent

CASE NUMBER:

8. Number of pages attached: ______

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 of Petitioner)

____________________________________________ (Signature of Petitioner)

______________________________________________ (Type or Print Name of Attorney)

____________________________________________ (Signature of Attorney)

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EX PARTE PETITION FOR COURT ORDER TO RELEASE THE REMAINS OF A DECEDENT
PRO 017 0407 Page 3 of 3 Health & Safety Code § 7105