The Statement of Domestic Partnership Form is the document, printed as the Statement and Certificate of Domestic Partnership, that the Los Angeles County Registrar-Recorder/County Clerk (RR/CC) uses to register a domestic partnership under Los Angeles County Code Chapter 2.210. Two people who are both 18 or older, and at least one of whom lives or works in the county, sign it to state that they are domestic partners. On this page you can fill out the form online on FillingPDF and download or print the completed PDF; the form is published, and filed, through the RR/CC.
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What is Statement of Domestic Partnership Form – Los Angeles County, CA?
The Statement of Domestic Partnership Form, printed on the PDF as the Statement and Certificate of Domestic Partnership (Los Angeles County Code Chapter 2.210), is the Los Angeles County Registrar-Recorder/County Clerk form in which two people state that they are domestic partners so the relationship is publicly registered.
In the form, both partners acknowledge that they are 18 years of age or older, that they consider themselves domestic partners, and that one or both of them reside or are employed in Los Angeles County. The county describes the filing as a place to publicly register your relationship.
Below that, the form offers optional statements the partners may check, such as sharing a common household, sharing financial responsibility for household expenses, owning real or personal property together, or having made provision for each other through a will, trust or other estate planning. The county says you are not required to check any of them; what you check is between you and your partner.
The form is not a substitute for legal documents. The form and the county's notice both say it does not take the place of properly executed documents authorizing each other to make medical or financial decisions, leave property to each other or make arrangements for incapacity or death. The statement is a public record. A partner's employer may accept it for other purposes, such as health insurance eligibility, but eligibility for domestic partnership benefits is determined between you and your employer.
Who needs to file Statement of Domestic Partnership Form – Los Angeles County, CA?
Two people who want to register a domestic partnership in Los Angeles County file this form together. The requirements stated by the county are:
- both partners must be 18 years or older;
- at least one partner must live or work in Los Angeles County.
Both partners sign and give their own printed name, address and date of birth on the form.
You do not have to check any of the optional statements; the county says that whichever you choose are between you and your partner.
The form is not for authorizing medical or financial decisions, leaving property or making arrangements for incapacity or death. Those require separate, properly executed legal documents, and the form advises consulting an attorney. The staff of the Registrar-Recorder/County Clerk cannot provide legal advice.
If you need the statement for a workplace benefit such as health insurance, the county notes that your employer decides its own eligibility requirements.
When to file Statement of Domestic Partnership Form – Los Angeles County, CA
File the form when you and your partner decide to register your domestic partnership; no deadline or renewal period is printed on the form or stated on the county's filing page. Both of you must already meet the requirements: both 18 or older, with at least one living or working in Los Angeles County.
Filing is done at an in-person appointment with the Registrar-Recorder/County Clerk, and appointments can be scheduled up to three weeks in advance. Complete the form before the appointment, since the county's steps are to complete it and bring it to the office.
How to fill out Statement of Domestic Partnership Form – Los Angeles County, CA
Confirm you both qualify
Both partners must be 18 years of age or older, and one or both must reside or be employed in Los Angeles County. The first paragraph of the form states these points.
Read the legal notice
Read the note at the bottom of the form and the county's notice: the statement does not replace documents for medical or financial decisions or for leaving property, and it is a public record.
Enter the date you became partners
If you choose, check the first optional box and write the date in the blank after "We have considered ourselves to be domestic partners since".
Check the optional statements
Check any of the optional statements that are true, such as "Neither of us is married", "We share a common household" or "We own real property together". You are not required to check any.
Complete the Other lines
If you want to add a statement not listed, check Other and write it on the two lines provided. Remember the form becomes a public record.
Sign for both partners
Each partner signs in the Signature space of their own column.
Print both names
Write each partner's name in the Print Name space of their own column.
Enter addresses
Give each partner's Address and City, State, Zip Code in their own column.
Enter dates of birth
Write each partner's Date of Birth in their column.
Review and download the PDF
Check that both columns are complete and that every checked statement is true. Download or print the completed PDF from FillingPDF and bring it to your appointment, as described under How to submit.
How to submit Statement of Domestic Partnership Form – Los Angeles County, CA
The county's filing page describes one channel: an in-person appointment with the Los Angeles County Registrar-Recorder/County Clerk.
- In person, by appointment: complete the Statement of Domestic Partnership Form and bring it to the office. Appointments can be scheduled up to three (3) weeks in advance. See the county's domestic partnership filing page for details.
- Fees: the county lists a fee for the Statement and Certificate of Domestic Partnership and fees for a certified copy and for each additional certificate or certified copy. Amounts are on the county's page; for questions, call the Registrar-Recorder/County Clerk at (800) 201-8999.
Before the visit, read the county's notice on domestic partnerships, which explains that the statement is a public record and does not replace legal documents. FillingPDF lets you fill out and download the PDF; submission follows the county's channels above.
Common mistakes to avoid
- Treating the statement as a substitute for medical or financial decision authorization, a will or other estate documents; the form says it does not take their place.
- Filing when neither partner lives or works in Los Angeles County; at least one of you must.
- Filing when either partner is under 18; both must be 18 years or older.
- Leaving one partner's signature, printed name, address, city, state, ZIP code or date of birth blank; the form has a column for each partner.
- Believing every optional box must be checked; the county says you are not required to check any of them.
- Checking optional statements that are not true for you, such as "Neither of us is married" or "We are each other's sole domestic partner", in a document that is a public record.
- Arriving without an in-person appointment; the county's filing step is an appointment, which can be scheduled up to three weeks in advance.
- Assuming the statement guarantees employer benefits; eligibility for domestic partnership benefits is decided between you and your employer.
Frequently asked questions
What is the Statement of Domestic Partnership Form?
It is the Los Angeles County Registrar-Recorder/County Clerk form, titled Statement and Certificate of Domestic Partnership, in which two partners state that they are domestic partners. It gives the county a place to publicly register the relationship under Los Angeles County Code Chapter 2.210.
Who can file a domestic partnership in Los Angeles County?
Two people who are both 18 years or older, when at least one of them lives or works in Los Angeles County. Both state this on the form and both sign it.
Do I have to check the optional boxes on the form?
No. The county says you are not required to check any optional box, and that whichever you choose to check are between you and your partner. The only statements that are not optional are the age, partnership and residence or employment statements in the opening paragraph.
Does the statement let my partner make medical or financial decisions for me?
No. The form and the county's notice say it does not take the place of properly executed legal documents for medical or financial decisions, leaving property or arrangements for incapacity or death. They recommend consulting an attorney; county staff cannot give legal advice.
Do I need an appointment to file a domestic partnership in Los Angeles County?
The county's filing steps call for an in-person appointment, and appointments can be scheduled up to three weeks in advance. Complete the form first and bring it to the office, as the county's page directs.
Is there a fee to file the Statement of Domestic Partnership?
Yes. The county lists a fee for the Statement and Certificate of Domestic Partnership and separate fees for a certified copy and for additional certificates or copies. Check the county's filing page for the amounts, or call (800) 201-8999.
Is a statement of domestic partnership a public record?
Yes. The form states that it is a public record, and the county's notice repeats it. Keep this in mind before writing personal details on the optional Other lines.
Will my employer accept the statement for health insurance?
It may. The county says the statement may be accepted by your employer for purposes such as health insurance eligibility, but eligibility requirements for domestic partnership benefits are determined between you and your employer.
Can I fill out the Statement of Domestic Partnership Form online?
Yes. You can fill out the PDF online on FillingPDF and download or print it. FillingPDF is an independent service, not connected to the county, and it does not file the form; you bring it to the Registrar-Recorder/County Clerk through the county's channels.
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