DV-180 Agreement and Judgment of Parentage Clerk stamps date here when form is filed. This form is used only when parents agree to be named as legal parents of their children. Parents complete 1 through 9 . 1 Protected Person: Name: Mother Father Relationship to the children in this case (check one): Your lawyer in this case (if you have one): Fill in court name and street address: Name: State Bar No.: Superior Court of California, County of Firm Name: Address (If you have a lawyer for this case, give your lawyer's information. If you do not have a lawyer and want to keep your home address private, give a different mailing address instead. You do not have to give your telephone, fax, or e-mail.): Address: Court fills in case number when form is filed. City: Zip: State: Case Number: Fax: Telephone: E-Mail Address: 2 Restrained Person: Name: Relationship to the children in this case (check one): Address: City: Mother Father State: Zip: Agreement of Parentage 3 No Other Parentage Case a. We are the parents of the children listed below. b. To the best of our knowledge (check each box that is true): There is no court case in which someone other than us claims to be or is alleged to be the parent of the 1. children. No court has ordered or found that someone other than us is a parent of the children. 2. There is no pending adoption or guardianship case for the children. 3. No other person has signed a voluntary declaration of paternity for the children. 4. 5. The mother was not married to another person when the children were conceived. 4 The children in this case are (specify): Child's Name a. b. c. d. Check here if you need more space. List additional children on an attached sheet of paper and write "DV-180, Children" as a title. Date of Birth Sex Judicial Council of California, www.courts.ca.gov Revised July 1, 2014, Mandatory Form Family Code, §§ 6323, 7600 et seq. Agreement and Judgment of Parentage (Domestic Violence Prevention) DV-180, Page 1 of 3 American LegalNet, Inc. www.FormsWorkFlow.com Case Number: Your name: 5 Orders Requested a. We ask the court to find that we are the legal parents of the children in 4 and to enter a judgment of parentage. b. We ask the court to order the children's birth certificates to be amended by (check each order you want): Adding the father's name. 1. 2. Changing the last name of the children to: 6 If you sign this form, you will give up these rights: · Right to a trial. You can ask a judge, in a separate case, to decide if you are the parent of the children in this case. You can bring evidence and witnesses to that trial. And you can question the witnesses against you. · Right to genetic tests. You can ask a judge, in a separate case, to order genetic tests to see if you are the parent of the children in this case. The court may order you to pay for those tests. 7 If you sign this form, the court may decide you are the legal parent. The court may order you to: · Pay child support. Child support may be taken out of your paycheck without notifying you first. Child support can be a lot of money, and it usually lasts until the child turns 18. If you do not support the children as ordered, you can face criminal charges. · Pay other expenses and costs. The court may also order that you pay other expenses for the children in this case. You will have all the legal duties of a parent. Before you sign this form, you can hire a lawyer. If you cannot afford to pay for a lawyer to represent you, call the local bar association for help. You can also ask the court's Family Law Facilitator for information on how to find a lawyer. 8 Sign below only if you understand and give up your rights. · We are saying that we are the legal parents of the children in this case. · If either of us has a lawyer for this agreement, that lawyer has read and explained this information to the person being represented and that person understands it. · We have read and understand this form. · If someone translated this form, we understood the translation. 9 We have read and understand the rights listed in this form. Both people named in 1 and 2 give up these rights and freely agree that the court can make orders naming us as legal parents of the children listed on this form. We declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Date Date Date Date Revised July 1, 2014 Type or print Protected Person's name Type or print Restrained Person's name Type or print Protected Person's lawyer's name Type or print Restrained Person's lawyer's name Protected Person signs here Restrained Person signs here Protected Person's lawyer signs here Restrained Person's lawyer signs here DV-180, Page 2 of 3 Agreement and Judgment of Parentage (Domestic Violence Prevention) Case Number: Your name: Judgment of Parentage 10 The court finds Name: Name: are the parents of the children listed below: Child's Name a. b. c. Check here if you need more space. List additional children on an attached sheet of paper and write "DV-180, Additional Children" as a title. 11 The court orders a. b. The last names of the child(ren) are changed to (specify the FULL name of each child): The birth certificates must be amended to conform to this court order by: (1) adding the father's name (specify): changing the last name of the children (2) Mother Mother Date of Birth Father Father Sex 12 Other (specify): Number of pages attached: 13 Notice of Entry of Judgment The parties must provide self-addressed, stamped envelopes and one original and two copies of the completed Notice of Entry of Judgment (form FL-190) to the court. Date: Judicial Officer 14 Interpreter's Declaration I have read or translated or interpreted this Agreement and Judgment of Parentage, to the best of my ability, to the (check one): Protected Person Restrained Person who said that: · He or she was unable to read or understand the English documents; · His or her primary language is (specify): · He or she now understands this document. 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 interpreter's name Date: Type or print interpreter's name Revised July 1, 2014 ; and Interpreter signs here Interpreter signs here DV-180, Page 3 of 3 Agreement and Judgment of Parentage (Domestic Violence Prevention)