FOR CLERK'S USE ONLY Name of Person Filing: _____________________________________________ Mailing Address: _____________________________________________ City, State, Zip Code: _____________________________________________ Day/Evening Phone Number: __________________________________________ ATLAS Number (if applicable) __________________________________________ Attorney Bar Number (if Applicable) _____________________________________ Representing: Self, Without a Lawyer OR Attorney for: Petitioner Respondent SUPERIOR COURT OF ARIZONA MOHAVE COUNTY ________________________________________ (Name of Petitioner) and ________________________________________ (Name of Respondent) Case Number: ________________________________ RESPONSE TO PETITION TO ESTABLISH PATERNITY, LEGAL DECISION MAKING and PARENTING TIME GENERAL INFORMATION: 1. INFORMATION ABOUT THE OTHER PARTY, THE PETITIONER: Name: Address: Date of Birth: _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ County of Residence:_________________________________________________________________________ Occupation(s): _____________________________________________________________________________ Relationship to minor child(ren) for whom the paternity order is requested: Mother Claims to be the Father Is a court-appointed guardian, conservator Or "best friend" for the child(ren) 2. INFORMATION ABOUT ME, THE RESPONDENT Name: Address: Date of Birth: _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ County of Residence:_________________________________________________________________________ Occupation(s): _____________________________________________________________________________ Relationship to minor child(ren) for whom the paternity order is requested: Mother Claims to be the Father Is a court-appointed guardian, conservator Or "best friend" for the child(ren) 3. INFORMATION ABOUT THE MINOR CHILD(REN) is contained in the Affidavit Regarding Minor Children filed with the Petition or in the Petition itself and incorporated by referen Page 1 of 5 Revised: 1/1/2013 American LegalNet, Inc. www.FormsWorkFlow.com Case No._____________________________ STATEMENTS ABOUT PATERNITY: 4. WHY YOU THINK YOU OR THE OTHER PERSON IS NOT THE FATHER OF THE MINOR CHILD(REN): (Check all boxes that apply) A. AFFIDAVIT: Petitioner and Respondent did not sign an Affidavit or Acknowledgment of Paternity acknowledging that Petitioner or Respondent is the child(ren)'s natural father. BIRTH CERTIFICATE: __________________________________ is not named as the natural father on the minor child(ren)'s birth certificate(s), OR a father by the name of ____________________________ is named on the birth certificates. BLOOD TEST: The parties had DNA (Deoxyribonucleic Acid) Testing and __________________________ (name of father) is shown not to be the minor child(ren)'s natural father. A copy is attached to this Response. PARTIES NOT LIVING TOGETHER: Petitioner and Respondent were not married to each other at any time during the ten months before the birth of the minor child(ren). The parties did not live together during the period(s) when the minor child(ren) could have been conceived. NO SEXUAL INTERCOURSE: Petitioner and Respondent were not living together and did not have sexual intercourse at the probable date of conception of the minor child(ren). SEXUAL INTERCOURSE: The mother of the minor child(ren) had sexual intercourse with someone else during the period in which the minor child(ren) could have been conceived. B. C. D. E. F. G. OTHER: (explain) _________________________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________ 5. ABOUT MARRIAGE AND HUSBAND (if applicable, check one box only). Mother was not married at the time the minor child(ren) were born or conceived or at least 10 months before minor (child(ren) were born or conceived, OR Mother was married when minor child(ren) were born or conceived or at least 10 months before the minor child(ren) were born or conceived, but husband is not the father of minor child(ren). (Husband must be included as a party to this court case because of marriage.) 6. SUMMARY OF WHAT I SAY ABOUT THE MINOR CHILD(REN) THAT IS DIFFERENT FROM WHAT THE PETITIONER ASKED FOR IN THE PETITION: (Summarize what is different between what you say about the minor child(ren), and what the other party said in the Petition.) ____________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ Page 2 of 5 Revised: 1/1/2013 American LegalNet, Inc. www.FormsWorkFlow.com Case No._____________________________ OTHER STATEMENTS TO THE COURT: 7. MEDICAL EXPENSES: (Check the applicable boxes) There are OR There are not unreimbursed medical expenses incurred by the mother, resulting from the birth of the minor child(ren). If there are, these costs and expenses should be paid by Plaintiff OR Defendant according to law. OTHER EXPENSES: The parties should be ordered to divide between them any uninsured medical, dental, or health expenses, reasonably incurred for the minor child(ren), in proportion to their respective incomes. DOMESTIC VIOLENCE: (Check the correct box if you are asking for joint legal decision making) Significant domestic violence has OR has not occurred between the parties. VENUE: This is the proper court to bring this lawsuit under Arizon