COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : TELEPHONE NO.: ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address): Index No. : TELEPHONE NO: E-MAIL ADDRESS (Optional): ATTORNEY FOR (Name): FAX NO. (Optional): FL-355 FOR COURT USE ONLY Calendar No. Plaintiff(s) : : : : JUDICIAL SUBPOENA -againstSUPERIOR COURT OF CALIFORNIA, COUNTY OF STREET ADDRESS: MAILING ADDRESS: CITY AND ZIP CODE: BRANCH NAME: PETITIONER: RESPONDENT: Defendant(s) : . . . . .OTHER: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..... STIPULATION AND ORDER FOR CUSTODY AND/OR VISITATION OF CHILDREN CASE NUMBER: MODIFICATION THE PEOPLE OF THE STATE OF NEW YORK The parties signing this stipulation agree that: 1. This court has jurisdiction over the minor children because California is the children's home state. TO 2. The habitual residence of the children is the United States of America. 3. The parties acknowledge they were advised that any violation of this order may result in civil or criminal penalties, or both. 4. a. The parties stipulate that the attached document, dated (specify): and consisting of (number): pages is their custody and visitation agreement and request that it be made an order of the court, or FL-341(D) being laid aside, you FL-341(E) of you attend before and each are Honorable their children and request that they be made an order of the court. , the their agreement regarding custody and/or visitation of at the Court located at County of under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Each party declares in room , on the day of , 20 , at o'clock in the noon, and at any recessed Date: or adjourned date, to testify and give evidence as a witness in this action on the part of the Date: Date: (TYPE OR PRINT NAME) (SIGNATURE OF PETITIONER) b. The parties stipulate that the attached forms FL-341(A) FL-341(B) FL-341(C) FL-341 COMMAND YOU, that all business and excuses WE GREETINGS: (TYPE OR PRINT NAME) (SIGNATURE OF RESPONDENT) Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to the party on (TYPE OR PRINT NAME) subpoena was issued for a maximum penalty of $50 andPETITIONER) whose behalf this (SIGNATURE OF ATTORNEY FOR all damages sustained as a Date: result of your failure to comply. Witness, Honorable (TYPE OR PRINT NAME) County, Date:Court in (TYPE OR PRINT NAME) Date: (TYPE OR PRINT NAME) (SIGNATURE OF ATTORNEY FOR RESPONDENT) , one of the Justices of the day of , 20 (SIGNATURE OF OTHER) (SIGNATURE OF ATTORNEY FOR OTHER) THE COURT FINDS: 1. This court has jurisdiction over the minor children because California is the children's home state. 2. The habitual residence of the children is the United States of America. Attorney(s) for 3. Both parties have been advised that any violation of this order may result in civil or criminal penalties, or both. THE COURT ORDERS: 1. The agreement of the parties regarding custody and visitation as set forth in the attached document dated (specify): and consisting of (number): pages or set forth in the attached forms: Office and P.O. Address FL-341 FL-341(A) FL-341(B) FL-341(C) FL-341(D) FL-341(E) is adopted as the order of the court and fully incorporated by reference herein. Date: FINDINGS AND ORDER (Attorney must sign above and type name below) Form Approved for Optional Use Judicial Council of California FL-355 [New January 1, 2004] STIPULATION AND ORDER FOR CUSTODY AND/OR VISITATION OF CHILDREN Telephone No.: Facsimile No.: ______________________________________________ JUDICIAL OFFICER E-Mail Address: Page 1 of 1 Mobile Tel. No.: www.courtinfo.ca.gov American LegalNet, Inc. www.USCourtForms.com