FL-820 PARTY WITHOUT ATTORNEY OR ATTORNEY (Name, State Bar number, and address): FOR COURT USE ONLY TELEPHONE NO.: E-MAIL ADDRESS (Optional): ATTORNEY FOR (Name): FAX NO. (Optional): SUPERIOR COURT OF CALIFORNIA, COUNTY OF STREET ADDRESS: MAILING ADDRESS: CITY AND ZIP CODE: BRANCH NAME: MARRIAGE OF HUSBAND: WIFE: CASE NUMBER: REQUEST FOR JUDGMENT, JUDGMENT OF DISSOLUTION OF MARRIAGE, AND NOTICE OF ENTRY OF JUDGMENT 1. The Joint Petition for Summary Dissolution (form FL-800) was filed on (date): (Use this form ONLY if the Joint Petition for Summary Dissolution (form FL-800) was filed before January 1, 2011. If it was filed after January 1, 2011, use Judgment of Dissolution and Notice of Entry of Judgment (form FL-825) instead.) 2. No notice of revocation has been filed, and the parties have not become reconciled. 3. I request that judgment of dissolution of marriage be a. b. entered to be effective now. entered to be effective (nunc pro tunc) as of (date): for the following reason: 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) (SIGNATURE OF HUSBAND OR WIFE) 4. Husband Wife who did not request that his or her own former name be restored when he or she signed the joint petition, now requests that it be restored. The applicant's former name is: Date: (TYPE OR PRINT NAME) (For Court Use Only) (SIGNATURE OF PARTY WISHING TO HAVE HIS OR HER NAME RESTORED) JUDGMENT OF DISSOLUTION THE COURT ORDERS 5. A judgment of dissolution of marriage will be entered, and the parties are restored to the status of unmarried persons. a. b. c. The judgment of dissolution of marriage will be entered nunc pro tunc as of (date): Wife's former name is restored (specify): Husband's former name is restored (specify): Husband and wife must comply with any agreement attached to the petition. Date: JUDICIAL OFFICER Page 1 of 2 Form Adopted for Mandatory Use Judicial Council of California FL-820 [Rev. January 1, 2012] REQUEST FOR JUDGMENT, JUDGMENT OF DISSOLUTION OF MARRIAGE, AND NOTICE OF ENTRY OF JUDGMENT (Family Law--Summary Dissolution) Family Code, § 2403 www.courts.ca.gov American LegalNet, Inc. www.FormsWorkFlow.com HUSBAND: WIFE: CASE NUMBER: NOTICE: Dissolution may automatically cancel the rights of a spouse under the other spouse's will, trust, retirement benefit plan, power of attorney, pay-on-death bank account, transfer-on-death vehicle registration, survivorship rights to any property owned in joint tenancy, and any other similar instrument. It does not automatically cancel the rights of a spouse as beneficiary of the other spouse's life insurance policy. You should review these matters, as well as any credit cards, other credit accounts, insurance policies, retirement benefit plans, and credit reports, to determine whether they should be changed or whether you should take any other actions. NOTICE OF ENTRY OF JUDGMENT 6. You are notified that a judgment of dissolution of marriage was entered on (date): Date: Clerk, by , Deputy CLERK'S CERTIFICATE OF MAILING I certify that I am not a party to this cause and that a true copy of the Notice of Entry of Judgment was mailed first class, postage fully prepaid, in a sealed envelope addressed as shown below, and that the notice was mailed at (place): on (date): Date: Clerk, by , Deputy California, HUSBAND'S ADDRESS WIFE'S ADDRESS FL-820 [Rev. January 1, 2012] REQUEST FOR JUDGMENT, JUDGMENT OF DISSOLUTION, AND NOTICE OF ENTRY OF JUDGMENT (Family Law--Summary Dissolution) Page 2 of 2