ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address): FOR COURT USE ONLY TELEPHONE NO.: FAX NO. (Optional): E-MAIL ADDRESS (Optional): ATTORNEY FOR (Name): SUPERIOR COURT OF CALIFORNIA, COUNTY OF LOS ANGELES STREET ADDRESS: MAILING ADDRESS: CITY AND ZIP CODE: BRANCH NAME: MARRIAGE AND/OR DOMESTIC PARTNERSHIP OF PETITIONER 1: and PETITIONER 2: JUDGMENT OF DISSOLUTION OF MARRIAGE AND/OR DOMESTIC PARTNERSHIP AND NOTICE OF ENTRY OF JUDGMENT 1. CASE NUMBER: The Joint Petition for Summary Dissolution of Marriage and/or Domestic Partnership (form FL-800) was filed on (date): The petitioners requested the dissolution of their: a. marriage, entered into on (date of marriage): b. registered domestic partnership, entered into on (date of registration): 2. 3. No notice of revocation has been filed and the parties have not become reconciled. JUDGMENT OF DISSOLUTION OF MARRIAGE AND/OR DOMESTIC PARTNERSHIP 4. THE COURT ORDERS A judgment of dissolution of marriage and/or domestic partnership will be entered, and the parties are restored to the status of single persons. Both Petitioners must comply with any agreement attached to the petition. a. b. c. The judgment of dissolution of marriage and/or domestic partnership will be entered nunc pro tunc as of (date): ______________________. The former name of Petitioner 1 _________________ is restored to : _______________________ The former name of Petitioner 2 _________________ is restored to : _______________________ Date: JUDGE OF THE SUPERIOR COURT NOTICE: Dissolution may automatically cancel the rights of a spouse or partner under the other spouse's or partner'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 thing. It does not automatically cancel the rights of a spouse or partner as beneficiary of the other spouse's or partner'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. FAM 064 New January 1, 2011 JUDGMENT OF DISSOLUTION OF MARRIAGE AND/OR DOMESTIC PARTNERSHIP AND NOTICE OF ENTRY OF JUDGMENT Page 1 of 2 Family Code § 2403 American LegalNet, Inc. www.FormsWorkFlow.com CASE NAME: CASE NUMBER: NOTICE OF ENTRY OF JUDGMENT 5. You are notified that a judgment of dissolution of: a. marriage b. domestic partnership was entered on (date): Date: by:__________________________________ Deputy CLERK'S CERTIFICATE OF MAILING I, the below named Executive Officer/Clerk of the above-entitled court, do hereby certify that I am not a party to the cause herein, and that on this date I served a true copy of the Judgment of Dissolution of Marriage and/or Domestic Partnership and Notice of Entry of Judgment upon each party or counsel named below by depositing in the United States mail at the courthouse in Los Angeles, California, one copy of the original filed/entered document in a separate sealed envelope to each address shown below with the postage thereon fully prepaid, in accordance with standard court practices. John A. Clarke, Executive Officer/Clerk Date: by:__________________________________ Deputy PETITIONER 1 PETITIONER 2 Address: City: Zip Code: Address: City: Zip Code: FAM 064 New January 1, 2011 JUDGMENT OF DISSOLUTION OF MARRIAGE AND/OR DOMESTIC PARTNERSHIP AND NOTICE OF ENTRY OF JUDGMENT Page 2 of 2 Family Code § 2403 American LegalNet, Inc. www.FormsWorkFlow.com