Petitioner Pro Se IN THE FAMILY COURT OF THE SECOND CIRCUIT STATE OF HAWAII Petitioner(s), vs. Respondent(s). FC-P No. PETITION FOR PATERNITY;SUMMONS PETITION FOR PATERNITY Comes now Petitioner, , (hereinafter referred to as 223Petitioner224), a resident of the County of Maui, seeking an adjudication of paternity and other relief pursuant to Chapter 584, Hawaii Revised Statutes, and respectfully shows that: I. Petitioner, the [ natural mother [ natural father [ legal father of the child below named, is: Name: aka/fka: Date of Birth: Address: 1 003003 ) 002) 002) 002003) ) )002 )002 ) 002)002 ) 002) 002) 002 ] ] ] 2FP-02 (Rev 11/11) CommonLook256 508 Certified American LegalNet, Inc. www.FormsWorkFlow.com II. The child subject to this action is: Name: Sex: Date of Birth: Place of Birth: Period of Conception: Place of Conception: III. Mother is: Name: aka/fka: Date of Birth: Address: IV. The Respondent named below having had sexual intercourse with the Petitioner during the probable period of conception of the child is joined in this action as the alleged natural father [ natural mother pursuant to section 584-9, Hawaii Revised Statutes, as amended. Name: aka/fka: Date of Birth or Age: Last Known Address: The above-named Respondent is a member of the military service of the United States. 2 [ ] ] [ ] 003 2FP-02 (Rev 11/11) CommonLook256 508 Certified American LegalNet, Inc. www.FormsWorkFlow.com V. The legal father, if any, of the child is: Name: aka/fka: Date of Birth or Age: Date of Marriage to Natural Mother: Date of Separation from Natural Mother: Date of Divorce from Natural Mother: Last Known Address: VI. The caretaker, if any, of the child is: Name: aka/fka: Date of Birth or Age: Relationship to Child: Address: VII. Petitioner has made payments which resulted from or were incident to the natural mother222s pregnancy, the birth of the child, and post natal care and treatment of the child and said payments create a debt due and owing by [ ] Respondent to Petitioner. VIII. The subject child is currently in the custody of ] Petitioner [ ] Respondent [ ] Caretaker [ IX. [ ] The legal custody of the child should be awarded to ] Petitioner [ ] Respondent [ Caretaker [ 3 [ ][ ] ] 2FP-02 (Rev 11/11) CommonLook256 508 Certified American LegalNet, Inc. www.FormsWorkFlow.com 4 002Physical custody should be awarded to ] Petitioner [ ] Respondent [ ] Caretaker [ ] subject to reasonable visitation by [ ] Petitioner [ ] Respondent [ ] Caretaker 002] The issue of visitation should be reserved. X. The Department of Health should be required to prepare a new Certificate of Live Birth inserting thereon the name of the natural father as the father of the subject child and changing the child222s name to: First Name: Middle Name: Last Name:XI. The gross monthly income or reasonable earning capacity of Petitioner is $ . XII. The gross monthly income or reasonable earning capacity of Respondent is $ . XIII. ] Respondent [ ] Petitioner should be ordered to pay child support based upon the gross income of the parties and calculated pursuant to Hawaii Revised Statutes section 576D-7 and Hawaii Child Support Guidelines. XIV. ] Respondent [ ] Petitioner should be ordered to provide medical, dental, drug and vision coverage for the subject child. 002[ ] 002[ [ ] . 002[ 002[ ] ] [ [ ] [ [ 002002002 2FP-02 (Rev 11/11) CommonLook256 508 Certified American LegalNet, Inc. www.FormsWorkFlow.com 5 002[ 002002] [ 002[ [ XV. The child is still alive and has not been adopted or emancipated. WHEREFORE, PETITIONER respectfully prays that: ] The Respondent(s) be compelled to appear before the above entitled court for a 002 hearing pursuant to Chapter 584, Hawaii Revised Statutes. be adjudged to be the legal and natural father of the child. ] The presumption of paternity of Respondent is rebutted. ] Legal custody of the child be awarded to , physical custody awarded to , subject to rights of reasonable visitation. should be ordered to pay for the support, maintenance and education of the child from the time of birth until the child attains the age of 18 years of age and for so long thereafter, including summer months, as said child is pursuing a high school diploma or is enrolled as a full time student in an accredited educational, vocational or technical institution and under the age of 23. ] Current child support should be paid pursuant to an order of income assignment. should be ordered to pay past child support accrued from the time of the birth of the subject child up until the time of the entry of a current support order herein. should be ordered to provide medical, dental, drug and vision insurance coverage for the child. should be ordered to provide military benefits for the subject child. should be ordered to pay or make reimbursement for his or her share of the expenses resulting from or incident to the pregnancy and birth of the subject child. ] The Department of Health shall issue a new certificate of live birth for the child [ ] [ [ ] [ ] [ ] [ ] [ 2FP-02 (Rev 11/11) CommonLook256 508 Certified American LegalNet, Inc. www.FormsWorkFlow.com inserting the name of the natural father as the father of the subject child [ ] and changing 002 the name of the child. 002 [ ] The Court order such other relief as may be appropriate under the provisions of 002 chapter 584, Hawaii Revised Statutes. DATED: , Hawaii PETITIONER222S signature In accordance with the Americans with Disabilities Act and other applicable state and federal laws, if you require a reasonable accommodation for a disability, please contact the ADA Coordinator at the Family Court Administration Office at PHONE NO. 244-2700, FAX 244-2704 OR TTY 244-2889 at least ten (10) working days prior to your hearing or appointment date. For all Civil related matters, please call 244-2706 or visit the Service Center at 2145 Main Street, Room 141, Wailuku, HI 96793 0026 002 () 2FP-02 (Rev 11/11) CommonLook256 508 Certified American LegalNet, Inc. www.FormsWorkFlow.com IN THE FAMILY COURT OF THE SECOND CIRCUIT STATE OF HAWAII Petitioner(s), vs. Respondent(s). FC-P No. SUMMONSTO THE DEFENDANT: YOU ARE HEREBY SUMMONED and required to serve a written answer to the attached Petition, within 20 days after service of this Summons upon you, exclusive of the date of service. Your written answer must be filed with the Chief Clerk of the Second Circuit at the following address: CIRCUIT COURT OF THE SECOND CIRCUIT 002STATE OF HAWAII 002Hoapili Hale 0022145 Main Street 002Wailuku, Hawaii 96793 002A copy of your answer should also be served upon the Petitioner222s attorney, or in the event Petitioner is not represented by an attorney, upon the Petitioner at the address shown on the attached Petition. If you fail to file your written answer within the 20 day time limit, or fail to appear on the day of the trial, further action may be taken in this case, including judgment for the relief demanded in the Petition, without further notice to you. IT IS ALSO ORDERED: )002 )002 )002 )002 )002 ) 002)002) 002) 002) ) ) [ ] 7 1. Both parties shall appear at the Family Court of the Second Circuit , Hoapili Hale, 2FP-02 (Rev 11/11) CommonLook256 508 Certified American LegalNet, Inc. www.FormsWorkFlow.com 8 2145 Main Street, Wailuku, Maui, Hawaii for a hearing on this Petition on at m. in CourtroomTHIS SUMMONS SHALL NOT BE PERSONALLY DELIVERED BETWEEN 10:00 P.M. AND 6:00 A.M. ON PREMISES NOT OPEN TO THE PUBLIC, UNLESS A JUDGE OF THE DISTRICT OR CIRCUIT COURTS PERMITS, IN WRITING ON THE SUMMONS, PERSONAL DELIVERY DURING THOSE HOURS. FAILURE TO OBEY THE SUMMONS MAY RESULT IN AN ENTRY OF A DEFAULT AND DEFAULT JUDGMENT AGAINST THE PERSONS SUMMONED. In accordance with the Americans with Disabilities Act and other applicable state and federal laws, if you require a reasonable accommodation for a disability, please contact the ADA Coordinator at the Family Court Administration Office at PHONE NO. 244-2700, FAX 244-2704 OR TTY 244-2889 at least ten (10) working days prior to your hearing or appointment date. For all Civil related matters, please call 244-2706 or visit the Service Center at 2145 Main Street, Room 141, Wailuku, HI 96793 Dated: , Hawaii, . C