Superior Court of Washington County of In re: No. Petitioner, Motion/Declaration for Default (Child Support Modification) (MTDFL) and Respondent. I. Motion ________________________________________ [Name] moves the court for an order of default against ________________________________________ [Name]. Venue of this action is proper as set forth in the declaration below. Dated: Signature of Moving Party or Lawyer/WSBA No. Print or Type Name II. Declaration 2.1 Proper Venue Venue is proper in this court. [] The most recent support order was entered in this county. The petitioner resides in _________________________________________ [County and State]. The child(ren) reside(s) in ________________________________________ [County and State]. Respondent resides in ___________________________________________ [County and State]. [] 2.2 Other: Jurisdiction Over Parties. Mot/Decl for Default (Child Suppt Mod) (MTDFL) - Page 1 of 3 WPF DR 06.0400 (6/2006) - CR 55 (a); RCW 26.09.175 American LegalNet, Inc. www.USCourtForms.com This court has jurisdiction over the parties because: [] [] [] 2.3 There is a Washington Order of Child Support. Both parties presently reside in the state of Washington. Other: Service of Process The affidavit of service on file with the court shows that the nonmoving party was served with summons, petition and child support worksheet. 2.4 Time Elapsed Since Service of Process [] [] [] [] [] 2.5 The nonmoving party was served within the state of Washington and more than 20 days have elapsed since the date of service. The nonmoving party was served outside the state of Washington and more than 60 days have elapsed since the date of service. The nonmoving party was served by mail in lieu of publication and more than 90 days have elapsed since the date of mailing. The nonmoving party was served by publication and more than 60 days have passed since the date of first publication. Other: Appearance of the Parties The nonmoving party has failed to appear, or if appeared, has failed to otherwise defend this action. 2.6 Servicemembers Civil Relief Act Statement 2.6.1 [] 2.6.2 The nonmoving party – service member: The nonmoving party is not a service member or a dependent of a service member. [] is on active duty in the U.S. armed forces (excluding National Guard and reserves); [] is on active duty and is a National Guard member or a Reservist residing in Washington; [] is not on active duty in the U.S. armed forces (excluding National Guard and reserves); [] is not on active duty and is a National Guard member or a Reservist residing in Washington; [] I am unable to determine whether the nonmoving party is or is not on active duty as a National Guard member or a Reservist residing in Washington; [] I am unable to determine whether the nonmoving party is or is not on active duty in the U.S. armed forces; based upon the following facts: [] As indicated above, the nonmoving party is on active duty and (check all that apply): Mot/Decl for Default (Child Suppt Mod) (MTDFL) - Page 2 of 3 WPF DR 06.0400 (6/2006) - CR 55 (a); RCW 26.09.175 American LegalNet, Inc. www.USCourtForms.com [] [] [] 2.6.3 The nonmoving party is represented by an attorney. The court has appointed an attorney to represent the nonmoving party. A stay of these proceedings [ ] has [ ] has not been entered by the court. The nonmoving party – dependent of service member: [] is a dependent of a resident of Washington who is on active duty and is a National Guard member or a Reservist; [] is not a dependent of a resident of Washington who is on active duty and is a National Guard member or a Reservist; [] I am unable to determine whether the nonmoving party is a dependent of a resident of Washington who is on active duty and is a National Guard member or a Reservist; based upon the following facts: [] [] As indicated above, the nonmoving party is a dependent of a resident of Washington who is on active duty and is a National Guard member or a Reservist and (check all that apply): [] [] [] 2.7 The nonmoving party failed to respond to a notice to him or her as a dependent of a person in Military Service that was [ ] served on [ ] mailed by first class mail on ________________________________________ [Date], therefore he or she should be presumed not a dependent of a resident of Washington who is on active duty and is a National Guard member or a Reservist. The nonmoving party is represented by an attorney. The court has appointed an attorney to represent the nonmoving party. A stay of these proceedings [ ] has [ ] has not been entered by the court. Mailing of Documents [] [] Does not apply because the nonmoving party has failed to appear or otherwise defend. Copies of the following documents were mailed on ______________________ [Date] to: I declare under penalty of perjury under the laws of the state of Washington that the foregoing is true and correct. Signed at _______________________, [City ]___________ [State] on ____________________ [Date]. Signature of Moving Party Print or Type Name Mot/Decl for Default (Child Suppt Mod) (MTDFL) - Page 3 of 3 WPF DR 06.0400 (6/2006) - CR 55 (a); RCW 26.09.175 American LegalNet, Inc. www.USCourtForms.com