Superior Court of Washington County of In re Parentage: No. Petitioner, and Respondent, and [ ] Presumed Father, if applicable Respondent. Findings of Fact and Conclusions of Law on Rescission of Paternity Acknowledgment (FNFCL) I. Basis for Findings The findings are based upon: [] [] [] agreement of the parties. an order of default signed by the court on this date or dated _______________________. a hearing held on (date) _________________________. The following people attended: [] [] [] Mother Acknowledged Father Presumed Father [] [] [] Mother’s Attorney Acknowledged Father’s Attorney Presumed Father’s Attorney [] Guardian ad Litem [] Other: II. Findings of Fact Based upon the court record, the court finds: 2.1 Notice and Personal Jurisdiction Over the Parties All parties necessary to adjudicate the issues were served with a copy of the summons and petition and are subject to the jurisdiction of this court. At the commencement of this action, no other court hearing involving these parties and the child had taken place. The facts below establish personal jurisdiction over the parties: [] The mother signed the Paternity Acknowledgment that was filed with the Washington State Registrar of Vital Statistics on (date) ___________________. Findings/Concl of Laws (Resc Pat Ackn) (FNFCL) - Page 1 of 4 WPF PS 11.0400 Mandatory (06/2012) - RCW 26.26.330 and 340 American LegalNet, Inc. www.FormsWorkFlow.com [] [] [] 2.2 The acknowledged father signed a Paternity Acknowledgment that was filed with the Washington State Registrar of Vital Statistics on (date) _____________________________. The presumed father signed a Denial of Paternity that was filed with the Washington State Registrar of Vital Statistics on (date) ___________________. Other: The Child Whose Paternity Is Affected in This Action This action affects the paternity of (name) ________________________ born on (date) ___________________________. The result of this proceeding does not establish or disestablish the paternity of the acknowledged father; it will only establish whether the Paternity Acknowledgment may be rescinded (withdrawn). 2.3 Parentage Action [ ] A parentage action has been filed. [ ] A parentage action has not been filed. [ ] (Name) _______________________________ should be ordered to file a proceeding to adjudicate parentage in this cause. 2.4 Rescission Period The effective date of the Paternity Acknowledgment is (date) ______________________, and this proceeding was begun [ ] more [ ] not more than 60 days from the effective date of the Paternity Acknowledgment. [ ] There was no court hearing involving the petitioner on issues concerning the child held before the petitioner started this case. [ ] There was a court hearing involving the petitioner on issues concerning the child before the petitioner started this case. [ ] The effective date of the Denial of Paternity is (date) _________________________, and this proceeding was begun [ ] more [ ] not more than 60 days from the effective date of the Denial of Paternity. [ ] There was no court hearing involving the petitioner on issues concerning the child held before the petitioner started this case. [ ] There was a court hearing involving the petitioner on issues concerning the child before the petitioner started this case. [ ] The petitioner was a minor when he or she signed the Paternity Acknowledgment or Denial of Paternity, and the petition in this case [ ] was [ ] was not filed or served on or before the petitioner’s 19th birthday. 2.5 Child’s Name [] [] 2.6 There is not good cause to change the child’s surname. There is good cause to change the child’s surname to __________________________. Continuing Restraining Order [] [] Does not apply. A continuing restraining order against the [ ] father [ ] mother [ ] both parties is necessary because: Findings/Concl of Laws (Resc Pat Ackn) (FNFCL) - Page 2 of 4 WPF PS 11.0400 Mandatory (06/2012) - RCW 26.26.330 and 340 American LegalNet, Inc. www.FormsWorkFlow.com [] 2.7 Protection Order [] [] 2.8 Other: Does not apply. The [ ] domestic violence [ ] antiharassment Order for Protection signed by the court on this date or dated ______________________, is approved and incorporated as part of these findings. Attorney Fees and Costs Fees and costs in the amount of $______________ should be awarded to (name) _________________________ payable by (name) _____________________________. III. Conclusions of Law 3.1 Jurisdiction [] [] 3.2 The court has jurisdiction to enter an order in this matter. The court does not have jurisdiction to enter an order. Disposition The court shall enter an order on rescission: [] [] [] [] [] [] [] [] [] Dismissing the petition because this proceeding to rescind the Paternity Acknowledgment was not timely begun. Granting the Petition to Rescind the Paternity Acknowledgment [ ] and voiding the Denial of Paternity. Denying the Petition to Rescind the Paternity Acknowledgment. Making provision for an amended birth certificate of the child. Making provision for a domestic violence protection order. Making provision for an antiharassment protection order. Making provision for a continuing restraining order. Ordering (name) __________________________ to begin a proceeding to adjudicate paternity. Ordering (name) __________________________ to pay attorney fees and costs in the amount of $______________ payable to (name) ______________________________. Findings/Concl of Laws (Resc Pat Ackn) (FNFCL) - Page 3 of 4 WPF PS 11.0400 Mandatory (06/2012) - RCW 26.26.330 and 340 American LegalNet, Inc. www.FormsWorkFlow.com Dated: Judge/Commissioner Presented by: Approved for entry: Notice of presentation waived: Signature of Party or Lawyer/WSBA No. Signature of Party or Lawyer/WSBA No. Print or Type Name Print or Type Name Date Date Signature of Party or Lawyer/WSBA No. Print or Type Name Date Findings/Concl of Laws (Resc Pat Ackn) (FNFCL) - Page 4 of 4 WPF PS 11.0400 Mandatory (06/2012) - RCW 26.26.330 and 340 American LegalNet, Inc. www.FormsWorkFlow.com