COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : Index No. : Plaintiff(s) -against- Calendar No. : JUDICIAL SUBPOENA : : : Defendant(s) : ...................................................... SUPERIOR COURT OF WASHINGTON THE PEOPLE OF THE STATE OF NEW YORK COUNTY OF TO In re the matter of: NO. Petitioner, JUDGMENT AND ORDER ON PETITION FOR ESTABLISHMENT OF WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before PARENTAGE PURSUANT TO , the Honorable at the Court RCW 26.26.540(2) AND Respondent located at County of GRANTING OTHER RELIEF and in room , on the day of , 20 , at o'clock in the noon, and at any recessed (JDOEP) or adjourned date, to testify and give evidence as a witness in this action on the part of the [ ] Acknowledged Father, if applicable, Respondent Clerk’s action required. [ ] Adjudicated Father, if applicable, Respondent. Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to I. JUDGMENT a maximum the party on whose behalf this subpoena was issued for SUMMARY penalty of $50 and all damages sustained as a result of your failure to comply. GREETINGS: and [] Does not apply. Witness, Honorable [ ] in Judgment Summary is set forth below: Court County, day of A. B. C. D. E. F. G. H. I. J. K. L. , one of the Justices of the , 20 Judgment creditor Judgment debtor (Attorney must sign above and type name below) Principal judgment amount $ Interest to date of judgment $ Attorney’s fees $ Costs $ Attorney(s) for Other recovery amount $ Principal judgment shall bear interest at __________ % per annum Attorney’s fees, costs and other recovery amounts shall bear interest at __________ % per annum Attorney for judgment creditor Office and P.O. Address Attorney for judgment debtor Other: JUDGMENT/ORD (PT ESTABL PARENTAGE) (JDOEP) - Page 1 of 5 WPF PS 16.0500 (7/2003) - RCW 26.26.540(2) Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : Index No. : Plaintiff(s) II. BASIS Calendar No. : JUDICIAL SUBPOENA -against: This matter has come before the court on ____________________________ [Name]’s Petition for Establishment of Parentage Pursuant to RCW 26.26.540(2). The:court considered the case record and has previously entered its Findings of Fact and Conclusions of Law. : This action affects the paternity of _______________________________ [Name of child] _______ [Age Defendant(s) : . .on. the. date.of.this. order].. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. ... . .. ..... III. ORDER THEIS ORDEREDTHE STATE OF NEW YORK IT PEOPLE OF that: TO 3.1 PETITION FOR ESTABLISHMENT OF PARENTAGE. [] [] GREETINGS: [] This proceeding for establishment of parentage was not timely begun and is dismissed. The Petition for Establishment of Parentage is granted. The Petition for Establishment of Parentage is denied. WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before 3.2 DETERMINATION OF PATERNITY. , the Honorable at the Court located at County of [] Does not apply. in room [ ] , on the day of , 20 at o'clock in and _________________________ [Name] is ,the father of the childthe any noon, and at any recessed acknowledged or adjourned date, to testify and give evidence as a witness in this action on the part of the father or adjudicated father named in the proceeding is not the father 3.3 FATHER’S OBLIGATION FOR CHILD SUPPORT. Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to [] The father shall pay child support as set maximum penalty Child and all which [ ] is the party on whose behalf this subpoena was issued for aforth in the Order ofof $50Support damages sustained as a attached [ ] is result of your failure to comply.filed separately. [] Effective as of _______________________ [Date], ______________________ [Name] [ ] is [ ] is not Witness, Honorable relieved from any obligation to pay child support under the child support , one of the Justices of the order entered on _____________________ [Date]. Court in County, day of , 20 3.4 JUDGMENT. (Note - do not repeat this judgment in the Order of Child Support WPF PS 01.0500). (Attorney must sign above and type name below) [] [] Does not apply. _______________________________ [Name] shall have judgment against ______________________ [Name] in the total amount of $_______________ as follows: Attorney(s) for [] $_______________ for genetic testing costs. [] $_______________ for guardian ad litem fees. [] $_______________ for attorney’s fees. Office and P.O. Address [] $_______________ costs. [] $_______________ for other fees andTelephone No.: expenses. JUDGMENT/ORD (PT ESTABL PARENTAGE) (JDOEP) - Page 2 of 5 WPF PS 16.0500 (7/2003) - RCW 26.26.540(2) Facsimile No.: E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : Index No. : [] [] Other: Plaintiff(s) Calendar No. : JUDICIAL SUBPOENA -against: ____________________ [Name] shall have judgment against ________________ [Name] for _________________________ in the amount: of $_______________. : JUDGMENT FOR BACK CHILD SUPPORT. Defendant(s) (Note - do not repeat this judgment in the Order of Child Support WPF PS 01.0500). : ...................................................... 3.5 [] [] Does not apply. _________________________________ [Name] is awarded a judgment against ________________________ [Name] in the amount of $__________________, for back THE PEOPLE OF THE STATE OF NEW YORK child support for the period from _______________ [Date] to _____________ [] The unpaid child support due to _________________________________ [Name] by TO ______________________________ [Name] is waived and will not be collected by ____________________________ [Name]. This does not waive any child support owing to the state as a result of payment of public assistance. [] GREETINGS: All child support due under temporary court orders has been paid. [] Unpaid support due under a court or administrative order is preserved for collection and is not merged in or that all business and excuses WE COMMAND YOU, extinguished by this order. being laid aside, you and each of you attend before [] , the Honorable Other: at the Court located at County of ] in[room Collection on the , Limitation Against Wages: day of , 20 , at o'clock in the noon, and at any recessed or adjourned date, to testify and give evidence as a witness in this action on the part of the The back child support provision above shall be paid at a rate of at least $__________ per month beginning __________________ [Date]. So long as the payments for current support, back support and the judgment are timely, collection against the judgment Your failure to comply with this subpoena is punishable assum payments, court be limited to you liable to debtor’s wages, excluding bonuses and other lump a contempt of shall and will make the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a $_______________ per month (for current support, back support and judgment). THIS result of your failure to comply. TERMINATES IF A SINGLE PAYMENT IS PAST DUE. This provision LIMITATION does not limit or bar the state of Washington from using other collection remedies available to Witness, Honorable it by law, including, but not limited to, certification for collection to thethe , one of the Justices of Internal Revenue Service. Payment shall be made to: Court in County, day of , 20 [] Wage Withholding Action: [] (Attorney must sign above and type name below) Withholding action may be taken against wages, earnings, assets, or benefits, and liens enforced against real and personal property under the child support statutes Attorney(s) for of this or any other state, without further notice to the judgment debtor any time after entry of an order by the court, except as limited by the Collection Limitation Against Wages paragraph above. [] Office and or other income Wage withholding, by notice of payroll deduction P.O. Address withholding action under Chapter 26.18 RCW or Chapter 74.20 RCW, without further notice to the judgment debtor, is delayed until a payment is past due, because: Telephone No.: JUDGMENT/ORD (PT ESTABL PARENTAGE) (JDOEP) - Page 3 of 5 Facsimile No.: WPF PS 16.0500 (7/2003) - RCW 26.26.540(2) E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : : Index No. Calendar No. : [] there is good cause not to require immediate income withholding. JUDICIAL SUBPOENA Plaintiff(s) [] the parties have reached a written agreement which the court approves -against- provides for an alternative arrangement. (See below) : that [] : Judgment and Back Support Payments Shall Be Made to: : [ ] __________________________________________ Defendant(s) __________________________________________ : ...................................................... [] Washington State Support Registry P.O. Box 45868 Olympia, Washington 98504 THE PEOPLE OF THE STATE OF NEW YORK Phone: 1-800-922-4306 1-800-442-5437 TO Each party shall notify the Washington State Support Registry of any change in residence address 3.6 JURISDICTION OVER THE CHILD. GREETINGS: The court has jurisdiction over the child as set forth in being laid aside, you and each of you attend before WE COMMAND YOU, that all business and excuses the Findings of Facts and Conclusions of Law. , the Honorable at the Court located at County of in3.7 room RESIDENTIAL SCHEDULE/PARENTING PLAN. , on the day of , 20 , at o'clock in the noon, and at any recessed or adjourned date, to testify and give evidence as a witness in this action on the part of the [] The primary residence of the child shall be with ______________________ [Name], who is designated custodian solely for the purpose of other state and federal statutes. [] The residential plan/parenting plan signed by the court on __________________ [Date] is Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to adopted and incorporated by reference. the party on whose behalf this subpoena was issued for[Name] shall be designated the custodian of the sustained as a [] ______________________________ a maximum penalty of $50 and all damages result of your failure to comply.child shall reside with _______________________ [Name] at all times. child, and the [] Determination of residential time of ________________________________ [Name] with the child is denied. Witness, Honorable , one of the Justices of the Other: Court in [ ] County, day of , 20 3.8 AMENDMENT OF BIRTH CERTIFICATE. (Attorney must sign above and type name below) The birth certificate of the child, __________________________ [Name] [ ] shall [ ] shall not be amended by the Washington State Registrar of Vital Statistics by removing ______________________________ [Name] from the birth certificate as the child’s father [ ] and Attorney(s) for by changing the child’s surname to ____________________________ [Surname]. [] [] The Washington State Registrar of Vital Statistics shall amend the child’s birth certificate to identify _____________________________ [Name] as the child’s father. Other: Office and P.O. Address JUDGMENT/ORD (PT ESTABL PARENTAGE) (JDOEP) - Page 4 of 5 WPF PS 16.0500 (7/2003) - RCW 26.26.540(2) Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : Index No. : 3.9 : Plaintiff(s) OTHER. -against- Calendar No. JUDICIAL SUBPOENA : : : Defendant(s) : ...................................................... Dated: _________________________________ THE PEOPLE OF THE STATE OF NEW YORK Presented by: TO _______________________________________ Signature GREETINGS: ______________________________________ Judge/Commissioner Approved for entry: Notice of presentation waived: ______________________________________ Signature _______________________________________ ______________________________________ WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before Print or Type Name Print or Type Name , the Honorable at the Court located at County of Approval required in Public Assistance cases. ______________________________________ inApproved for entry, notice of presentation waived: , 20 Signature o'clock in the room , on the day of , at noon, and at any recessed or adjourned date, to testify and give evidence as a witness in this action on the part of the _______________________________________ ______________________________________ Public Assistance DPA Signature/WSBA No. Print or Type Name Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to the party on whose behalf this subpoena was issued for a ______________________________________ maximum penalty of $50 and all damages sustained as a Print or Type Name Signature result of your failure to comply. Witness, Honorable Court in County, day of ______________________________________ , one of the Justices of the Print or Type Name , 20 (Attorney must sign above and type name below) Attorney(s) for Office and P.O. Address JUDGMENT/ORD (PT ESTABL PARENTAGE) (JDOEP) - Page 5 of 5 WPF PS 16.0500 (7/2003) - RCW 26.26.540(2) Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com