Superior Court of Washington County of In re the matter of: No. Petitioner, and Respondent Judgment and Order on Petition to Disestablish Paternity Based on Presumption and Granting Other Relief (JODRDP) Clerk’s Action Required, para. 3.4, 3.5, 3.7 Law Enforcement Notification 3.7 I. Judgment/Order Summaries 1.1 Restraining Order Summary [ ] Does not apply. [ ] Restraining Order Summary is set forth below: . Name of person(s) Name of person(s) restrained: protected: . See Paragraph 3.7. Violation of a Restraining Order in Paragraph 3.7 below with actual knowledge of its terms is a criminal offense under Chapter 26.50 RCW and will subject the violator to arrest. RCW 26.26.590 1.2 Money Judgment Summary [] A. B. C. D. E. F. G. H. Does not apply. [] Judgment Summary is set forth below: Judgment creditor Judgment debtor Principal judgment amount Interest to date of judgment Attorney fees Costs Other recovery amount Principal judgment shall bear interest at __________ % per annum $ $ $ $ $ Judgment/Ord (Pt Disestabl Pat) (JODRDP) - Page 1 of 5 WPF PS 17.0500 (6/2006) - RCW 26.26.116, 26.26.500 – .630 American LegalNet, Inc. www.USCourtForms.com I. J. K. L. Attorney fees, costs and other recovery amounts shall bear interest at __________ % per annum Attorney for judgment creditor Attorney for judgment debtor Other: II. Basis This matter has come before the court on ____________________________ [Name]’s Petition to Disestablish Paternity Based on Presumption. Findings of Fact and Conclusions of Law have been entered in this case. This action affects the paternity of _______________________________ [Name of Child] _______ [Age on the date of this order]. III. Order It is Ordered: 3.1 Petition to Disestablish Paternity Based on Presumption [] [] 3.2 Determination of Paternity [] [] 3.3 The presumed father is declared not to be the father of the child. The presumed father is determined to be the father of the child. Amendment of Birth Certificate [] [] 3.4 The Petition to Disestablish Paternity Based on Presumption is granted. The Petition to Disestablish Paternity Based on Presumption is denied. Does not apply. The birth certificate of the child, __________________________ [Name of child] shall be amended by the Washington State Registrar of Vital Statistics by removing ______________________________ [Name] from the birth certificate as the child’s father. Judgment [] [] Does not apply. _______________________________ [Name] shall have judgment against ______________________ [Name] in the total amount of $_______________ as follows: [] $_______________ for genetic testing costs. [] $_______________ for guardian ad litem fees. [] $_______________ for attorney fees. [] $_______________ costs. [] $_______________ for other fees and expenses. Judgment/Ord (Pt Disestabl Pat) (JODRDP) - Page 2 of 5 WPF PS 17.0500 (6/2006) - RCW 26.26.116, 26.26.500 – .630 American LegalNet, Inc. www.USCourtForms.com [] [] Other: ____________________ [Name] shall have judgment against _______________ [Name] for _________________________ in the amount of $_______________. 3.5 County Costs [] [] [] 3.6 Does not apply. The Superior Court of __________________________ shall have judgment against _____________________________ [Name] for costs of this action specified as follows: Other: Guardian ad Litem [] [] [] 3.7 Does not apply. Any guardian ad litem appointed by the court is discharged. Other: Continuing Restraining Order [] [] Does not apply. A continuing restraining order is entered as follows: [] [] [] [] ______________________________ [Name] is restrained and enjoined from disturbing the peace of the other party. _______________________________ [Name] is restrained and enjoined from going onto the grounds of or entering the home, work place or school of the other party, or the day care or school of the following named children: _______________________________________________________________ _____________________________ [Name] is restrained and enjoined from knowingly coming within or knowingly remaining within _________________ [Distance] of the home, work place or school of the other party, or the day care or school of these children: _______________________________________________________________. Other: ________________________________________________________. _____________________________ [Name] is restrained and enjoined from molesting, assaulting, harassing or stalking _____________________ [Name]. (The following firearm restrictions apply if this box is checked: Effective immediately and continuing as long as this continuing restraining order is in Judgment/Ord (Pt Disestabl Pat) (JODRDP) - Page 3 of 5 WPF PS 17.0500 (6/2006) - RCW 26.26.116, 26.26.500 – .630 American LegalNet, Inc. www.USCourtForms.com [] effect, the restrained person may not possess a firearm or ammunition. 18 U.S.C. § 922(g)(8). A violation of this federal firearms law carries a maximum possible penalty of 10 years in prison and a $250,000 fine. An exception exists for law enforcement officers and military personnel when carrying department/government-issue firearms. 18 U.S.C. § 925(a)(1).) Other: Violation of a Restraining Order in Paragraph 3.7 with actual knowledge of its terms is a criminal offense under Chapter 26.50 RCW and will subject the violator to arrest. rCW 26.26.130 [] Service [] [] Clerk’s Action. The clerk of the court shall forward a copy of this order, on or before the next judicial day, to__________________________________ [name of the appropriate law enforcement agency] which shall enter this order into any computerbased criminal intelligence system available in this state used by law enforcement agencies to list outstanding warrants. (A law enforcement information sheet must be completed by the party or the party’s attorney and provided with this order before this order will be entered into the law enforcement computer system.) The restrained party or attorney appeared in court or signed this order; service of this order is not required. The restrained party or attorney did not appear in court; service of this order is required. Expiration [Month/Day/Year]. This restraining order expires on: This restraining order supersedes all previous temporary restraining orders in this cause number. [] Any temporary restraining order previously entered in this cause number is terminated. Clerk’s Action. The clerk of the court shall forward a copy of this order, on or before the next judicial day, to: ______________________________ law enforcement agency where Petitioner resides which shall enter this order into any computer-based criminal intelligence system available in this state used by law enforcement agencies to list outstanding warrants. Full Faith and Credit Pursuant to 18 U.S.C. § 2265, a court in any of the 50 states, the District of Columbia, Puerto Rico, any United States territory, and any tribal land within the United States shall accord full faith and credit to the order. 3.8 Protection Order [] [] Does not apply. The parties shall comply with the Order for Protection signed by the court on this date, _____________________________ in this cause number. The Order for Protection signed by the court is approved and incorporated as part of this decree. Judgment/Ord (Pt Disestabl Pat) (JODRDP) - Page 4 of 5 WPF PS 17.0500 (6/2006) - RCW 26.26.116, 26.26.500 – .630 American LegalNet, Inc. www.USCourtForms.com 3.9 Other 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 Date ______________________________________ Print or Type Name Date ______________________________________ Signature of Guardian ad Litem _____________________________________ Print or Type Name Date Judgment/Ord (Pt Disestabl Pat) (JODRDP) - Page 5 of 5 WPF PS 17.0500 (6/2006) - RCW 26.26.116, 26.26.500 – .630 American LegalNet, Inc. www.USCourtForms.com