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 Parentage: NO. Petitioner, JUDGMENT AND ORDER ON RESCISSION OF ACKNOWLEDGMENT OF WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before PATERNITY WITHIN 60 DAYS AND , the Honorable at the Court GRANTING OTHER RELIEF Respondent located at County of and (JDOAKP) in room , 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 [ ] Presumed Father, if applicable, Respondent. Clerk’s action required. GREETINGS: and I. JUDGMENT SUMMARY Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to the ]party on not apply. [ Does whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a result of your failure to comply. [ ] Judgment Summary is set forth below: Witness, Honorable , one of the Justices of the A. in Judgment creditor Court County, day of , 20 B. Judgment debtor C. Principal judgment amount $ D. Interest to date of judgment $ (Attorney must sign above and type name below) E. Attorney’s fees $ F. Costs $ G. Other recovery amount $ H. Principal judgment shall bear interest at __________ % per annum for Attorney(s) I. Attorney’s fees, costs and other recovery amounts shall bear interest at __________ % per annum J. Attorney for judgment creditor K. Attorney for judgment debtor L. Other: Office and P.O. Address JUDGMENT/ORD (RESC ACKN OF PAT) (JDOAKP) - Page 1 of 2 WPF PS 11.0500 (7/2003) - RCW 26.26.330 and 340 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 Rescission of Acknowledgment of Paternity Within 60 Days. 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 [] This proceeding to rescind the Acknowledgment of Paternity was not timely begun and is dismissed. [] The Petition to Rescind the Acknowledgment of Paternity is granted [ ] and the Denial of Paternity is void. GREETINGS: The Petition to Rescind the Acknowledgment of Paternity is denied. [] [] The birth certificate of the child, __________________________ [Name], shall be WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before amended by the Washington State Registrar of Vital Statistics by removing the , the Honorable at the Court acknowledged father’s name from the birth certificate [ ] and by changing the child’s located at County of surname to ____________________________ [Surname]. in room [ ] , on the day of , 20 , at o'clock in the noon, in at ________________________ [Name] is ordered to pay attorney fees and costsandthe any recessed or adjourned date, to testify and give evidence as a witness in this action on the part of the amount of $________________ payable to ______________________________ [Name] Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to Dated: the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a Judge/Commissioner result of your failure to comply. Presented by: Witness, Honorable Court in County, day of Approved for entry:one of the Justices of the , Notice of presentation waived: , 20 Signature Signature (Attorney must sign above and type name below) Print or Type Name Print or Type Name Attorney(s) for Signature Office and P.O. Address Print or Type Name JUDGMENT/ORD (RESC ACKN OF PAT) (JDOAKP) - Page 2 of 2 WPF PS 11.0500 (7/2003) - RCW 26.26.330 and 340 Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com