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, and GREETINGS: PETITION FOR ESTABLISHMENT OF PARENTAGE PURSUANT TO WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before Respondent RCW 26.26.540(2) , the Honorable at the Court and (PTDTP) located at County of in room Acknowledgedthe , on Father, ifday of , 20 o'clock in the noon, and at any recessed [] applicable, Respondent , at or adjourned date, to testify and give evidence as a witness in this action on the part of the [ ] Adjudicated Father, if applicable, Respondent. Use thisYour failure tothere is an adjudicated fatheris punishable as a contempt of court filed will make you liable to petition when comply with this subpoena or an Acknowledgment of Paternity and with the Washington State Registrar ofsubpoena was issued for ause form WPF PS 01.0100.and all damages sustained as a the party on whose behalf this Vital Statistics; otherwise maximum penalty of $50 result of your failure to comply. I. BASIS 1.1 CAUSE OF ACTION. Witness, Honorable , one of the Justices of the This action affects the paternityof of: Court in County, day , 20 ___________________________________ [Name], born on __________________ [Date], a resident of _______________________ County, Washington. (Attorney must sign above and type name below) ___________________________________ [Name], born on __________________ [Date], a resident of _______________________ County, Washington. Petitioner, _____________________ [Name] brings this petition for the establishment of Attorney(s) for parentage pursuant to RCW 26.26.540(2). The respondents in this action are the child’s mother __________________________ [Name], [ ] the child’s acknowledged father, _____________________________ [Name], who signed an Acknowledgment of Paternity and filed it with the Washington State Registrar of Vital Statistics on Office and P.O. Address _______________________________ [Date]; [ ] the child’s adjudicated father ______________________ [Name], as determined by court order and judgment entered on ______________________________ [Date]. A copy of the judgment of paternity is attached. Telephone No.: PET FOR ESTAB PARENTAGE (PTDTP) - Page 1 of 5 Facsimile No.: WPF PS 16.0100 (7/2003) - RCW 26.26.540(2) E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : : 1.2 Index No. Calendar No. : EFFECTIVE DATE OF ACKNOWLEDGMENT OF PATERNITY. JUDICIAL Plaintiff(s) [] [] SUBPOENA -against: Does not apply. The effective date of the Acknowledgment of Paternity is ___________________ [Date] : because: [ ] the acknowledgment was filed with the Washington State Registrar of Vital Statistics : on that date. Defendant(s) : [ ] that was the date of the child’s birth which is after the date on which the ...................................................... acknowledgment was filed with the Washington State Registrar of Vital Statistics. A copy of the Acknowledgment of Paternity is filed with this petition. THE PEOPLE OF THE STATE OF NEW YORK 1.3 BASIS OF PERSONAL JURISDICTION. (Check all that apply.) TO [] The mother and petitioner engaged in sexual intercourse in the state of Washington as a result of which the child was conceived. GREETINGS: Jurisdiction over mother: WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before , the Honorable The mother was personally servedat the a summons within this state; Court [] with located at County of[ ] The mother submits to jurisdiction of this state by consent as evidenced by joinder or in room , on the day of , 20 , o'clock in the noon, and at any recessed consent to jurisdiction signed by the mother;at or adjourned date,The mother resided evidencechild witness in this action on the part of the to testify and give with the as a in this state; [] [] The mother resided in this state and provided prenatal expenses or support for the child; [] The child resides in this state as a result of the acts or directives of the mother; [] Other: 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 result of your failure to comply. Jurisdiction over acknowledged or adjudicated father: Witness, Honorable , one with summons the [] ___________________________ [Name] was personally served of theaJustices of within Court in County, day of , 20 this state. [] __________________________ [Name] submits to jurisdiction of this state by consent as evidenced by joinder or consent to jurisdiction signed by the acknowledged or adjudicated father; (Attorney must sign above and type name below) [] __________________________ [Name] resided with the child in this state; [] __________________________ [Name] resided in this state and provided prenatal expenses or support for the child Attorney(s) for [] The child resides in this state as a result of the acts or directives of ___________________________ [Name of acknowledged or adjudicated father]. [] Other: [] Office and Washington: The following parties are presently residing in the state of P.O. Address [ ] mother PET FOR ESTAB PARENTAGE (PTDTP) - Page 2 of 5 WPF PS 16.0100 (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. : [ ] acknowledged father [ ] adjudicated father [ ] Other: -against1.4 Plaintiff(s) TIME FOR FILING PETITION. Calendar No. : JUDICIAL SUBPOENA : : : This proceeding is begun not more than two years after [ ] the effective date of the Acknowledgment of Paternity [ ] theDefendant(s) date the judgment adjudicating paternity was entered. : ...................................................... 1.5 JURISDICTION OVER THE CHILD. This court has jurisdiction over the child for the reasons set forth below: THE PEOPLE OF THE STATE OF NEW YORK [ ] This court has exclusive continuing jurisdiction. The court has previously made a child custody, parenting plan, residential schedule or visitation determination in this matter and TO retains jurisdiction under RCW 26.27.211. [ ] This state is the home state of the child because [ ] the child lived in Washington with a parent or person acting as a parent for at least six consecutive months immediately preceding the commencement of this GREETINGS: proceeding; [ ] the child is less than six months old and has lived in Washington with a parent WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before or a person acting as parent since birth; , the Honorable at the Court [ ] any absences from Washington have only been temporary; located at County of [ ] Washington was the home state of the child within six months before the in room , on thecommencement of this proceeding ,and the child is absent from the stateand at any recessed day of , 20 at o'clock in the noon, but a or adjourned date, to testify and give evidence as a witness in this action on the part of the parent or person acting as a parent continues to live in this state; [ ] The child and the parents or the child and at least one parent or person acting as a parent, have significant connection with the state other than mere physical presence; and substantial evidence is available in this state concerning of child’s care, protection, Your failure to comply with this subpoena is punishable as a contempt thecourt and will make you liable to training and personal relationships and the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a [ ] the result of your failure to comply. child has no home state elsewhere; [ ] the child’s home state has declined to exercise jurisdiction on the ground that this state is the more appropriate forum under RCW 26.27.261 Justices of the Witness, Honorable , one of the or .271. [ ] All courts in the child’s home state have declined to exercise jurisdiction on the ground Court in County, day of , 20 that a court of this state is the more appropriate forum to determine the custody of the child under RCW 26.27.261 or .271. [ ] No other state has jurisdiction. (Attorney must sign above and because the child [ ] This court has temporary emergency jurisdiction over this proceedingtype name below) is present in this state and the child has been abandoned or it is necessary in an emergency to protect the child because the child, or a sibling or parent of the child is subjected to or threatened with abuse. RCW 26.27.231.for Attorney(s) [ ] Other: 1.6 CHILD SUPPORT. Office and P.O. Address The child is entitled to financial support pursuant to the Washington State Support Schedule and health insurance coverage from any parent owing a duty of child support. PET FOR ESTAB PARENTAGE (PTDTP) - Page 3 of 5 WPF PS 16.0100 (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. : 1.7 PARENTAGE AND RESIDENTIAL PLACEMENT. Plaintiff(s) Calendar No. : JUDICIAL SUBPOENA -against: It is in the child’s best interest to obtain a judicial determination of the parentage of the child and to make provisions for the residential placement of the child. : [] It is in the child’s best interests to enter the residential schedule/parenting plan proposed by : petitioner. Defendant(s) : . . . . . . . . During the. last . . . . years,. the. child has .lived: . . . . . . . . . . . . . . . . . . . . . five . . . . . . . . . . . . . . . . . [] in no place other than the state of Washington and with no person other than the declarant or a named party. THE PEOPLE OF THE followingOF NEW YORK [] in the STATE places with the following persons (list each place the child lived, including the state of Washington, the dates the child lived there and the names of the persons with TO whom the child lived. The present addresses of those persons must be listed in the required Confidential Information Form.): GREETINGS: to custody or visitation. Claims WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before [] I do not know of any person other than a named party who has physical custody of, or , the Honorable at the Court claims to have custody or visitation rights to the child. located at County of [] The following persons have physical custody of, or claim to have custody or visitation in room , on to day of 20 at o'clock in the noon, and at any rightsthe the child (list their names, and the ,child(ren) concerned below and list their presentrecessed or adjourned date, to testify and give evidence as a witness in this action on the part of the addresses in the Confidential Information Form. Do not list the responding party.): Involvement in any other proceeding concerning the child: 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 [] I have not been result of your failure to comply. involved in any other proceeding regarding the child. [] I have been involved in the following proceedings regarding the child (list the court, the case number, and the date of the judgment or order): Witness, Honorable , one of the Justices of the Court in County, day of , 20 Other legal proceedings concerning the child: [] [] 1.8 (Attorney must child. I do not know of any other legal proceedings concerning thesign above and type name below) I know of the following legal proceedings which concern the child (list the child concerned, the court, case number and the kind of proceeding): Attorney(s) for OTHER. Office and P.O. Address II. RELIEF REQUESTED Telephone No.: PET FOR ESTAB PARENTAGE (PTDTP) - Page 4 of 5 Facsimile No.: WPF PS 16.0100 (7/2003) - RCW 26.26.540(2) E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : Index No. : : The court is requested to enter an order and judgment that: Plaintiff(s) Calendar No. JUDICIAL SUBPOENA : Declares -against_________________________ [Name] to be the father of the child. Amends the birth certificate of the child to identify the father. : Changes the child’s surname to _______________________ [Surname]. Determines support for the dependent child pursuant to the Washington State Child : Support Schedule and orders either or both parents to maintain or provide health insurance coverage for the child and pay extraordinary uninsured costs proportionate to their income. Defendant(s) : . . . . . . . . [ . . . . . .Adopts.a residential.schedule/parenting. plan. for .the child as proposed by petitioner. .] ..... ......... .............. ... .. . [] Awards court costs, genetic test costs, guardian ad litem, attorney, and other reasonable fees. [] Other: THE PEOPLE OF THE STATE OF NEW YORK [] [] [] [] TO Dated: ______________________________ _______________________________________ Petitioner or Lawyer for Petitioner/WSBA No. III. DECLARATION GREETINGS: I declare under penalty of perjury under the laws of the state of Washington that I am the petitioner in this WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before action, that I have made the allegations contained in this petition based upon my first hand knowledge, and , the Honorable at the Court therefore believe that they are true. located at County of inSigned at ________________________, [City] __________ [State] on ____________________ [Date]. recessed room , on the day of , 20 , at o'clock in the noon, and at any or adjourned date, to testify and give evidence as a witness in this action on the part of the Signature of Petitioner Print or Type Name [] JOINDER. Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to the party on whose _______________________________ [Name] join in the petition.and all damages sustained as a [] I behalf this subpoena was issued for a maximum penalty of $50 By joining in the result of your failure to comply. to the entry of a judgment and order in accordance with the petition, petition, I agree without further notice. Witness, Honorable Dated: ____________________________ Court in County, day of , one of the Justices of the _____________________________________ , 20 Signature of Joining Party _____________________________________ Print or Type Name (Attorney must sign above and type name below) [] I _______________________________ [Name] join in the petition. By joining in the petition, I agree to the entry of a judgment and order in accordance with the petition, without further notice. Attorney(s) for Dated: ____________________________ _____________________________________ Signature of Joining Party _____________________________________ Office and P.O. Print or Type Name Address PET FOR ESTAB PARENTAGE (PTDTP) - Page 5 of 5 WPF PS 16.0100 (7/2003) - RCW 26.26.540(2) Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com