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. PETITION FOR RESCISSION OF GREETINGS: and ACKNOWLEDGMENT OF PATERNITY WITHIN 60 DAYS BY WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before Respondent [ ] ACKNOWLEDGED FATHER , the Honorable at the Court and [ ] MOTHER located at County of (PT) in room Presumed ,father, if applicable, Respondent. 20 on the day of , , 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 I. BASIS Petitioner, 1.1 CAUSE OF ACTION. 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 of: issued for a maximum penalty of $50 and all damages sustained as a This action affects the paternity was result of your failure to comply. ___________________________________ [Name], born on ____________________ [Date], a resident of _____________________________ County, Washington.one of the Justices of the Witness, Honorable , Court in County, day of , 20 ___________________________________ [Name], born on ____________________ [Date], a resident of _____________________________ County, Washington. (Attorney must sign above The result of this proceeding will not establish or disestablish the paternity ofand type name below) the acknowledged father; it will only establish whether the Acknowledgment of Paternity may be rescinded (withdrawn). Attorney(s) for This action is brought by petitioner _____________________ [Name], the [ ] mother [ ] acknowledged father, to rescind the Acknowledgment of Paternity signed by petitioner and filed with the Washington State Registrar of Vital Statistics on __________________ [Date]. The respondent in this action is __________________________ [Name], the [ ] mother Office and 26.26.330 and [ ] acknowledged father. This action is brought pursuant to RCW P.O. Address .340. A copy of the acknowledgment is attached to this petition. PET FOR RESCISSION ACKN. OF PAT (PT) - Page 1 of 4 WPF PS 11.0100 (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. Calendar No. 1.2 : EFFECTIVE DATE OF ACKNOWLEDGMENT OF PATERNITY. JUDICIAL SUBPOENA Plaintiff(s) The effective date -againstof the Acknowledgment of Paternity is : ___________________________ , because: : [ ] the acknowledgment was filed with the Washington State Registrar of Vital Statistics on that date. : [ ] 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. Defendant(s) : ...................................................... 1.3 PRIOR COURT PROCEEDINGS. No hearing in a court proceeding to which the petitioner was a party has taken place regarding the THE PEOPLE OF THE STATE OF NEW YORK child. TO 1.4 PATERNITY ACTION. [] [] GREETINGS: A paternity action is pending, or will be filed by petitioner. A paternity action will not be filed by petitioner. 1.5 PRESUMED FATHER. WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before , the Honorable at the Court The child does not have a presumed father. located at County of[ ] Under RCW 26.26.116, _____________________________in the is the presumedany recessed in room [ ] , on the day of , 20 , at o'clock [Name] noon, and at father of the child, who signed a Denial ofin this action on theit with the Washington State Paternity and filed part of the or adjourned date, to testify and give evidence as a witness Registrar of Vital Statistics on _______________________ [Date]. This action, if successful, will void the Denial of Paternity. A copy of the denial is attached to this petition. 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 1.6 JURISDICTION. result of your failure to comply. All persons who signed the Acknowledgment of Paternity filed on __________________ [Date], [ Witness, Honorable , one of the Justices to ] and Denial of Paternity filed on _____________________________ [Date], submitted of the Court in jurisdiction of the court on the filing date pursuant to RCW 26.26.340(2); and less than 60 days County, day of , 20 have passed since the effective date of the Acknowledgment of Paternity and Denial of Paternity. 1.7 CHILD SUPPORT. [] [] (Attorney must sign above and type name below) Does not apply. A Washington State Department of Social and Health Services Division of Child Support Attorney(s) for Administrative Child Support Order was entered on ______________________ [Date], requiring ____________________ [Name] to pay $______________ per month for the support of the child Office and P.O. Address PET FOR RESCISSION ACKN. OF PAT (PT) - Page 2 of 4 WPF PS 11.0100 (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. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : : 1.8 Index No. Calendar No. : JUDICIAL Plaintiff(s) SUSPENSION OF CHILD SUPPORT. -against: [] Does not apply. : [] A motion to suspend the child support order will be filed. SUBPOENA : II. RELIEF REQUESTED Defendant(s) : . .The petitioner. asks. the. court .to .enter. an . . . . . and . . . . . . . . that:. . . . . . . . . . . . . . . . . . . . . . . . . . . order . . . judgment . . . [] Declares the Acknowledgment of Paternity is rescinded. [] Declares the Denial of Paternity is void. THE PEOPLE OF THE STATE OF NEW YORK [] Amends the birth certificate by removing the acknowledged father as the father of the child. TO [] Changes the surname of the child to __________________________ [Surname]. [] Awards attorney’s fees and costs to petitioner. GREETINGS: WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before Dated: ____________________________ __________________________________________ , the Honorable at the Court Petitioner or Lawyer for Petitioner/WSBA No. located at County of in room , on the day of , 20 , at o'clock in the noon, and at any recessed III. DECLARATION or adjourned date, to testify and give evidence as a witness in this action on the part of the I declare under penalty of perjury under the laws of the state of Washington that I am the petitioner named above, that I have made the allegations contained in this petition based upon my first hand knowledge, and therefore believe that to comply with this subpoena is punishable as a contempt of court and will make you liable to Your failure they are true. the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a Signed at ______________________, [City] __________ [State] on ____________________ [Date]. result of your failure to comply. Witness, Honorable Signature of Petitioner Court in County, [] day of Print or Type Name , 20 , one of the Justices of the JOINDER. [] [] (Attorney must sign above and type name below) Does not apply. 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. Address _____________________________________ Print or Type Name PET FOR RESCISSION ACKN. OF PAT (PT) - Page 3 of 4 WPF PS 11.0100 (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. Calendar No. I _______________________________ [Name] :join inJUDICIAL SUBPOENA the petition. By joining in the Plaintiff(s) petition, I agree to the entry of a judgment and order in accordance with the petition, -against: without further notice. : _____________________________________ Signature of Joining Party : Dated: ____________________________ Defendant(s) _____________________________________ : . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Print.or Type Name ... . THE PEOPLE OF THE STATE OF NEW YORK TO GREETINGS: WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before , the Honorable at the Court located at County of 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 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. Witness, Honorable Court in County, , one of the Justices of the day of , 20 (Attorney must sign above and type name below) Attorney(s) for Office and P.O. Address PET FOR RESCISSION ACKN. OF PAT (PT) - Page 4 of 4 WPF PS 11.0100 (7/2003) - RCW 26.26.330 and 340 Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com