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    FL-620GOVER NM EN TA L A G EN C Y ( u nder F am ily C ode, § § 1 7400 a nd 1 7406):F O R C O URT U SE O NLY TELEPHONE NO.:FAX NO.: ATTORNEY FOR (Name):SU PER IO R C O UR T O F C ALIF O RN IA , C O UNTY O FSTR EET A D DRESS:M AIL IN G A D DRESS:C IT Y A N D Z IP C O DE:BR AN CH N AM E:PETITIONER/PLAINTIFF:RESPONDENT/DEFENDANT:OTHER PARENT:CASE N UM BER :R EQ UEST T O E N TE R D EFA ULT J U DG M EN T1. M ore t h an 3 0 d ays h ave p asse d s in ce s e rv ic e o f t h e s u m mons, c o m pla in t, a nd c o py o f t h e p ro pose d ju dgm ent.2 . T o m y k n ow le dg e n o a nsw er o r o th er r e sp onsiv e p le adin g h as b een f ile d.3. T he p are nt a ga in st w hom ju dgm ent is s o ught is n ot in t h e m ilit a ry s e rv ic e o r in t h e m ilit a ry s e rv ic e o f t h e U nit e d S ta te s a s d efin ed in se ctio n 5 11 e t s e q. o f t h e S erv ic e m em bers C iv il R elie f A ct ( 5 0 U .S .C . A ppen. § 5 11) a nd is n ot e ntit le d t o t h e b enefit s o f s u ch a ct.4 . T he lo ca l c h ild s u pport a gency r e quests t h at d efa ult a nd ju dgm ent b e e nte re d u nder F am ily C ode s e ctio n 1 7430.I d ecla re u nder p e nalt y o f p erju ry u nder t h e la w s o f t h e S ta te o f C alif o rn ia t h at t h e f o re goin g is t r u e a nd c o rre ct.D ate :(T Y PE O R P R IN T N AM E)(S IG NATU RE O F D EC LA R AN T)F O R C O URTUSE O NLY(1 )(2 )D efa ult e n te re d a s r e queste d o n ( d ate ): De fa ult n o t e nte re d a s r e queste d. ( S ta te r e aso n):B y:P age 1 o f 1F orm A dopte d fo r M andato ry U se Ju dic ia l C ouncil o f C alif o rn ia FL -6 20 [R ev. J a nuary 1 , 2 005]R EQ UEST T O E N TE R D EFA ULT J U DG M EN T (G overn m en ta l)F am ily C ode , § 1 7400 1 7 402, 17404,1 7430ele ctr o nic f o rm  2 005 WWW.LawCA.com La w P ublis h ers