Fill and Sign the Order 60 Days Form

Superior Court of Washington County of In re Parentage: Petitioner, and Respondent and [ ] Presumed Father, if applicable, Respondent. No. Judgment and Order on Rescission of Acknowledgment of Paternity Within 60 Days and Granting Other Relief (JDOAKP) Clerk’s action required [ ] Law Enforcement Notification, Sec III I. Judgment/Order Summaries 1.1 Restraining Order Summary [ ] Does not apply. [ ] Restraining Order Summary is set forth below: Name of person(s) restrained: . Name of person(s) protected: . See Section III . Violation of a Restraining Order in Section III 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 [ ] Does not apply. [ ] Judgment Summary is set forth below: A. Judgment creditor B. Judgment debtor C. Principal judgment amount $ D. Interest to date of judgment $ E. Attorney fees $ F. Costs $ G. Other recovery amount $ H. Principal judgment shall bear interest at __________ % per annum I. Attorney fees, costs and other recovery amounts shall bear interest at __________ % per annum J. Attorney for judgment creditor J udgment /O rd (Resc Ackn of Pat) (JDOAKP) - Page 1 of 4 WPF PS 11.0500 (6/2006) - RCW 26.26.330 and 340 K. Attorney for judgment debtor L. Other: II. Basis 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 on the date of this order]. III. Order It is Ordered : [ ] 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. [ ] The Petition to Rescind the Acknowledgment of Paternity is denied. [ ] The birth certificate of the child, __________________________ [Name], shall be amended by the Washington State Registrar of Vital Statistics by removing the acknowledged father’s name from the birth certificate [ ] and by changing the child’s surname to ____________________________ [Surname]. [ ] ________________________ [Name] is ordered to pay attorney fees and costs in the amount of $________________ payable to _____________________________ [Name]. [ ] 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. [ ] 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 J udgment /O rd (Resc Ackn of Pat) (JDOAKP) - Page 2 of 4 WPF PS 11.0500 (6/2006) - RCW 26.26.330 and 340 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. § 9259a)(1).) [ ] Other: Violation of a Restraining Order 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. [ ] 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 computer-based 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 .) Service [ ] 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 This restraining order expires on: [Month/Day/Year]. 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. Dated: Judge/Commissioner J udgment /O rd (Resc Ackn of Pat) (JDOAKP) - Page 3 of 4 WPF PS 11.0500 (6/2006) - RCW 26.26.330 and 340 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 Approval required in Public Assistance Case. The DSHS’ Division of Child Support Received Signature of Party or Lawyer/WSBA No. Notice required by RCW 26.23.130. This order has been reviewed and approved as to: Print or Type Name Date [ ] Current Child Support [ ] Back Child Support [ ] Medical Support [ ] Other: _______________________________________ Deputy Prosecuting Attorney/WSBA No. _______________________________________ Print or Type Name Date J udgment /O rd (Resc Ackn of Pat) (JDOAKP) - Page 4 of 4 WPF PS 11.0500 (6/2006) - RCW 26.26.330 and 340