Superior Court of Washington, County of
In re parentage:
Petitioner (person who started this case) :
And Respondent/s: ( other person/s who signed
the Acknowledgment or Denial)
No.
Response to Petition to Withdraw (Rescind)
Paternity Acknowledgment or Denial
(RSP)
Response to Petition to Withdraw (Rescind)
Paternity Acknowledgment or Denial
1. Your response
Look at each section of the Petition . Check below to say if you agree or
disagree with what the other party said in each section, or say if you
don’t know because you don’t have enough information. (If you
disagree with any part of a section, check “I disagree.”) List your
reasons for disagreeing on page 2.
Section in the Petition Your response (check one)
1. I ask the court to withdraw (rescind)…
I agree I disagree I don’t know
2. Parties to this case
I agree I disagree I don’t know
3. Correct County (Venue)
I agree I disagree I don’t know
4. Personal Jurisdiction
I agree I disagree I don’t know
5. Effective Date
I agree I disagree I don’t know
6. Withdrawal Deadline
I agree I disagree I don’t know
7. Parentage Petition
I agree I disagree I don’t know
8. Child Support
I agree I disagree I don’t know
9. Protection Order
I agree I disagree I don’t know
10. Restraining Order
I agree I disagree I don’t know
If you checked “I disagree” for any of the sections, list your reasons here:
RCW 26.26.330, .340
Mandatory Form (07/2017)
FL Parentage 342 Response to Petition to Withdraw
(Rescind) Pat. Ackn. or Denial
p. 1 of 5
Section #: Reasons:
Section #: Reasons:
Section #: Reasons:
Section #: Reasons:
Section #: Reasons:
Section #: Reasons:
Section #: Reasons:
Section #: Reasons:
(If you need more space, you may add more pages to this Response. Number, date and
sign each page that you add.)
2. Protection Order
Do you want the court to issue an Order for Protection as part of the final orders in this
case ?
No. I do not want an Order for Protection .
Yes. (You must file a Petition for Order for Protection, form DV-1.015 for domestic
violence, or form UHST-02.0200 for harassment. You may file your Petition for Order
for Protection using the same case number assigned to this case.)
Important! If you need protection now , ask the court clerk about getting a Temporary Order for Protection.
There already is an Order for Protection between (name):
and me. (Describe):
RCW 26.26.330, .340
Mandatory Form (07/2017)
FL Parentage 342 Response to Petition to Withdraw
(Rescind) Pat. Ackn. or Denial
p. 2 of 5
Court that issued the order:
Case number:
Expiration date:
3. Restraining order
Do you want the court to issue a Restraining Order as part of the final orders in this case?
No. (Skip to 4 .)
Yes. Check the type of orders you want:
Do not disturb – Order (name/s): not to
disturb my peace or the peace of the child.
Stay away – Order (name/s): not to
go onto the grounds of or enter my home, workplace, or school, and the daycare or
school of the child .
Also, not knowingly to go or stay within feet of my home, workplace,
or school, or the daycare or school of the child.
Do not hurt or threaten – Order ( name/s ) ______________________________:
Not to assault, harass, stalk or molest me or the child; and
Not to use, try to use, or threaten to use physical force against
me or the child that would reasonably be expected to cause
bodily injury.
Warning! If the court makes this order, the court must consider if weapons restrictions are required by
state law; federal law may also prohibit the Restrained Person from possessing firearms or ammunition.
Prohibit weapons and order surrender – Order ( name/s ) __________________:
Not to possess or obtain any firearms, other dangerous weapons, or concealed
pistol license until the Order ends, and
To surrender any firearms, other dangerous weapons, and any concealed
pistol license that he/she possesses t o (check one): t he police chief or
sheriff. h is/her lawyer. other person (name): .
Other restraining orders:
Important! If you want a restraining order now , you must file a Motion for Temporary Family Law Order and
Restraining Order (form FL Parentage 323) or a Motion for Immediate Restraining Order (Ex Parte) (form FL
Parentage 321).
4. Requests
I ask the court to (check all that apply):
Deny the Petition . The Paternity Acknowledgment and Denial , if any, are still valid
because (check all that apply):
the Petition was first filed or served after the deadline.
other reason (explain):
.
RCW 26.26.330, .340
Mandatory Form (07/2017)
FL Parentage 342 Response to Petition to Withdraw
(Rescind) Pat. Ackn. or Denial
p. 3 of 5
Order Petitioner to pay my lawyer fees and costs.
Approve the Petition . (Check all that apply):
Acknowledgment / Denial of Paternity
Withdraw the Paternity Acknowledgment (and cancel any related Denial of
Paternity ).
Withdraw the Denial of Paternity (and cancel the related Paternity
Acknowledgment ).
Child’s Name and Birth Certificate
Change the child’s birth certificate so:
(Acknowledged father’s name):
is no longer listed as the child’s parent.
(Presumed father’s name):
is listed as the child’s parent.
The child’s last name is changed to: .
Protection or Restraining Order
Approve an Order for Protection .
Approve a Restraining Order.
Fees / Other
Order who should pay for court costs, genetic testing, guardian ad litem, lawyer
fees, and other reasonable fees.
Other (specify):
Respondent fills out below:
I declare under penalty of perjury under the laws of the state of Washington that the facts I have
provided on this form (including any attachments) are true.
I have attached (number): _____ pages.
Signed at (city and state): Date:
Respondent signs here Print name
I agree to accept legal papers for this case at (check one):
my lawyer’s address, listed below.
the following address ( this does not have to be your home address):
street address or PO box city state zip
(Optional) email:
(If this address changes before the case ends, you must notify all parties and the court clerk in writing.
You may use the Notice of Address Change form (FL All Family 120).)
RCW 26.26.330, .340
Mandatory Form (07/2017)
FL Parentage 342 Response to Petition to Withdraw
(Rescind) Pat. Ackn. or Denial
p. 4 of 5
Important! You must fill out and file a Confidential Information form (FL All Family 001) with the court clerk.
Lawyer (if any) fills out below:
Lawyer signs here Print name and WSBA No. Date
Lawyer’s address city state zip
Email (if applicable):
RCW 26.26.330, .340
Mandatory Form (07/2017)
FL Parentage 342 Response to Petition to Withdraw
(Rescind) Pat. Ackn. or Denial
p. 5 of 5
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