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PETITIONER:
CASE NUMBER:
RESPONDENT:
The respondent requests that the court make the orders listed below.
Petitioner Respondent a.
is the parent of the children listed in item 1.
8. Child custody and visitation
Petitioner
Joint
Other
b. Legal custody of the children should go to
c. Physical custody of the children should go to
None(1)
(2) Reasonable visitation
Petitioner Respondent should have the right to visit the children as follows (specify): (3)
Visitation should occur with the following restrictions (specify):
(4)
(5)
9. Reasonable expenses of pregnancy and birth
Reasonable expenses of pregnancy and birth should be paid by
Both
Petitioner
10. Fees and costs of litigation
Both
a. Attorney fees should be paid by
b. Expert fees, guardian ad litem fees, and other costs
of the action or pretrial proceedings should be paid by
11. Name change.
The children’s names should be changed, according to Family Code section 7638, as follows (specify old
13. Child support. The court may make orders for support of the children and issue an earnings assignment without further notice
to either party.
I have read the restraining order on the back of the Summons (form FL-210) and I understand it applies to me.
I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
Date:
(TYPE OR PRINT NAME) (SIGNATURE OF RESPONDENT)
NOTICE: If you have a child from this relationship, the court is required to order child support based upon the income of
both parents. Support normally continues until the child is 18. You should supply the court with information about your
finances. Otherwise, the child support order will be based upon information supplied by the other parent. Any party
required to pay child support must pay interest on overdue amounts at the “legal” rate, which is currently
10 percent.
FL-220 [Rev. January 1, 2006]
Page 2 of 2
7. Parent-child relationship (check all that apply):
d. Visitation of the children should be as follows:
I request mediation to work out a parenting plan.
RespondentPetitioner
Respondent
Respondent
RESPONSE TO PETITION TO ESTABLISH PARENTAL RELATIONSHIP
(Uniform Parentage)
b.
Other (specify):
Petitioner Respondent
is not the parent of the children listed in item 1.Other (specify):
a. If
Respondent Petitioner
Other is found to be the parent of the children in listed in item 1:
`
FL-220
12. Other orders requested (specify):
Respondent requests genetic (blood) tests to determine whether the petitioner respondent is the parent
of the children listed.
c.
and new names):
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