FL-618
GOVERNMENTAL AGENCY (under Family Code §§ 17400, 17406): FOR COURT USE ONLY

TELEPHONE NO.: E-MAIL ADDRESS (Optional): ATTORNEY FOR (Name):

FAX NO. (Optional):

SUPERIOR COURT OF CALIFORNIA, COUNTY OF
STREET ADDRESS: MAILING ADDRESS: CITY AND ZIP CODE: BRANCH NAME:

PETITIONER/PLAINTIFF: RESPONDENT/DEFENDANT: OTHER PARENT:
CASE NUMBER:

REQUEST FOR DISMISSAL
1. TO THE CLERK: Please dismiss the following: a. (1) b. (1) (2) (3) (4) (5) (6) (7) Date: With prejudice (2) Complaint ____ Supplemental complaint ____ Amended complaint ____ Amended supplemental complaint Uniform Interstate Family Support Act (UIFSA) petition Entire action of all parties and all related causes of action Other (specify): Without prejudice filed on (date): filed on (date): filed on (date): filed on (date): filed on (date): filed on (date): filed on (date):

(TYPE OR PRINT NAME OF GOVERNMENTAL ATTORNEY) (SIGNATURE) ____________________________________________________________________________________________________________

2. TO THE CLERK: Consent to the above dismissal is hereby given.* Date:

(TYPE OR PRINT NAME OF

ATTORNEY OR

PARTY WITHOUT ATTORNEY)

(SIGNATURE)

Attorney for or respondent/defendant without attorney * If a responsive pleading seeking affirmative relief is on file, the attorney for respondent must sign the consent if required by Code of Civil Procedure section 581(i) or (j). ____________________________________________________________________________________________________________ (To be completed by clerk) 3. 4. 5. 6. Dismissal entered as requested on (date): Dismissal entered on (date): as to only (name each): Dismissal not entered as requested for the following reasons (specify): a. Attorney or party without attorney notified on (date): b. Attorney or party without attorney not notified. Filing failed to provide a copy to conform Date:
Form Adopted for Mandatory Use Judicial Council of California FL-618 [New January 1, 2008]

means to return conformed copy Clerk, by , Deputy
Page 1 of 1 Code of Civil Procedure, § 581 et seq. Cal. Rules of Court, rule 3.1390 www.courtinfo.ca.gov American LegalNet, Inc. www.FormsWorkflow.com

REQUEST FOR DISMISSAL (Governmental, UIFSA)