FL-117 - Notice and Acknowledgment of Receipt

Summary

Notice and Acknowledgment of Receipt

Text

Form ID: FL-117
Title: Notice and Acknowledgment of Receipt
Effective Date: 2021-01-01
Mandatory Form: no
Languages: español
Info Page: https://selfhelp.courts.ca.gov/jcc-form/FL-117
Primary Download URL: https://www.courts.ca.gov/documents/fl117.pdf
Alternate Download URLs: https://www.courts.ca.gov/documents/fl117s.pdf
Form Detail Page:
Notice and Acknowledgment of Receipt
(FL-117)
Tell the court that your spouse or domestic partner agreed to (and received) by mail the legal papers to start your case.
Get form FL-117
español
Get form FL-117 in Spanish
(Spanish)
Effective: January 1, 2021
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PDF Text:
NOTICE AND ACKNOWLEDGMENT OF RECEIPT 
(Family Law)
Form Approved for Optional Use 
Judicial Council of California 
FL-117  [Rev. January 1, 2021]
Code of Civil Procedure, § 415.30, 417.10
FL-117
NOTICE AND ACKNOWLEDGMENT OF RECEIPT
FOR COURT USE ONLY
CASE NUMBER:
PARTY WITHOUT ATTORNEY  or  ATTORNEY             STATE BAR NO.:
NAME:
FIRM NAME:
STREET ADDRESS:
CITY: STATE: ZIP CODE:
TELEPHONE NO.: FAX NO.:
E-MAIL ADDRESS:
ATTORNEY FOR (name):
SUPERIOR COURT OF CALIFORNIA, COUNTY OF
STREET ADDRESS:
MAILING ADDRESS:
CITY AND ZIP CODE:
BRANCH NAME:
PETITIONER:
RESPONDENT:
(Sender completes items 1 through 4 and signs before mailing.  Recipient completes items 5 and 6, signs, then returns)
1. To (name of individual being served):
NOTICE   
The documents identified below are being served on you by mail with this acknowledgment form. You must personally sign, or a  
person authorized by you must sign, this form to acknowledge receipt of the documents.  
 
If the documents described below include a summons and you fail to complete and return this acknowledgment form to the sender 
within 20 days of the date of mailing, you will be liable for the reasonable expenses incurred after that date in serving you or 
attempting to serve you with these documents by any other methods permitted by law.  If you return this form to the sender, service 
of a summons is deemed complete on the date you sign the acknowledgment of receipt below. This is not an answer to the action.  
If you do not agree with what is being requested, you must submit a completed Response form to the court within 30 calendar days.
 
2. Date of mailing (specify):
3.
(TYPE OR PRINT SENDER'S NAME)
 (SIGNATURE OF SENDER—MUST NOT BE A PARTY IN THIS CASE 
AND MUST BE 18 YEARS OR OLDER)
ACKNOWLEDGMENT OF RECEIPT 
4. I agree I received the following:
a. Family Law: Petition—Marriage/Domestic Partnership  (form             ), Summons (form             ), and blank Response—
Marriage/Domestic Partnership (form             )
b. Uniform Parentage: Petition to Determine Parental Relationship (form             ), Summons (form            ), and blank 
Response to Petition to Determine Parental Relationship (form            )
c. Custody and Support: Petition for Custody and Support of Minor Children  (form             ), Summons (form            ), and 
blank Response to Petition for Custody and Support of Minor Children (form             )
d. (1) Completed and blank Declaration Under Uniform 
Child Custody Jurisdiction and Enforcement Act 
(UCCJEA) (form            )
(2) Completed and blank Declaration of Disclosure 
(form             )
(3) Completed and blank Schedule of Assets and 
Debts (form             )
(4) Completed and blank Income and Expense 
Declaration (form             )
(5) Completed and blank Financial Statement 
(Simplified) (form             )
(6) Completed and blank Property Declaration 
(form             )
(7) Request for Order (form             ), and blank 
Responsive Declaration to Request for Order 
(form            )
(8) Other (specify):
5. Recipient signed this acknowledgment on (specify date):
6.
(TYPE OR PRINT NAME OF PERSON ACKNOWLEDGING RECEIPT)
 (SIGNATURE OF PERSON ACKNOWLEDGING RECEIPT)
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• #1

  Form ID: FL-117 Title: Notice and Acknowledgment of Receipt Effective Date: 2021-01-01 Mandatory Form: no Languages: español Info Page: https://selfhelp.courts.ca.gov/jcc-form/FL-117 Primary Download URL: https://www.courts.ca.gov/documents/fl117.pdf Alternate Download URLs: https://www.courts.ca.gov/documents/…

• #2

  ACKNOWLEDGMENT OF RECEIPT 4. I agree I received the following: a. Family Law: Petition—Marriage/Domestic Partnership (form ), Summons (form ), and blank Response— Marriage/Domestic Partnership (form ) b. Uniform Parentage: Petition to Determine Parental Relationship (form …