Form FL-117 "Notice and Acknowledgment of Receipt" - California

What Is Form FL-117?

This is a legal form that was released by the California Superior Court - a government authority operating within California. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on January 1, 2021;
  • The latest edition provided by the California Superior Court;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form FL-117 by clicking the link below or browse more documents and templates provided by the California Superior Court.

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Download Form FL-117 "Notice and Acknowledgment of Receipt" - California

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FL-117
PARTY WITHOUT ATTORNEY or ATTORNEY
STATE BAR NO.:
FOR COURT USE ONLY
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:
CASE NUMBER:
NOTICE AND ACKNOWLEDGMENT OF RECEIPT
(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.
(SIGNATURE OF SENDER—MUST NOT BE A PARTY IN THIS CASE
(TYPE OR PRINT SENDER'S NAME)
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
FL-100
), Summons (form
FL-110
), and blank Response—
Marriage/Domestic Partnership (form
)
FL-120
b.
Uniform Parentage: Petition to Determine Parental Relationship (form
FL-200
), Summons (form
), and blank
FL-210
Response to Petition to Determine Parental Relationship (form
)
FL-220
c.
Custody and Support: Petition for Custody and Support of Minor Children (form
FL-260
), Summons (form
FL-210
), and
blank Response to Petition for Custody and Support of Minor Children (form
)
FL-270
d.
Completed and blank Financial Statement
(1)
Completed and blank Declaration Under Uniform
(5)
(Simplified) (form
)
Child Custody Jurisdiction and Enforcement Act
FL-155
(UCCJEA) (form
)
FL-105
Completed and blank Property Declaration
(6)
(form
FL-160
)
(2)
Completed and blank Declaration of Disclosure
(form
FL-140
)
(7)
Request for Order (form
FL-300
), and blank
Responsive Declaration to Request for Order
Completed and blank Schedule of Assets and
(3)
(form
)
FL-320
Debts (form
FL-142
)
Other (specify):
(8)
(4)
Completed and blank Income and Expense
FL-150
Declaration (form
)
5. Recipient signed this acknowledgment on (specify date):
6.
(TYPE OR PRINT NAME OF PERSON ACKNOWLEDGING RECEIPT)
(SIGNATURE OF PERSON ACKNOWLEDGING RECEIPT)
Page 1 of 1
Form Approved for Optional Use
NOTICE AND ACKNOWLEDGMENT OF RECEIPT
Code of Civil Procedure, § 415.30, 417.10
Judicial Council of California
www.courts.ca.gov
(Family Law)
FL-117 [Rev. January 1, 2021]
For your protection and privacy, please press the Clear
This Form button after you have printed the form.
Print this form
Save this form
Clear this form
FL-117
PARTY WITHOUT ATTORNEY or ATTORNEY
STATE BAR NO.:
FOR COURT USE ONLY
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:
CASE NUMBER:
NOTICE AND ACKNOWLEDGMENT OF RECEIPT
(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.
(SIGNATURE OF SENDER—MUST NOT BE A PARTY IN THIS CASE
(TYPE OR PRINT SENDER'S NAME)
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
FL-100
), Summons (form
FL-110
), and blank Response—
Marriage/Domestic Partnership (form
)
FL-120
b.
Uniform Parentage: Petition to Determine Parental Relationship (form
FL-200
), Summons (form
), and blank
FL-210
Response to Petition to Determine Parental Relationship (form
)
FL-220
c.
Custody and Support: Petition for Custody and Support of Minor Children (form
FL-260
), Summons (form
FL-210
), and
blank Response to Petition for Custody and Support of Minor Children (form
)
FL-270
d.
Completed and blank Financial Statement
(1)
Completed and blank Declaration Under Uniform
(5)
(Simplified) (form
)
Child Custody Jurisdiction and Enforcement Act
FL-155
(UCCJEA) (form
)
FL-105
Completed and blank Property Declaration
(6)
(form
FL-160
)
(2)
Completed and blank Declaration of Disclosure
(form
FL-140
)
(7)
Request for Order (form
FL-300
), and blank
Responsive Declaration to Request for Order
Completed and blank Schedule of Assets and
(3)
(form
)
FL-320
Debts (form
FL-142
)
Other (specify):
(8)
(4)
Completed and blank Income and Expense
FL-150
Declaration (form
)
5. Recipient signed this acknowledgment on (specify date):
6.
(TYPE OR PRINT NAME OF PERSON ACKNOWLEDGING RECEIPT)
(SIGNATURE OF PERSON ACKNOWLEDGING RECEIPT)
Page 1 of 1
Form Approved for Optional Use
NOTICE AND ACKNOWLEDGMENT OF RECEIPT
Code of Civil Procedure, § 415.30, 417.10
Judicial Council of California
www.courts.ca.gov
(Family Law)
FL-117 [Rev. January 1, 2021]
For your protection and privacy, please press the Clear
This Form button after you have printed the form.
Print this form
Save this form
Clear this form