The Legal Innovation & Technology Lab's Form Explorer ^Beta @ Suffolk Law School Last updated 2023-04-02

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Here is the text we could read:

PARTY WITHOUT ATTORNEY  or  ATTORNEY             STATE BAR NO.:

FOR COURT USE ONLY

FL-117

STATE:

ZIP CODE:

FAX NO.:

SUPERIOR COURT OF CALIFORNIA, COUNTY OF

NAME:

FIRM NAME:

STREET ADDRESS:

CITY:

TELEPHONE NO.:

E-MAIL ADDRESS:

ATTORNEY FOR (name):

STREET ADDRESS:

MAILING ADDRESS:

CITY AND ZIP CODE:

BRANCH NAME:

PETITIONER:

RESPONDENT:

NOTICE AND ACKNOWLEDGMENT OF RECEIPT

CASE NUMBER:

(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):

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.  

NOTICE   

f 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):

I agree I received the following:
a.

(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 

Family Law: Petition—Marriage/Domestic Partnership (form             ), Summons (form             ), and blank Response—
Marriage/Domestic Partnership (form             )

Uniform Parentage: Petition to Determine Parental Relationship (form             ), Summons (form            ), and blank 
Response to Petition to Determine Parental Relationship (form            )

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             )

(1)

(2)

(3)

(4)

Completed and blank Declaration Under Uniform 
Child Custody Jurisdiction and Enforcement Act 
(UCCJEA) (form            )

Completed and blank Declaration of Disclosure 
(form             )

Completed and blank Schedule of Assets and 
Debts (form             )
Completed and blank Income and Expense 
Declaration (form             )

(5)

(6)

(7)

(8)

Completed and blank Financial Statement 
(Simplified) (form             )

Completed and blank Property Declaration 
(form             )

Request for Order (form             ), and blank 
Responsive Declaration to Request for Order 
(form            )
Other (specify):

5. Recipient signed this acknowledgment on (specify date):

(TYPE OR PRINT NAME OF PERSON ACKNOWLEDGING RECEIPT)

(SIGNATURE OF PERSON ACKNOWLEDGING RECEIPT)

Form Approved for Optional Use 
Judicial Council of California 
FL-117  [Rev. January 1, 2021]

NOTICE AND ACKNOWLEDGMENT OF RECEIPT 
(Family Law)

Page 1 of 1

Code of Civil Procedure, § 415.30, 417.10

 I

3.

4.

6.

b.

c.

d.

Notice and Acknowledgment of Receipt

This info page is part of the LIT Lab's Form Explorer project. It is not associated with the California state courts. To learn more about the project, check out our about page.

Downloads: You can download both the original form (last checked 2023-03) and the machine-processed form with normalized data fields.

About This Form:

Sourced from selfhelp.courts.ca.gov (2023-03)
Page(s): 1
Fields(s): 37
Average fields per page: 37
Reading Level: Grade 8
LIST Grouping(s): Unknown

Use our Rate My PDF tool to learn more. Go beyond the above insights and learn more about this or any pdf form at RateMyPDF.com, includes: counts of difficult words used, passive voice decetion, and suggestions for how to make the form more usable.

Identified Data Fields:

We have done our best to automaticly identify and name form fields according to our naming conventions. When possible, we've used names tied to our question library. See e.g., user1_name. If we think we've found a match to a question in our library, it is highlighted in green. Novel names are auto generated. So, you will probably need to edit some of them if you're trying to stick to the convention.

Here are the fields we could identify.

f_l_page_case_number_ft was FL-117[0].Page1[0].CaseNumber[0].CaseNumber_ft[0] (0.55 conf)
f_l_page_add_info_party_ft was FL-117[0].Page1[0].AddInfo[0].PartyAttyAddInfo_ft[0] (0.34 conf)
f_l_page_add_info_text_field__1 was FL-117[0].Page1[0].AddInfo[0].TextField1[0] (0.39 conf)
f_l_page_add_info_text_field__2 was FL-117[0].Page1[0].AddInfo[0].TextField2[0] (0.39 conf)
f_l_page_add_info_text_field__3 was FL-117[0].Page1[0].AddInfo[0].TextField3[0] (0.39 conf)
f_l_page_add_info_text_field__4 was FL-117[0].Page1[0].AddInfo[0].TextField4[0] (0.39 conf)
f_l_page_add_info_text_field__5 was FL-117[0].Page1[0].AddInfo[0].TextField5[0] (0.39 conf)
f_l_page_add_info_text_field__6 was FL-117[0].Page1[0].AddInfo[0].TextField6[0] (0.39 conf)
f_l_page_contact_phone_ft was FL-117[0].Page1[0].OtherContact[0].Phone_ft[0] (0.38 conf)
f_l_page_contact_fax_ft was FL-117[0].Page1[0].OtherContact[0].Fax_ft[0] (0.42 conf)
f_l_page_contact_email_ft was FL-117[0].Page1[0].OtherContact[0].Email_ft[0] (0.41 conf)
f_l_page_contact_atty_ft was FL-117[0].Page1[0].OtherContact[0].AttyFor_ft[0] (0.41 conf)
l_page_court_info_county_ft was FL-117[0].Page1[0].CourtInfo[0].CrtCounty_ft[0] (0.37 conf)
l_page_court_info_street_ft was FL-117[0].Page1[0].CourtInfo[0].Street_ft[0] (0.32 conf)
l_page_court_info_add_ft was FL-117[0].Page1[0].CourtInfo[0].MailingAdd_ft[0] (0.41 conf)
f_l_page_court_info_city_zip_ft was FL-117[0].Page1[0].CourtInfo[0].CityZip_ft[0] (0.37 conf)
f_l_page_court_info_branch was FL-117[0].Page1[0].CourtInfo[0].Branch_ft[0] (0.41 conf)
l_page_title_party_name_petitioner__1 was FL-117[0].Page1[0].TitlePartyName[0].Petitioner_1_ft[0] (0.34 conf)
l_page_title_party_name_petitioner__2 was FL-117[0].Page1[0].TitlePartyName[0].Petitioner_2_ft[0] (0.34 conf)
f_l_page_list_person_served was FL-117[0].Page1[0].List1[0].LI1[0].NameofPersonBeingServed_tf[0] (0.32 conf)
f_l_page_list_date_mailed_dt was FL-117[0].Page1[0].List2[0].LI1[0].DateMailed_dt[0] (0.39 conf)
f_l_page_list_print_nameof_petitioner_tf__1 was FL-117[0].Page1[0].List3[0].LI1[0].PrintNameofPetitioner_tf[0] (0.37 conf)
f_l_page_list_area_check_box__1 was FL-117[0].Page1[0].List4[0].LI1[0].#area[0].CheckBox1[0] (0.37 conf)
f_l_page_list_area_check_box__2 was FL-117[0].Page1[0].List4[0].LI2[0].#area[0].CheckBox1[0] (0.37 conf)
f_l_page_list_area_check_box__3 was FL-117[0].Page1[0].List4[0].LI3[0].#area[0].CheckBox1[0] (0.37 conf)
f_l_page_list_check_box__1 was FL-117[0].Page1[0].List4[0].LI4[0].CheckBox1[0] (0.37 conf)
f_l_page_list_area_check_box__4 was FL-117[0].Page1[0].List4[0].LI4[0].List1[0].LI1[0].#area[0].CheckBox1[0] (0.36 conf)
f_l_page_list_area_check_box__5 was FL-117[0].Page1[0].List4[0].LI4[0].List1[0].LI2[0].#area[0].CheckBox1[0] (0.36 conf)
f_l_page_list_check_box__2 was FL-117[0].Page1[0].List4[0].LI4[0].List1[0].LI3[0].CheckBox1[0] (0.36 conf)
f_l_page_list_check_box__3 was FL-117[0].Page1[0].List4[0].LI4[0].List1[0].LI4[0].CheckBox1[0] (0.36 conf)
f_l_page_list_check_box__4 was FL-117[0].Page1[0].List4[0].LI4[0].List1[0].LI5[0].CheckBox1[0] (0.36 conf)
f_l_page_list_check_box__5 was FL-117[0].Page1[0].List4[0].LI4[0].List1[0].LI6[0].CheckBox1[0] (0.36 conf)
f_l_page_list_check_box__6 was FL-117[0].Page1[0].List4[0].LI4[0].List1[0].LI7[0].CheckBox1[0] (0.36 conf)
f_l_page_list_check_box__7 was FL-117[0].Page1[0].List4[0].LI4[0].List1[0].LI8[0].CheckBox1[0] (0.36 conf)
f_l_page_list_text_field was FL-117[0].Page1[0].List4[0].LI4[0].List1[0].LI8[0].TextField[0] (0.34 conf)
f_page_date_signed_dt was FL-117[0].Page1[0].List5[0].LI1[0].DateAcknowledgmentSigned_dt[0] (0.42 conf)
f_l_page_list_print_nameof_petitioner_tf__2 was FL-117[0].Page1[0].List6[0].LI1[0].PrintNameofPetitioner_tf[0] (0.37 conf)

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The Legal Innovation & Technology Lab's Form Explorer Beta @ Suffolk Law School Last updated 2023-04-02

Notice and Acknowledgment of Receipt

About This Form:

Identified Data Fields:

Create an Interactive Version of this Form:

The Legal Innovation & Technology Lab's Form Explorer ^Beta @ Suffolk Law School Last updated 2023-04-02