ATTACHMENT JV-2022
JV-2022
REV 07/01/12
ADVISEMENT AND ACKNOWLEDGEMENT
RE: RIGHT TO COUNSEL IN JUVENILE DEPENDENCY PROCEEDINGS
Page 1 of 1
ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar Number and Address):
TELEPHONE NUMBER: FAX NUMBER (Optional):
EMAIL ADDRESS (Optional):
ATTORNEY FOR (Name):
SUPERIOR COURT OF CALIFORNIA, COUNTY OF SANTA CLARA
COURT ADDRESS:
MAILING ADDRESS:
CITY AND ZIP CODE:
BRANCH NAME:
201 North First Street, San José, CA 95113
191 North First Street
San José, CA 95113
Juvenile Dependency
CHILDREN’S NAMES:
FOR COURT USE ONLY
ADVISEMENT AND ACKNOWLEDGEMENT RE: RIGHT TO
COUNSEL IN JUVENILE DEPENDENCY PROCEEDING
CASE NUMBER:
RELATED CASES:
1. You have the right to be represented by an attorney in this case (W&I Section 316).
2.
You may have a court-appointed attorney if you cannot or do not want to hire an attorney yourself.
3.
If you choose to have a court-appointed attorney, you may later have to pay fees for that attorney’s
services, de
pending on your financial circumstances and your ability to
pay.
IMPORTANT – PLEASE NOTE
4. You also may have to pay fees for the services of the attorney who represents your children,
depending on your financial circumstances and your ability to
pay.
FINANCIAL DECLARATION
5. Complete the attached Financial Declaration (JV-2020). The Financial Declaration will be used by
the Court to determine your ability to
pay for the representation of your minor children
.
6.
If you choose to have a court-appointed attorney, the Financial Declaration will also be used to
assess your
ability to pa
y for your own costs.
7.
Failure to fill out the Financial Declaration does not prevent the Court from ordering that you pay
attorneys fees.
8. I
, understand this Advisement and have received
the Financial Declaration
Packet.
Dated:
Signature
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