Fillable Form 1: JV-569 Proof of Service Request for (Superior Court of California)

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Form 1: JV-569 Proof of Service Request for (Superior Court of California)

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The Form 1: JV-569 Proof of Service Request for (Superior Court of California) form is 3 pages long and contains:

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  • 85 other fields

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File type: PDF

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JV-569
Proof of Service —
Request for Disclosure
Clerk stamps date here when form is filed.
Fill in court name and street address:
Superior Court of California, County of
Case Number:
Fill in case number if known:
JV-569, Page 1 of 3
Judicial Council of California, www.courtinfo.ca.gov
New January 1, 2009, Mandatory Form
Welfare and Institutions Code, § 827
California Rules of Court, rules 5.552, 5.553
I was not able to provide notice of this petition to the following
because I did not know their names or addresses. If this is a
request for the case file of a living child, the clerk must serve a copy
of the petition. If this is a request for the case file of a deceased
child, the custodian of records must serve a copy of the petition.
2
a.
Attorney of record for the child
Child’s parent
Probation department if petition filed under section 601 or 602
District attorney if petition filed under section 601 or 602
Child
Child welfare agency/custodian of records if petition filed under section 300
Child’s identified Indian tribe
Child’s CASA volunteer
County counsel or other attorney representing the child welfare agency if petition filed under
section 300
Copies of Request for Disclosure of Juvenile Case File
(JV-570), Notice of Request for Disclosure of Juvenile
Case File (JV-571), and a blank Objection to Release of Juvenile Case File (JV-572) have been placed in a
sealed envelope with postage paid and deposited in the United States mail addressed to the following:
a. County counsel or other attorney representing the child welfare agency if petition filed under
3
section 300 (name and address):
Proof of Service —Request for Disclosure
Child’s legal guardian
Your name:
Relationship to child (if any):
Street address:
State:City: Zip:
Lawyer (if any) (name, address, telephone numbers, and State Bar
number):
1
Telephone number:
b
.
c.
d.
e.
f.
g.
h.
i.
j.
Date mailed:
or
Personally served on (date):
To keep other people from
seeing what you entered on
your form, please press the
Clear This Form button at the
end of the form when finished.
Your name:
Case Number:
JV-569,
Page 2 of 3
New January 1, 2009, Mandatory Form
h. Probation department if petition filed under section 601 or 602 (name and address):
e. Child’s parent (name and address):
g. Child’s legal guardian (name and address):
f. Child’s parent (name and address):
Proof of Service —Request for Disclosure
b. District attorney if petition filed under section 601 or 602 (name and address):
c. Child (name and address):
d. Attorney of record for the child (name and address):
Date mailed:
or
Personally served on (date):
Date mailed:
or
Personally served on (date):
Date mailed:
or
Personally served on (date):
Date mailed:
or
Personally served on (date):
Date mailed:
or
Personally served on (date):
Date mailed:
or
Personally served on (date):
Date mailed:
or
Personally served on (date):
Your name:
Case Number:
JV-569,
Page 3 of 3
New January 1, 2009, Mandatory Form
j. The Indian child’s tribal representative (name and address):
k. The child’s CASA volunteer (name and address):
I declare under penalty of perjury under the laws of the State of California that the information in this form
is true and correct. This means that if I lie on this form, I am guilty of a crime.
4
Date:
Sign your name
Type or print your name
Proof of Service—Request for Disclosure
i. Child welfare agency/custodian of records if petition filed under section 300 (name and address):
Date mailed:
or
Personally served on (date):
Date mailed:
or
Personally served on (date):
Date mailed:
or
Personally served on (date):
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Form 1: JV-569 Proof of Service Request for (Superior Court of California)

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Completed 20 November 2020

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