Fillable Form 13 16504 360 (Superior Court of California)

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Form 13 16504 360 (Superior Court of California)

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13
-16504-360 [Rev. Oct. 7, 2019]
Optional Form
CERTIFICATION OF COMPETENCY – DEPENDENCY
Page 1 of 1
LAW FIRM (Name and address): STATE BAR NO:
FIRM NAME:
STREET ADDRESS:
STREET ADDRESS:
CITY: STATE: ZIP CODE:
TELEPHONE NO:
FAX NO:
E-MAIL ADDRESS:
For Court Use Only
FILED Date
SUPERIOR COURT OF CALIFORNIA, COUNTY OF SAN BERNARDINO
STREET ADDRESS:
860 EAST GILBERT STREET
MAILING ADDRESS:
860 EAST GILBERT STREET
CITY AND ZIP CODE:
SAN BERNARDINO, CA 92415-0955
BRANCH NAME:
JUVENILE DEPENDENCY COURT
ATTORNEY’S NAME:
CERTIFICATION OF COMPETENCY
DEPENDENCY
Training and Education
Initial Certification
Recertification (Every three years)
(Attach copies of MCLE certificates or other documentation of training and/or attendance)
Date Completed
Course Title
Provider
Hours
I hereby certify that am an attorney licensed to practice in the State of California and I meet the minimum
standards of competency for practice before a Juvenile Court set forth in the California Rules of Court, Rules
5.660 – 5.664 and Superior Court of California, County of San Bernardino Local Rules 1692.4 through 1692.8
and have completed the minimum requirements for training, education and/or experience as required as set
forth above.
Dated: Signed:
For Court Use Only
□ Approved ☐ Denied
Dated:
Signed:
Presiding Judge of the Juvenile Court
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Form 13 16504 360 (Superior Court of California)

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Completed 22 July 2020

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