Fillable Form 3: JV-466 Request to Return to Juvenile (The Superior Court of California - County of Orange)

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Form 3: JV-466 Request to Return to Juvenile (The Superior Court of California - County of Orange)

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JV-466, Page 1 of 3
Judicial Council of California, www.courts.ca.gov
New January 1, 2012, Mandatory Form
Welfare and Institutions Code, §§ 224,1, 303, 388(e);
Cal. Rules of Court, rule 5.906
Request to Return to Juvenile Court Jurisdiction
and Foster Care
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-466
Request to Return to Juvenile Court
Jurisdiction and Foster Care
Your information:
1
1
This form can be used if the court kept its jurisdiction (authority) over you
just in case you wanted to return to the court’s jurisdiction and a foster care
placement. If you don’t want other people, for example, a parent or brother or
sister who was part of your case when you were a child, to know your contact
information, do not write it in . Write that information on Confidential
Information—Request to Return to Juvenile Court Jurisdiction and Foster Care
(form JV-468). Read How to Ask to Return to Juvenile Court Jurisdiction and
Foster Care (form JV-464-INFO) for information about filling out and filing
the forms. If you do not know the information asked for, leave the space blank.
Remember to get and keep copies of all court papers and other papers you sign
or receive from the child welfare services agency or the probation department.
Name:
Your address:
c.
Your area code and telephone number:
b.
Your city, state, zip code:
3
The location of the juvenile court that had authority over you when you
turned 18 years old.
1
2
a.
City:
a.
County:
d.
Your date of birth:
The name and court file number or case number of your case in juvenile court:
a.
Name of your case:
b.
Court file number or case number:
b.
4
The date the juvenile court terminated its jurisdiction (authority) over you:
1
5
I need help to keep or find an appropriate place to live.
Child welfare services
6
Voluntary Reentry Agreement with child welfare services or the probation department to return to foster care:
I agree to sign a voluntary reentry agreement for a supervised placement
I signed a voluntary reentry agreement for a supervised placement on (date): ____________ with
Probation department
I need a placement right now.
3
a.
3
1
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.
New January 1, 2012
JV-466, Page 2 of 3
Case Number:
Your name:
Request to Return to Juvenile Court Jurisdiction
and Foster Care
7
a.
You must plan to meet at least one of the five conditions listed below.
Please check all that apply to you:
I plan to attend a high school or a high school equivalency certificate (GED) program.
b.
I plan to attend a college, a community college, or a vocational education program.
d.
I plan to work at least 80 hours per month.
e.
I cannot go to a high school, a high school equivalency certificate (GED) program, a college, a community
college, a vocational education program, take part in a program or activities to help me find a job, or work
80 hours per month because of a medical condition.
c.
I plan to attend a program or take part in activities that will help train me to be employed or will help me
solve problems that prevented me from finding a job.
8
Parent’s name and address:
The judge will set a hearing about this request if the judge decides that he or she has enough information to think
that you have probably satisfied all the requirements.
Do you want your parents or former legal guardian to be told about the hearing if the judge sets one?
YES. I do want my parents or formal legal guardian to be told about the hearing. Their names and addresses are:
NO. I do not want my parents or former legal guardian to be told about the hearing.
Parent’s name and address:
Former legal guardian’s name and address:
Name and telephone number of the lawyer who used to represent me and who I want to represent me again:
The judge will give you a free lawyer to help before and during the hearing. If you want the lawyer who represented
you when you were a dependent, ward, or nonminor dependent, please write the lawyer’s name and telephone
number on the line below, and if that lawyer is available, the court will appoint him or her to help you before and
during the hearing.
1
9
10
Did you have a Court Appointed Special Advocate (CASA)?
YES. I did have a CASA.
NO. I did not have a CASA.
YES. I want the CASA to told about the hearing. The name of the person who was my CASA is:
NO. I do not want the CASA to told about the hearing.
Would you like the CASA to told about the hearing if the judge schedules a hearing?
New January 1, 2012
JV-466, Page 3 of 3
Request to Return to Juvenile Court Jurisdiction
and Foster Care
Case Number:
Your name:
5
I declare under penalty of perjury under the laws of the State of California that the information in this form, all
attachments, and in the Confidential Information—Request to Return to Juvenile Court Jurisdiction and Foster Care
(form JV-468), if filed, is true and correct to my knowledge. I understand that this means I am guilty of a crime if I
lie on this form, any of the attachments, or the form JV-468, if filed.
12
Date:
Sign your name
Type or print your name
5
The nonminor is unable to provide verification due to a medical condition. I declare under penalty of perjury
under the laws of the State of California that the information in this form, all attachments, and in the Confidential
Information—Request to Return to Juvenile Court Jurisdiction and Foster Care (form JV-468), if filed, is true and
correct to my knowledge. I understand that this means I am guilty of a crime if I lie on this form, any of the
attachments, or the form JV-468, if filed.
13
Date:
Signature of reprsentative
Type or print representative’s name
Your verification:
Verification by nonminor’s representative:
11
Did the Indian Child Welfare Act apply to you when you were under juvenile court jurisdiction as a child?
NO. The Indian Child Welfare Act did not apply to me.
YES. I do want the Indian Child Welfare Act to apply to me. The name of my tribe and the name,
address, and telephone number of my tribal representative is:
NO. I do not want the Indian Child Welfare Act to apply to me.
Would you like to have the Indian Child Welfare Act apply to you as a nonminor dependent?
YES. The Indian Child Welfare Act did apply to me.
1.
I am or may be a member of, or eligible for membership in, a federally recognized Indian tribe.
2.
Name of tribe(s) (name each):
I have no Indian ancestry as far as I know.
a.
b.
I DO NOT KNOW if the Indian Child Welfare Act applied to me.
Name of band (if applicable):
Name of tribe(s) (name each):
Name of band (if applicable):
I may have Indian ancestry
3.
For your protection and privacy, please press the Clear This Form
button after you have printed the form.
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Form 3: JV-466 Request to Return to Juvenile (The Superior Court of California - County of Orange)

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Completed 8 February 2021

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