1. Petitioner's name and address (if representing another person, organization, or agency, provide names and addresses):
2. Petitioner's relationship to child (if any):
3. Police department or law enforcement agency possessing records:
Report number:
4. The reasons for this request are:
(Describe in detail. Attach additional pages if necessary.)
Continued in Attachment 4.
5. The Notice to Child and Parent/Guardian Re: Release of Juvenile Police Records and Objections (form JV-580) was served
on the child or parent on (date):
I declare under penalty of perjury under the laws of the State of California that the foregoing and all attachments are true and correct.
Date:
(TYPE OR PRINT NAME) (SIGNATURE OF PETITIONER)
Number of pages attached:
PETITION DENIEDPETITION GRANTED
ADDITIONAL ORDERS:
Date:
JUDICIAL OFFICER
Page 1 of 1
Form Adopted for Mandatory Use
Judicial Council of California
JV-575 [Rev. January 1, 2007]
PETITION TO OBTAIN REPORT OF LAW ENFORCEMENT AGENCY
Welfare and Institutions Code, §§ 827.9, 828;
Cal. Rules of Court, rules 5.504, 5.552
www.courtinfo.ca.gov
JV-575
FOR COURT USE ONLYATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address):
TELEPHONE NO.: FAX NO. (Optional):
E-MAIL ADDRESS (Optional):
ATTORNEY FOR (Name):
SUPERIOR COURT OF CALIFORNIA, COUNTY OF
STREET ADDRESS:
MAILING ADDRESS:
CITY AND ZIP CODE:
BRANCH NAME:
CASE NUMBER:
CHILD’S NAME:
CHILD’S DATE OF BIRTH:
RELATED CASES (if any):
PETITION TO OBTAIN REPORT OF LAW ENFORCEMENT AGENCY
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