2. Best Interests (State why the proposed transfer is in the best interests of the child/nonminor.)
b. Disposition
a. The
1. Facts of Case
a. Type of Case
Delinquency Dependency Nonminor Dependent
Disposition not yet imposed/deferred
Disposition imposed from sending county on (date):
c.
Confinement time/custody credit (Delinquency cases only)
i.
As of (date): , the overall term of confinement time in the sending county was:
ii. Overall Custody Credits:
3. Verification of Residence
parent's/legal guardian's address
nonminor's address in the proposed receiving county
was confirmed by the sending county's agency as
Name:
Address:
City: State: Zip:
Phone:
confidential address
County
The motion is brought under Welfare and Institutions Code Section
Form Adopted for Mandatory Use
Judicial Council of California
JV-548 [New January 1, 2017]
MOTION FOR TRANSFER OUT
Welfare and Institutions Code, §§ 17.1, 300, 375, 601, 602, 750;
Cal. Rules of Court, rules 5.610, 5.612, 5.613
www.courts.ca.gov
Page 1 of 4
SUPERIOR COURT OF CALIFORNIA, COUNTY OF
BRANCH NAME:
CITY AND ZIP CODE:
STREET ADDRESS:
MAILING ADDRESS:
CHILD/NONMINOR'S NAME:
FOR COURT USE ONLY
CASE NUMBER:
DEPARTMENT:
HEARING DATE:
TIME:
JV-548
ATTORNEY OR PARTY WITHOUT ATTORNEY:
STATE: ZIP CODE:CITY:
STREET ADDRESS:
FIRM NAME:
NAME:
STATE BAR NO:
TELEPHONE NO.: FAX NO.:
E-MAIL ADDRESS:
ATTORNEY FOR (Name):
MOTION FOR TRANSFER OUT
Child Welfare Department, by and through counsel, or
Probation Department, requests an order transferring the above-referenced case to
County.
, attorney for
requests an order transferring the above-referenced case to County.
375 750 Other:
,
b. The
probation officer social worker in the receiving county sending county has
conducted an address check and verified the address.
c. Verification completed by: Date verified:
d. Documentation establishing residency in the proposed receiving county is attached to this motion. The following
documentation is attached:
4. Education Information
a. Name of last school attended:
b. Name of school district:
c.
Name of current Educational Rights Holder or Surrogate Parent:
d.
Name of proposed Educational Rights Holder or Surrogate Parent:
e.
There is an Individual Education Plan (IEP) for the child/nonminor.
5. Services
a. The level of services required by the child/nonminor
can
cannot be met in the proposed receiving county.
parent or legal guardian can cannot be met in the
proposed receiving county.
Probation has not previously supervised the child/nonminor.
6. Other
a.
The current status of the Indian Child Welfare Act (ICWA) is (specify):
3.
b.
The level of services required by
The type and level of services or supervision required by the child/nonminor and/or parent or legal guardian (e.g., drug
treatment, residential, outpatient, NA only, etc.) are
documented in the attached case plan or described as:
c.
d.
CHILD'S NAME: CASE NUMBER:
JV-548 [New January 1, 2017]
MOTION FOR TRANSFER OUT
Page 2 of 4
JV-548
JV-548 [New January 1, 2017]
MOTION FOR TRANSFER OUT
Page 3 of 4
CHILD'S NAME: CASE NUMBER:
JV-548
I declare under penalty of perjury under the laws of the State of California that the foregoing and any attachments are true and
correct.
Date:
SIGNATURE
(TYPE OR PRINT NAME OF
PARTY ATTORNEY FOR PARTY)
SIGNATURE
(TYPE OR PRINT NAME OF
PROBATIONOFFICER SOCIAL WORKER)
l.
Other:
k.
If applicable, in the below box, please list all dependency and delinquency cases for the child/nonminor.
Case Number
County
Case Type
f.
The child/nonminor qualifies for regional center services.
g.
There are pending Uniform Child Custody Jurisdiction and Enforcement Act (UCCJEA) issues in this case.
h.
A Special Juvenile Immigrant Status (SJIS) application is pending.
i.
A Social Security Income (SSI) application is pending.
j.
There are active orders regarding psychotropic medications. The last order is dated:
b.
Parentage has been determined as indicated in minute order dated:
c.
A WIC §241.1 determination has been made as indicated in the minute order dated:
d.
Restitution has been determined in the amount of $:
See minute order dated:
e.
The child/nonminor has exceptional medical needs (specify):
6.
JV-548 [New January 1, 2017]
MOTION FOR TRANSFER OUT
Page 4 of 4
CHILD'S NAME:
CASE NUMBER:
JV-548
PROOF OF SERVICE
I served a copy of the Motion for Transfer on the following persons or entities by personally delivering a copy to the person
served, OR by emailing the document to an agreed upon email address of the person served, OR by faxing the document to the
fax number provided by the person served, OR by delivering a copy to a competent adult at the usual place of residence or
business of the person served and thereafter mailing a copy by first-class mail to the person served at the place where the copy
was delivered, OR by placing a copy in a sealed envelope and depositing the envelope directly in the U.S. mail with postage
prepaid or at my place of business for same-day collection and mailing with the U.S. mail, following our ordinary business
practices with which I am readily familiar:
Name and address:
Date of service:
1.
Social worker Probation officer Attorney
a.
b.
Method of service:
c.
Name and address:
Date of service:
a.
b.
Method of service:
c.
Name and address:
Date of service:
2.
Mother Legal Guardian Attorney
a.
b.
Method of service:
c.
Name and address:
Date of service:
a.
b.
Method of service:
c.
Father
Name and address:
Date of service:
3.
Mother Legal Guardian Attorney
a.
b.
Method of service:
c.
Name and address:
Date of service:
a.
b.
Method of service:
c.
Father
Name and address:
Date of service:
4.
Child/nonminor (if 10 years of age or older)
Attorney
a.
b.
Method of service:
c.
Name and address:
Date of service:
a.
b.
Method of service:
c.
Additional parties served. Additional Proof of Service form attached.
5. At the time of service, I was at least 18 years of age and not a party to this cause. I am a resident of, or employed in, the county
where the mailing occurred. My residence or business address is specify):
I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
Date:
SIGNATURE
TYPE OR PRINT NAME
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