JV-635 SUPERIOR COURT OF CALIFORNIA, COUNTY OF STREET ADDRESS: MAILING ADDRESS: CITY AND ZIP CODE: BRANCH NAME: FOR COURT USE ONLY CASE NAME: PROMISE TO APPEAR--JUVENILE DELINQUENCY (Juvenile 14 Years or Older) LAW ENFORCEMENT AGENCY: REPORT NUMBER: Name of child: Date of birth of child: Address of child: Phone number of child: Name of parent, legal guardian, or adult relative: Address of parent, legal guardian, or adult relative (if different from that of child): Phone number of parent, legal guardian, or adult relative (if different from that of child): 1. I have been arrested for one or more of the following felony offenses (list code violations alleged): 2. The who is my peace officer mother probation officer father is releasing me to (name): relative (state relationship): legal guardian 3. I PROMISE TO APPEAR on (date): located at at (time): courthouse address above in Dept.: other (specify address): Room: 4. I understand that if I do not come to court on the date and at the time indicated, the court may order that a warrant be issued for my arrest. Date: (TYPE OR PRINT NAME) (SIGNATURE OF CHILD) (TYPE OR PRINT NAME) (SIGNATURE OF PARENT LEGAL GUARDIAN RELATIVE) Witnessed by: (TYPE OR PRINT NAME) SIGNATURE OF PROBATION OFFICER PEACE OFFICER (agency): Request for Accommodations Assistive listening systems, computer-assisted real-time captioning, or sign language interpreter services are available if you are ask at least five days before the proceeding. Contact the clerk's office or go to www.courts.ca.gov/forms for Request for Accommodations by Persons With Disabilities and Order (form MC-410. (Civil Code, § 54.8.) Page 1 of 1 Form Adopted for Mandatory Use Judicial Council of California JV-635 [Rev. May 22, 2017] PROMISE TO APPEAR--JUVENILE DELINQUENCY (Juvenile 14 Years or Older) Welfare and Institutions Code, § 629 Penal Code, § 830­830.6 www.courts.ca.gov · ORIGINAL--Transmitted to court · Copy to youth · Copy to parent, guardian, or relative · Copy to probation American LegalNet, Inc. www.FormsWorkFlow.com