Superior Court of California, County of Sutter ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, state bar number, and address) Effective July 1, 2013 FOR COURT USE ONLY TELEPHONE NO: ATTORNEY FOR (NAME): FAX NO: SUPERIOR COURT OF CALIFORNIA COUNTY OF SUTTER 446 SECOND STREET YUBA CITY, CA 95991 (530)822-3300 IN THE MATTER OF: CERTIFICATE OF COMPETENCY TO PRACTICE IN JUVENILE DEPENDENCY COURT I, Number is CASE NUMBER: , Attorney at Law, am licensed to practice in the State of California. My State Bar . I hereby certify that I meet the minimum standards for practice before the Juvenile Division of Sutter County Superior Court as set forth in Local Rule 5.0. I further certify that I have completed the minimum requirements for training, education and/or experience as set forth below. TRAINING AND EDUCATION (Attach copies of MCLE certificates or other documentation of attendance) COURSE TITLE DATE COMPLETED HOURS PROVIDER JUVENILE DEPENDENCY EXPERIENCE (Attach extra page if necessary) COURSE TITLE DATE COMPLETED HOURS PROVIDER Dated: Signature of Attorney APPROVED Dated: JUDGE OF THE SUPERIOR COURT Superior Court of California, County of Sutter Local Form JV-05 Adopted for Mandatory Use American LegalNet, Inc. www.FormsWorkFlow.com