Clerk stamps date here when form is filed. JV-323 Notice of Intent to Remove Child This notice must be served with a blank copy of form JV-321, Request for Prospective Adoptive Parent Designation, and a blank copy of form JV-325, Objection to Removal. 1 To: a. Court: b. Designated prospective adoptive parent or caregiver who may fit the definition of "prospective adoptive parent" (name): Fill in court name and street address: Superior Court of California, County of c. Child's attorney (name): d. Child, if 10 years of age or older (name): Fill in child's name and date of birth: e. Child's identified Indian tribe, if any (name): Child's Name: Date of Birth: f. Child's Indian custodian, if any (name): Fill in case number: Case Number: g. Child's Court Appointed Special Advocate (CASA) program, if any (name of person notified): 2 Name of agency proposing move: Address: Phone number: This agency is asking for a court order to remove (name of child): from his or her current home because (explain): If more space is needed, attach a sheet of paper and write "JV-323, Item 2--Reasons for Removal" at the top. Number of pages attached: Judicial Council of California, www.courtinfo.ca.gov Revised January 1, 2008, Mandatory Form Welfare and Institutions Code, § 366.26(n) Cal. Rules of Court, rules 5.726, 5.727 Notice of Intent to Remove Child JV-323, Page 1 of 2 American LegalNet, Inc. www.FormsWorkflow.com Case Number: Child's name: 3 If you do not agree with the removal, you may request a court hearing. To do this, you must fill out form JV-325, Objection to Removal, and file it with the court within five court days or seven calendar days, whichever is longer, from the date you received this notice. If the court has not designated you as a prospective adoptive parent, you must complete form JV-321, Request for Prospective Adoptive Parent Designation, and file it with this form. I declare under penalty of perjury under the laws of the State of California that the information in items 1 and 2 is true and correct, which means that if I lie on this form, I am committing a crime. Date: Type or print your name Sign your name Revised January 1, 2008 Notice of Intent to Remove Child JV-323, Page 2 of 2