JV-180 Request to Change Court Order Clerk stamps date here when form is filed. This form can be used to ask the court to change an order, to ask the court to dismiss your case, to ask the court to terminate reunification services, or to ask the court to recognize your relationship with your sister or brother. After filling out this form, take it to the clerk of the court. 1 Your information: a. I am the: child or youth foster parent social worker other b. My name: c. My address: d. My city, state, zip code: e. My telephone number: f. If you are an attorney: My client's name: My client's address (if confidential, see item 3): My client's relationship to the child or youth: My State Bar number: 2 mother father legal guardian sibling or other relative (specify): probation officer attorney Fill in court name and street address: Superior Court of California, County of Fill in child's name and date of birth: Name of Child or Youth: Clerk fills in case number when form is filed. Case Number: Type of request (check the appropriate box below and add specific details in items 6­9, as applicable): a. b. c. d. I am asking the court to change an order. I am asking the court to terminate its jurisdiction. I am asking the court to terminate reunification services. I am asking the court to recognize my relationship with my brother or sister. (1) I am related to him or her on our father's side. on our mother's side by marriage. by blood or adoption (2) I am related to him or her 3 If you want to keep your address or your client's address confidential, fill out Confidential Information (Request to Change Court Order) (form JV-182) and do not write the address on this form. Check here if form JV-182 is attached. Child's or youth's information: a. Name: b. Date of birth: c. Attorney (if known): d. The child or youth lives with or in a (check all that apply): parent legal guardian relative group home I don't know foster home e. Name of the person the child or youth lives with or the place where he or she lives: Address: Check here if unknown. 4 Judicial Council of California, www.courts.ca.gov Revised January 1, 2014, Mandatory Form Welfare and Institution Code, §§ 388, 778 California Rules of Court, rules 5.524, 5.570 Request to Change Court Order JV-180, Page 1 of 3 American LegalNet, Inc. www.FormsWorkFlow.com Case Number: Name of child or youth: 5 Information about parents, legal guardians, and others: a. Names of parents or legal guardians: Check here if unknown.) b. Address of parent/legal guardian: Check here if unknown.) c. Address of parent/legal guardian: Check here if unknown.) d. Indian tribe (if applicable and known): e. CASA volunteer (if applicable and known): f. Educational rights holder (if applicable and known): g. Social worker or probation officer (if applicable and known): If you are asking the court to recognize your relationship with your brother or sister but not asking the court to change an order, you may skip to item 8. 6 On (date, if known): the judge made the following order that I think should be changed: 7 What has happened since that order that might change the judge's mind? (Give new information that the judge did not have when the order was made): 8 What new order or orders do you want the judge to make now? 9 Why would the requested order or action be better for the child or youth? 10 Check here if you need more space for any of the answers. Attach a sheet of paper and write "JV-180" at the top of the page. Number of pages attached: Rev. January 1, 2014 Request to Change Court Order JV-180, Page 2 of 3 Case Number: Name of child or youth: 11 I have had a copy of my request sent to the people listed below, as applicable. I have checked the correct box to the right of each name to show whether, as far as I know, that person agrees with my request. If you do not have an attorney, the clerk will send notice and copies of your request to all persons required to receive notice under Welfare and Institutions Code sections 297 and 386 and rules 5.524 and 5.570 of the California Rules of Court. Not Don't Name Agree Disagree Know Applicable Child (if 10 years old, or older) or youth: Child's or youth's attorney: Parent: Parent: Legal guardian: Legal guardian: Social worker: Probation officer: Current caregiver/foster parent: Preadoptive parent: CASA volunteer: Educational rights holder: Indian tribe: Indian custodian: Sibling (if petition filed & 10+ years old:) Sibling's caregiver: Sibling's attorney: Attorney for parent/legal guardian: Attorney for parent/legal guardian: County counsel: District attorney: Other: 12 You can ask the judge to make a decision without a court hearing if all the people named above agree with your if you want a decision without a hearing. request. Check here 13 If anyone disagrees with your request, please explain why (if known): 14 I declare under penalty of perjury under the laws of the State of California that the information in this form is true and correct to the best of my knowledge. Date: Type or print name Rev. January 1, 2014 Signature Request to Change Court Order JV-180, Page 3 of 3