COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : CHILD'S NAME: Index No. CASE NUMBER: JV-400 : : Calendar No. JUDICIAL SUBPOENA VISITATION ATTACHMENT: PARENT, LEGAL GUARDIAN, INDIAN CUSTODIAN, OTHER IMPORTANT PERSON Plaintiff(s) 1. 2. : Anyone who appears to be-against- influence of alcohol or any controlled substance will not be allowed to participate in a under the scheduled visitation with the child. The visitation supervisor may terminate the visit if this order is violated. Matters relating to the allegations of the petition or issues related to the child's placement are not to be discussed with the child during visits except under the guidance of a counselor in a therapeutic setting. The visitation supervisor may terminate : the visit if this order is violated. Contact between the child and the mother Defendant(s) : ...................................................... a. In-person visitation (1) (2) Unsupervised Supervised by the THE(a) STATE OF NEW YORK county agency (c) other (specify): times per week for a total of times per month for a total of An overnight visit every week Other (specify): hours per week hours per month every other week : 3. THE PEOPLE OF TO (3) (b) foster family agency Frequency and duration (a) (b) (c) (d) GREETINGS: WE(4) Location YOU, that all business and excuses being laid aside, you and each of you attend before COMMAND Agency visitation facility (b) Foster family agency facility , the Honorable (a) at the Court (c) Other (specify):at located County of in room , on the day child , the , will o'clock in noon, and at any recessed (5) Transportation of the of to and from 20 visits at be provided by thethe or adjourned date,(a) testify and give evidence as a witness in this action on the part of the to (b) county agency. foster family agency. (c) (6) other (specify): Other orders concerning in-person visitation (specify): Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to Other the b. party on whosetypes of this subpoena was issued for a maximum penalty of $50 and all damages sustained as a behalf contact permitted (specify): result of your failure to comply. Contact restrictions. Witness, Honorable The following contact between the child and the ,mother would be detrimental to the best one of the Justices of the interest of the child at this time, and the mother is to have no such contact with the child: Court in County, day of , 20 c. (1) (2) 4. In-person contact Written communication presumed father alleged father (Attorney must sign above and type name below) legal guardian biological father (3) Telephone contact Contact between the child and a. In-person visitation (1) Unsupervised (2) Supervised by the (a) county agency other (specify): (3) Frequency and duration (a) (b) (c) (d) (c) other (specify): : Attorney(s) for (b) foster family agency Office and P.O. Address hours per week hours per month every other week times per week for a total of times per month for a total of An overnight visit every week Other (specify): Form Approved for Optional Use Judicial Council of California JV-400 [Rev. January 1, 2007] Telephone No.: Facsimile No.: E-Mail Address: VISITATION ATTACHMENT: PARENT, LEGAL GUARDIAN, INDIAN Mobile Tel. No.: CUSTODIAN, OTHER IMPORTANT PERSON Page 1 of 2 Welfare and Institutions Code, § 361.2; Cal. Rules of Court, rule 5.670 www.courtinfo.ca.gov American LegalNet, Inc. www.FormsWorkflow.com JV-400 CHILD'S NAME: CASE NUMBER: 4. (4) Location (a) (c) Agency visitation facility Other (specify): (b) Foster family agency facility (5) Transportation of the child to and from the visits will be provided by the (a) (b) county agency. foster family agency. (c) other (specify): Other orders concerning in-person visitation (specify): (6) b. Other types of contact permitted (specify): c. Contact restrictions. The following contact between the child and the specified person would be detrimental to the best interest of the child at this time and the person is to have no such contact with the child: (1) (3) In-person contact Telephone contact (2) Written communication Contact between the child and a. In-person visitation (1) (2) Unsupervised Supervised by the (a) county agency (c) (a) (b) (c) (d) Location (a) (c) other (specify): times per week for a total of times per month for a total of An overnight visit every week Other (specify): Agency visitation facility Other (specify): (b) hours per week hours per month every other week presumed father alleged father biological father other (specify): legal guardian 5. (b) foster family agency (3) Frequency and duration (4) Foster family agency facility (5) Transportation of the child to and from the visits will be provided by the (a) (b) county agency. foster family agency. (c) (6) b. other (specify): Other orders concerning in-person visitation (specify): Other types of contact permitted (specify): c. Contact restrictions. The following contact between the child and the specified person would be detrimental to the best interest of the child at this time and the specified person is to have no such contact with the child: (1) (3) In-person contact Telephone contact (2) Written communication 6. Other (specify): JV-400 [Rev. January 1, 2007] VISITATION ATTACHMENT: PARENT, LEGAL GUARDIAN, INDIAN CUSTODIAN, OTHER IMPORTANT PERSON Page 2 of 2