For Mandatory Use MSC-JV-002 [Rev. 18] DECLARATION FOR ACCESS TO JUVENILE CASE FILE IN POSSESSION OF JUVENILE COURT Page 1 of 2 MSC-JV-002 A. Persons entitled to inspect and receive copies of juvenile case files Declaration submitted by: Name: Office/Agency/Court: Street Address: City, State: Telephone Number: FOR COURT USE ONLY SUPERIOR COURT OF CALIFORNIA, COUNTY OF MERCED JUVENILE DIVISION Street Address: 627 W. 21 st Street 2 840 W. Sandy Mush City and Zip Code: Merced , CA 95 340 Merced, CA 95340 Name of Minor: Date of Birth: DECLARATION FOR ACCESS TO JUVENILE CASE FILE IN POSSESSION OF JUVENILE COURT ( Welfare & Institutions Code 247 827, California Rules of Court, rule 5.552) CASE NUMBER: I, , do hereby declare that I am a person described in Welfare and Institutions Code section 827(a)(1)(A)-(O), to wit: 1. Juvenile court personnel. [WIC 247 827(a)(1)(A)] 2. A district attorney, city attorney, or city prosecutor authorized to prosecute criminal or juvenile cases under state law. [WIC 247 827(a)(1)(B)] 3. The minor who is the subject of the juvenile proceeding. [WIC 247 827(a)(1)(C)] 4. A parent or guardian of the minor. [WIC 247 827(a)(1)(D)] 5. An attorney for the minor who is actively participating in criminal or juvenile proceedings involving the minor. [WIC 247 827(a)(1)(E)] 6. An attorney for the parent or guardian of the minor who is actively participating in criminal or juvenile proceedings involving the minor. [WIC 247 827(a)(1)(E)] 7. An attorney representing the petitioning agency in a dependency action. [WIC 247 827(a)(1)(F)] 8. A judge, referee, or hearing officer who is actively participating in criminal or juvenile proceedings involving the minor. [WIC 247 827(a)(1)(E)] 9. A probation officer actively participating in criminal or juvenile proceedings involving the minor. [WIC 247 827(a)(1)(E)] 10. A social worker or investigator employed by a child protective agency. [WIC 247247 272(a)(1) & 827(a)(1)(H)] 11. A law enforcement officer who is actively participating in criminal or juvenile proceedings involving the minor. [WIC 247 827(a)(1)(E)] 12. A deputy sheriff or city police officer who receives mandated reports of suspected child abuse or neglect. [WIC 247 827(a)(1)(H) & PC 247 11165.9] 13. A probation officer who receives mandated reports of suspected child abuse or neglect pursuant to county designation. [WIC 247 827(a)(1)(H) & PC 247 11165.9] 14. A State Department of Social Services employee engaged in the oversight and monitoring of county child welfare agencies, children in foster care or receiving foster care assistance, and/or out - of - state placements. [WIC 247 827(a)(1)(I)] 15. Court - Appointed Special Advocate (CASA). [WIC 247247 827(a)(1)(A) & 103(i)] 16. A person from an Indian tribe, reservation, or tribal court serving in a similar capacity as those described in section A, numbers 1 or 5 - 13, in a case involving a minor who is a member of, or who is eligible for membership in, that tribe. [WIC 247 827(f)] American LegalNet, Inc. www.FormsWorkFlow.com For Mandatory Use MSC-JV-002 [Rev. 8] DECLARATION FOR ACCESS TO JUVENILE CASE FILE IN POSSESSION OF JUVENILE COURT Page 2 of 2 MSC-JV-002 1.A superintendent or designee of the schooldistrict where the minor is enrolled orattending school. [WIC 247 827(a)(1)(G)]2.A State Department of Social Services legalstaff or special investigator peace officerengaged in the inspection, licensing andinvestigation of community care facilities.[WIC 247 827(a)(1)(J)]3.A person, agency, or member of amultidisciplinary team providing treatmentor supervision of the minor.[WIC 247 827(a)(1)(K)]4.A judge, commissioner, or hearing officerassigned to a family law case involving thecustody and/or visitation of the minor.[WIC 247 827(a)(1)(L))5.A family court mediator activelyparticipating in a family law case involvingthe minor. [WIC 247 827(a)(1)(L)]6.A child custody evaluator activelyparticipating in a family law case involving theminor. [WIC 247 827(a)(1)(L)] I further declare: 7.An attorney appointed for the minor in afamily law case. [WIC 247 827(a)(1)(L)]8.A statutorily authorized or court-appointedprobate investigator who is activelyparticipating in an active guardianship caseinvolving the minor. [WIC 247 827(a)(1)(M)]9.A statutorily authorized or court-appointedinvestigator conducting an investigationpursuant to Family Code section 7663,7851, or 9001 in an active case.[WIC 247 827(a)(1)(M)]10.A local child support agency employeeengaged in establishing paternity and/orestablishing and enforcing child supportorders. [WIC 247 827(a)(1)(N)]11.A juvenile justice commissioner appointedpursuant to Welfare and Institutions Code247225. [WIC 247 827(a)(1)(O)]12.A person from an Indian tribe, reservation,or tribal court serving in a similar capacityas those described in section B, numbers3-9, in a case involving a minor who is amember of, or who is eligible formembership in, that tribe. [WIC 247 827(f)] C. I am requesting to view and/or receive copies of the juvenile case file concerning the above-named minor for use in my capacity described above, and will not share any portion of the records released to me or information relating to their contents, other than as provided by law. [Initial] D. I will not attach any portion of the juvenile case file or any information relating to the contents of the juvenile case file to any other document without the prior approval of the Presiding Judge of the Juvenile Court, unless they are used in connection with and in the course of a criminal investigation, a proceeding to declare a person a dependent child or ward of the Juvenile Court, or a proceeding described in Welfare and Institutions Code section 827(a)(1)(I) by the State Department of Social Services. [Initial] E. Except as permitted under section D, I will not attach any portion of the juvenile case file or any information relating to the contents of the juvenile case file to any document used in any case or proceeding, including a criminal, civil, of family law case or proceeding, without the prior approval of the Presiding Judge of the Juvenile Court. [Initial] I declare under penalty of perjury that the above is true and correct. Executed this day of , 20 in Merced, California. Signature Print Title If applicable, indicate the following: State Bar No. (Attorneys): Badge No. (Law Enforcement): Agency Case No.: Related (non - juvenile) Case No.: B. Persons entitled to inspect juvenile case files ( no copies without court order ) American LegalNet, Inc. www.FormsWorkFlow.com