NAME, ADDRESS, AND TELEPHONE NUMBER OF PARTY Reserved for Court Use SUPERIOR COURT OF CALIFORNIA, COUNTY OF NAPA 825 Brown Street Napa CA 94559 Petitioner: Respondent: EX-PARTE APPLICATION AND ORDER TO BE RELIEVED AS ATTORNEY OF RECORD FOR MINOR CASE NUMBER: I ______________________, declare as follows: (Name of Attorney) On _____________ I was appointed by the court to represent the minor(s) in the above-entitled matter, pursuant to Family Code 3150. I have completed all services and acts ordered by the court. I request an order to be relieved as attorney for the minor(s) in this matter. I declare under penalty of perjury, under the laws of the State of California, that the foregoing is true and correct. Date: ________________________________ ______________________________________ (Type or Print Name of Attorney) (Signature of Attorney) ORDER It appearing from the aforesaid application that the attorney for the minor(s) in the above-entitled matter has completed all services and acts ordered by the Court, and good cause having been shown, IT IS THEREFORE ORDERED that ______________________ is hereby relieved as attorney for the (Name of Attorney) minor(s). Date: _____________________________________ Judge of the Napa Superior Court _____________________________________________________________________________________________ Ex Parte Application and Order to Be Relieved (Minor) Family Code 3150 May 2010 American LegalNet, Inc. www.FormsWorkFlow.com