JC-E 338 Application submitted by: (Name and Address) Name: Street Address: City, State: Telephone Number: SUPERIOR COURT OF CALIFORNIA, COUNTY OF SACRAMENTO SITTING AS THE JUVENILE COURT DEPENDENCY COURT: 3341 Power Inn Road William R. Ridgeway Family Relations Courthouse Sacramento, CA 95826 NAME OF CHILD / MINOR: FOR COURT USE ONLY JUVENILE JUSTICE COURT: 9605 Kiefer Blvd. Juvenile Courthouse Sacramento, CA 95827 DATE OF BIRTH: CASE NUMBER: DEPARTMENT: REQUEST AND ORDER TO APPOINT SACRAMENTO CASA (COURT APPOINTED SPECIAL ADVOCATES) (Welfare & Institutions Code § 102, California Rules of Court, rule 5.655) I, ______________________________________________________________, do hereby declare that: I am: the Child the CASA Executive Director/designee the Child's___________________________________________________________ I believe the Child's best interest would be served by appointing Sacramento Court Appointed Special Advocates (CASA). I therefore request this Court appoint CASA to assist the Child. I declare under penalty of perjury that the above is true and correct. Executed this _________ day of ____________________________ in Sacramento, California. Signature: ____________________________________________ ORDER It is the order of this Court that Sacramento Court Appointed Special Advocates (CASA) is appointed. Date: ______________________________ ________________________________ Judge/Referee of the Juvenile Court JC-E 338 Revised 01/03/17 REQUEST AND ORDER TO APPOINTMENT SACRAMENTO CASA (COURT APPOINTED SPECIAL ADVOCATE) Page 1 of 1 Welfare and Institutions Code §102, CRC Rule 5.655 American LegalNet, Inc. www.FormsWorkFlow.com