CONFIDENTIAL SUPERIOR COURT OF CALIFORNIA, COUNTY OF SAN BERNARDINO REFERRAL FOR CII/CARPOS/ICMS REPORT (Family Law) Case Number Petitioner Name: Petitioner: (Please mark one) Male Female Petitioner AKAs, if any: Petitioner Date of Birth: Petitioner SSN: Date Referred Department Referring Date Report Due Report to Department Respondent Name: Respondent: (please mark one) Male Female Respondent AKAs, if any: Respondent Date of Birth: Respondent SSN: COURT ORDER: This matter is referred to Family Law Processing for a CARPOS (CLETS) history report and a Criminal History Inquiry (CII) pursuant to Family Code 6306 and/or California Rule of Court 5.445. This matter is referred to Family Law Processing for a search of the Superior Court of California, County of San Bernardino Integrated Case Management System for a history report regarding existing custody and visitation orders pursuant to CRC 5.445. Notes: Special Order Form A This form is required with any filing where Child Custody and Visitation Orders are at issue and in all Domestic Violence Restraining Order Request. SB-13546 (Rev. 01/18/13) American LegalNet, Inc. www.FormsWorkFlow.com