REQUEST TO VACATE PACKETPage 1 of 1 AGENCY SUBMITTING REQUEST (Name, Department, and address): FAX NO (Optional): TELEPHONE NO:E-MAIL ADDRESS (Optional): For Court Use Only SUPERIOR COURT OF CALIFORNIA, COUNTY OF SAN BERNARDINO STREET ADDRESS: 860 EAST GILBERT STREET MAILING ADDRESS: 860 EAST GILBERT STREET CITY AND ZIP CODE: SAN BERNARDINO, CA 92415 -0955 BRANCH NAME: JUVENILE DEPENDENCY COURT CASE NAME: REQUEST TO VACATE PACKET JUVENILE DEPENDENCY PROCEEDING Welfare & Institutions Code 247 300 CASE NUMBER: RELATED CASE (if any): (Name of social worker) is requesting to vacate the packet dated (date of packet) filed with the court on (date filed) for the following reason: I served a copy of the REQUEST TO VACATE PACKET on (date) on the following persons or entities (indicate name of person served and method of service): County Counsel : Attorney - other: Children222s Advocacy Group : Attorney - other: Friedman, Cazares & Gilleece: Attorney - other: Alvarenga & Clark: Other: Friedland & Associates: Other: At the time of service I was at least 18 years of age and not a party to this cause. I am a resident of or employed in the county where the service occurred. My residence or business address is (specify): I declare under the penalty of perjury under the laws of the State of California that the foregoing is true and correct. Date: (TYPE OR PRINT NAME) (SIGNATURE) American LegalNet, Inc. www.FormsWorkFlow.com