SDSC JUV-259 (New 6/15) EX PARTE APPLICATION AND ORDER NONMINOR DEPENDENT ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address): TELEPHONE NO.: FAX NO. (Optional): EMAIL ADDRESS (Optional): ATTORNEY FOR (Name): FOR COURT USE ONLY SUPERIOR COURT OF CALIFORNIA, COUNTY OF SAN DIEGO CENTRAL DIVISION, CENTRAL COURTHOUSE, 1100 UNION ST., SAN DIEGO, CA 92101 CENTRAL DIVISION, COUNTY COURTHOUSE, 220 W. BROADWAY, SAN DIEGO, CA 92101 CENTRAL DIVISION, JUVENILE COURT, 2851 MEADOW LARK DR., SAN DIEGO, CA 92123 EAST COUNTY DIVISION, 250 E. MAIN ST., EL CAJON, CA 92020 NORTH COUNT SOUTH COUNTY DIVISION, 500 3RD AVE., CHULA VISTA, CA 91910 IN THE MATTER OF A NON MINOR DEPENDENT EX PARTE APPLICATION AND ORDER NONMINOR DEPENDENT CASE NUMBER The San Diego County Juvenile Court assumed or resumed jurisdiction over (name) as a nonminor dependent (NMD) on (date) . Next scheduled hearing date:NMD YES NO SUBMIT NMD222s Attorney YES NO SUBMIT County Counsel YES NO SUBMIT Social Worker YES NO SUBMIT Probation Officer YES NO SUBMIT CASA YES NO Other YES NO SUBMIT See attached for additional notice. DECLARATION IN SUPPORT OF REQUESTED ORDER Continued on attachment. 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 Signature ORDER Granted Denied Hearing set for . Comments: Date: Judge/Referee of the Superior Court American LegalNet, Inc. www.FormsWorkFlow.com