ATTACHMENT JV-2001 ATTORNEY OR PARTY WITHOUT ATTORNEY (Name and Address): TELEPHONE NUMBER: FOR COURT USE ONLY ATTORNEY FOR: (name): SUPERIOR COURT OF CALIFORNIA, COUNTY OF SANTA CLARA STREET ADDRESS: MAILING ADDRESS: CITY AND ZIP CODE: BRANCH: 191 North First Street San Jose, CA 95113 In the Matter of (Name of Child), a Minor, [D.O.B. ] CASE NUMBER: ORDER REFERRING CASE TO COURT DESIGNATED CHILD ADVOCATES FOR SCREENING The Minor having been adjudged a ward of the Juvenile Court (Welfare & Institutions Code section 602) and good cause appearing therefore, the Court orders that this case be referred to Court Designated Child Advocates for a screening to determine whether the Child Advocate program can undertake the case. To aid in this determination, Court Designated Child Advocates shall have access to the records and files of the Court and Probation Department with respect to the Minor for a period of 90 days after the date of this Order. All confidential information acquired during the course of this determination shall remain confidential and may be disclosed only to a Probation Officer, attorneys representing parties to this case, or the Court, unless specifically authorized by the Court. Date: Judicial Officer JV-2001 REV 7/01/08 ORDER REFERRING CASE TO COURT DESIGNATED CHILD ADVOCATES FOR SCREENING Page 1 of 1 American LegalNet, Inc. www.FormsWorkflow.com