ATTORNEY OR PARTY WITHOUT AN 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 SANTA CRUZ 1 Second Street, Room 301 Watsonville , CA 950 76 Watsonville Branch NAME OF CHILD : DATE OF BIRTH : DECLARATION IN SUPPORT OF REQUEST TO INSPECT AND/OR COPY JUVENILE COURT RECORDS WITHOUT A COURT ORDER ( Welfare and Institutions Code 247827 ) CASE NUMBER: Form Adopted for OPTIONAL USE Superior Court of Santa Cruz County SUP JV 801 0 2 /0 6 /19 DECLARATION IN SUPPORT OF REQUEST TO INSPECT JUVENILE COURT RECORDS WITHOUT COURT ORDER Page 1 of 3 Welfare & Institutions Code 247 827 SUP JV 801 CONFIDENTIALITY REQUIREMENTS/WARNING: No person or entity may copy or inspect confidential psychological, medical or educational information absent an order from the Dependency or Juvenile Justice Judge of the Juvenile Court. For records you are provided today, all records, reports or information obtained from Juvenile Court shall not be further released or disseminated to persons or agencies not otherwise entitled pursuant to Welf. & Inst. Code 247247 827 or 362.5. Said information shall not be attached to any document without prior approval of the Dependency or Juvenile Justice Judge of the Juvenile Court unless they are used in connection with adult criminal or juvenile court proceedi ngs to declare a minor a dependent or ward of the court. Pursuant to the amendment of Labor Code 247 432.7, an employer, whether a public agency utilize as a factor in de termining any condition of employment. DECLARATION REGARDING YOUR ROLE: ( FILL IN EITHER SECTION 1 OR 2 ON THE FOLLOWING PAGES ) American LegalNet, Inc. www.FormsWorkFlow.com In the Matter of : CASE NUMBER : Form Adopted for OPTIONAL USE Superior Court of Santa Cruz County SUP JV 801 0 2 /0 6 /19 DECLARATION IN SUPPORT OF REQUEST TO INSPECT JUVENILE COURT RECORDS WITHOUT COURT ORDER Page 2 of 3 Welfare & Institutions Code 247 827 1. I am or represent one of the following individuals and entities that m a y inspect, receive, and copy the juvenile case file without an order of the juvenile court pursuant to Welf . & Inst. Code 247 827 or Welf. & Inst. Code 247 362.5: The district attorney, a city attorney, or a city prosecutor authorized to prosecute criminal or juvenile cases under the law; The child or non - minor dependent who is the subject of the proceeding; parental rights have not been terminated. If the subj ect is older than 17 years and 6 months of age, I am currently receiving reunification services form the social services agency; An attorney for a party, including any trial court or appellate attorney representing a party in the juvenile proceeding or rel ated appellate proceeding; A judge, referee, other hearing officer, probation officer, and law enforcement officer who is actively participating in criminal or juvenile proceedings involving the child or non - minor dependent, including the district attorney if the non - minor is also a ward of the Juvenile Court ; The county counsel, city attorney, or any other attorney representing the petitioning agency in a dependency action; A member of a child protective agency as defined in Penal Code 247 11165.9; An assign ed Social Worker or Probation Officer charged with review of court records for the purpose of making a written recommendation to the court in a social study report pursuant to Welf. & Inst. Code 247 241.1 for determination of dual status suitability of a cur rent dependent or ward of the court; A Court Appointed Special Advocate, or CASA Administrative Personnel; The California Department of Social Services in order to carry out its duty to oversee and monitor county child welfare agencies, children in foster care or receiving foster - care assistance, and out - or - state placements, or authorized legal staff or special investigators who are peace officers employed by, or who are authorized representatives of the State Department of Social Services, as necessary fo r the performance of their duties to inspect, license, and investigate community care facilities, to ensure that the standards of care and services provided in those facilities are adequate and appropriate, and to ascertain compliance with the rules and re gulation to which the facilities are subject; The Juvenile Justice commission; A judge, commissioner or other hearing officer assigned to a family law or probate case involving the minor, or the following person if actively participating in the family law or probate case: A court appointed mediator or evaluator conducting a court connected child custody evaluation, investigation or assessment pursuant to Family Code 247247 3111 or 3118, and counsel appointed for the minor in the family law case pursuant to Fami ly Law Code 247 3150. Counsel for the minor on related matters is required to s case. NOTE: A Request for Release of Juvenile Case File (JV - 570) mu st be submitted to the Dependency or Juvenile Justice Judge of the Juvenile Cour t for review if copies of records are being requested under number one (1) above. American LegalNet, Inc. www.FormsWorkFlow.com In the Matter of : CASE NUMBER : Form Adopted for OPTIONAL USE Superior Court of Santa Cruz County SUP JV 801 0 2 /0 6 /19 DECLARATION IN SUPPORT OF REQUEST TO INSPECT JUVENILE COURT RECORDS WITHOUT COURT ORDER Page 3 of 3 Welfare & Institutions Code 247 827 2. I understand I am not authorized to receive copies of a Juvenile Court r ecord without a prior court order. I am or represent one of the following individuals and entities that may inspect Juvenile Court records. the child; A court appointed investigator who is actively participating in a guardianship case involving a child pursuant to 247247 7663, 7851, or 9001 of the Family Code or Part 2 (commencing with 247 1500) of Division 4 of the Probate Code, and acting within the scope of the duties in that case; A local child support agency for the purposed of establishing paternity and establishing and enforcing child support orders; A child welfare agency of a county responsible for the supervision and placement or service that has been ordered for the minor or non - minor dependent by the court. NOTE: A Request for Release of Juvenile Case File (JV - 570) must be filed if copies of records are being requested under number two (2) above. Authorization may be ordered only by the Dependency or Juvenile Justice Judge of the Juvenile Court. ALL REQUESTORS MUST COMPLETE ITEMS 3 & 4 BELOW. 3. I have read and agree to the following terms for inspection (initial next to each item) : I shall not disclose or disseminate any information contained in t he records to any person, unless otherwise ordered by the court. I may receive the documents in an electronic format for inspection on site at Juvenile Court. I shall not alter, delete, transmit, copy, or photograph, by any means, anything conta ined in the case file ( I may take notes regarding the contents of the documents). If these, or any other document (s) placed in a confidential or sealed envelope is provided, said envelope shall NOT be o pened or viewed by me . I acknowledge that the Court may monitor my order. 4. I have verified the truth of my identity by providing the attached copy of a valid photo identification. 5. ATTORNEY/AGENCY INFORMATION: State Bar # Client 6. I am aware of the above warning regarding dissemination of juvenile records. I understand and will abide with the terms set forth for inspection of the juvenile records provided . I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Date: Type of print your name Signature American LegalNet, Inc. www.FormsWorkFlow.com