Petitioner's Name ____________________________________________________________ Address _____________________________________________________________________ Phone______________________________________________________________________ _ Fax________________________________________________________________________ _ Relationship to Minor___________________________________________________________ FOR COURT USE ONLY SUPERIOR COURT OF CALIFORNIA, COUNTY OF STANISLAUS JUVENILE DIVISION IN THE MATTER OF: a minor. Date of birth_________________________________________ DECLARATION IN SUPPORT OF ACCESS TO AND COPIES OF JUVENILE COURT RECORDS (WIC � 827/828) Juvenile Court Case Number:_______________________ A. Person/Agency Entitled To Access Pursuant to WIC � 827/828: The district attorney, a city attorney, or city prosecutor authorized to prosecute criminal or juvenile cases under state law. The minor who is the subject of the proceeding. The minor's parent or legal guardian. The attorneys for the parties. Probation officers and law enforcement officers who are actively participating in criminal or juvenile proceedings involving the minor. The county counsel, city attorney, or any other attorney representing the petitioning agency in a dependency action. The superintendent or designee of the school district where the minor is enrolled or attending school. Member of the child protective agencies as defined in Section 11165.9 of the Penal Code. The State Department of Social Services. Member of children's multidisciplinary teams, persons, or agencies providing treatment or supervision of the minor. B. Child support agency. Juvenile Justice Commission. Other: __________________________________ Attorney State Bar #____________Client_______________ Court__________________ (minor, mother, father, etc.) (Dependency, Delinquency, Civil, Criminal) Any records, reports or information obtained from the above juvenile record(s) shall not be further released or disseminated to persons or agencies not otherwise entitled to access pursuant to WIC �827. Said information shall not be attached to any documents without prior approval of the Presiding Judge of Juvenile Court, unless they are used in connection with adult criminal or juvenile court proceedings to declare a minor a dependent or ward of the court. C. I hereby request copies of the following documents: All documents Other:__________________________________________________________________ Other:__________________________________________________________________ Petition and disposition (specify date):__________________________________ I declare under penalty of perjury pursuant to the laws of the State of California that the foregoing is true JV001 Rev 05/06 American LegalNet, Inc. www.FormsWorkFlow.com and correct. Date:________________________ Agency:__________________________________ __________________________________________ Signature __________________________________________ Printed Name JV001 Rev 05/06 American LegalNet, Inc. www.FormsWorkFlow.com