Superior Court of California, County of Yuba ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, state bar number, and address) Effective January 1, 2010 FOR COURT USE ONLY TELEPHONE NO: ATTORNEY FOR (NAME): FAX NO: SUPERIOR COURT OF CALIFORNIA COUNTY OF YUBA 215 FIFTH STREET, SUITE 200 MARYSVILLE, CA 95901 (530) 749-7600 IN THE MATTER OF: CERTIFICATE OF COMPETENCY TO PRACTICE IN JUVENILE DEPENDENCY COURT CASE NUMBER: I, __________________________________________, Attorney at Law, am licensed to practice in the State of California. My State Bar Number is ________________. I hereby certify that I meet the minimum standards for practice before the Juvenile Division of Yuba County Superior Court as set forth in Local Rule 7.2. I further certify that I have completed the minimum requirements for training, education and/or experience as set forth below. TRAINING AND EDUCATION (Attach copies of MCLE certificates or other documentation of attendance) COURSE TITLE DATE COMPLETED HOURS PROVIDER _________________________________________________________________________________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________ JUVENILE DEPENDENCY EXPERIENCE (Attach extra page if necessary) COURSE TITLE DATE COMPLETED HOURS PROVIDER _________________________________________________________________________________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________ Dated: ______________ _____________________________________________ Signature of Attorney APPROVED. Dated: ______________ _____________________________________________ JUDGE OF THE SUPERIOR COURT ________________________________________________________________________________________________ American LegalNet, Inc. www.FormsWorkFlow.com