NT of Intent to file Dependency (NTIEFC) - Page 1 of 1 Petition 226 Extended Foster Care WPF JU 03.1100 (06/2018) 226 RCW 13.34.268 Superior Court of Washington County of Juvenile Court In re: D.O.B.: No : Notice of Intent to File Dependency Petition 226 Extended Foster Care (NTIEFC) To: The Clerk of the Court The Juvenile Court of (name of county) DSHS/DCYF Please be advised that I intend to file a Dependency Petition 226 Extended Foster Care asking the court to: Decide if I am eligible for extended foster care services Enter an order of dependency I requested extended foster care services from DSHS/DCYF while under 21 years of age, and was notified in writing that my request was declined. I understand that an attorney must be appointed to represent me at no cost. I declare under penalty of perjury under the laws of the State of Washington that the statements above are true and correct. Signed at (city) (state) on (date) Signature of Youth Print or type Name Address Telephone number American LegalNet, Inc. www.FormsWorkFlow.com