ATTORNEY, ATTORNEY DESIGNEE, OR PARTY WITHOUT
ATTORNEY (name and address):
Attorney Or Attorney Designee for (Client’s Name):
Telephone No.:
Fax No.:
SUPERIOR COURT OF CALIFORNIA, COUNTY OF LOS ANGELES
Juvenile Division
201 Centre plaza Drive
Monterey Park, CA 91754
CHILD’S NAME:
DOB:
Juvenile Case Number
DECLARATION IN SUPPORT OF
:
Dependency ______________
ACCESS TO AND COPIES OF JUVENILE RECORDS
Delinquency ______________
(WIC §827, CRC Rule 5.552; Local Rule 7.2)
A. Person/Agency Entitled to Access Pursuant to Welfare & Institutions Code (WIC)
§827, California Rules of Court, Rule 5.552, and Los Angeles Superior Court (LASC)
Local Rules, Rule 7.2:
Subject child
Subject child's parent or legal guardian
Attorney for subject child (including appellate attorney) [continue to Section B below]
Attorney for subject child's parent/legal guardian (including appellate attorney) [continue to Section B
below]
The county counsel, city attorney, or any other attorney representing the petitioning agency in a
dependency action. [Continue to Section B below]
Attorney authorized to prosecute adult criminal or juvenile matters under California state law (district
attorney, city attorney, city prosecutor) [Continue to Section B below]
Person/agency actively participating in adult criminal or juvenile proceedings involving the minor
(hearing officers, probation officers, law enforcement officers)
State Department of Social Services staff for the purposes delineated in WIC §827(a)(1)(I)
Member of child protective agencies per Penal Code §11165.9 (police, sheriff, county probation, county
child welfare)
Superintendent or designee of school district where child attends or is enrolled
State Department of Social Services staff for the purposes delineated in WIC §827(a)(1)(J)
Member of child's multi-disciplinary team
providing supervision or treatment of child
Person/Agency currently
Title & Relationship to Child ________________________________________________________
Family law judicial officer, or clerk acting on behalf of judicial officer; family law case # ____________
Family law mediator or evaluator (including person performing investigation or assessment)
Court-appointed probate guardianship investigator
Local child support agency
Juvenile justice commission
Other (including pursuant to court order; please attach copy of order)
________________________________________________________________________________________
NOTE: Attorney designees (including paralegals, investigators, and social workers) must check the
appropriate box in Section A as to the attorney, and must fill out the attorney information in Section B.
B. Attorney
Name: ________________________
State Bar #: _____________
Case No: _____________________
Court (criminal, juvenile, etc.) ___________________________ Client Name: ________________________
Client’s relationship to subject of juvenile records: _____________________________________________