Jv365 Termination Of Juvenile Court Jurisdiction
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1
2JV-365
ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address):
FOR COURT USE ONLY
To keep other people from
seeing what you entered on
your form, please press the
Clear This Form button at the
end of the form when
TELEPHONE NO.:
FAX NO. (Optional):
finished.
E-MAIL ADDRESS (Optional):
ATTORNEY FOR (Name):
SUPERIOR COURT OF CALIFORNIA, COUNTY OF
STREET ADDRESS:
MAILING ADDRESS:
CITY AND ZIP CODE:
BRANCH NAME:
NONMINOR'S NAME:
NONMINOR'S DATE OF BIRTH:
HEARING DATE AND TIME:
DEPT.:
CASE NUMBER:
TERMINATION OF JUVENILE COURT JURISDICTION—
NONMINOR
Directions for the social worker or probation officer: Check the appropriate boxes in items 1 through 6, complete item 7, attach
documents as required, and sign and date item 8.
Directions for the nonminor (if nonminor is available): Review the boxes checked by the social worker or probation officer in items
1 through 6. If the box checked in item 1 is wrong, check the correct box and sign your initials next to the box. Sign your initials on the
line after items 2a–h, items 3a–j, item 4, items 5a–b, and items 6a–g if you received the service or information. Then sign and date item
9. The form may be given to the judge on the day of the hearing if you didn't give it to your social worker, probation officer, or attorney
before the hearing.
1.
a.
The nonminor wants to attend the termination hearing.
The nonminor does not want to attend the termination hearing. The petitioner has attached verification that the nonminor
b.
has been informed of the potential consequences of failure to attend the termination hearing.
c.
The nonminor is unavailable and/or has refused to sign this form. Evidence of reasonable efforts to locate the nonminor
and to obtain his or her signature is attached.
2. An attached report verifies that the nonminor has received written information concerning his or her juvenile court case,
including (check all that apply):
a.
Information known about the nonminor's Indian heritage or tribal connections, if applicable ________
b.
The nonminor’s family history ________
c.
The nonminor's placement history ________
d.
The nonminor's educational and medical history ________
Any photographs of the nonminor or his or her family in the possession of the county child welfare department or
e.
probation department, other than forensic photographs ________
f.
The whereabouts of any siblings under the jurisdiction of the juvenile court except for those siblings for whom the juvenile
court has found that sibling contact would jeopardize the safety or welfare of the sibling________
The nonminor’s right to go to the clerk’s office and, after demonstrating his or her identity by showing an identification
g.
card or by other means, inspect, receive, and copy his or her juvenile case file without an order from the juvenile court
(see Welf. & Inst. Code, §§ 826.6 and 827 and rule 5.552 of the California Rules of Court) ________
The date on which the jurisdiction of the court will be terminated ________
h.
3.
The nonminor has been provided with the following documents (check all that apply):
Certified birth certificate ________
a.
Social security card ________
b.
Identification card and/or driver’s license ________
c.
Proof of citizenship or residency status ________
d.
e.
Death certificate of parent or parents, if applicable ________
f.
Health and Education Passport maintained by the county welfare department or the probation department ________
Page 1 of 2
Welfare and Institutions Code, § 391;
Form Adopted for Mandatory Use
TERMINATION OF JUVENILE COURT JURISDICTION—NONMINOR
Cal. Rules of Court, rule 5.555
Judicial Council of California
JV-365 [Rev. January 1, 2012]
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