Notice Of Petition And Petition To Transfer Case To Tribal Jurisdiction
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3ICWA-050
FOR COURT USE ONLY
ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address):
To keep other people from
seeing what you entered on
your form, please press the
Clear This Form button at the
FAX NO. (Optional):
TELEPHONE NO.:
end of the form when finished.
E-MAIL ADDRESS (Optional):
ATTORNEY FOR (Name):
SUPERIOR COURT OF CALIFORNIA, COUNTY OF
STREET ADDRESS:
MAILING ADDRESS:
CITY AND ZIP CODE:
BRANCH NAME:
CHILD'S NAME:
CASE NUMBER:
NOTICE OF PETITION AND PETITION TO TRANSFER CASE
(if any):
RELATED CASES
INVOLVING AN INDIAN CHILD TO TRIBAL JURISDICTION
TO ALL PARTIES:
1. A hearing on this petition will be held as follows:
a. Date:
Time:
Dept.:
Room:
b. Address of court:
same as noted above
other (specify):
2. Child's name:
Date of birth:
On behalf of the
parent
3.
Indian custodian
child's tribe, I ask the court to transfer jurisdiction over the
above named child's case to the jurisdiction of the tribe listed below:
Name of federally recognized tribe:
Name of tribal court or tribal administrative body:
Street address:
Mailing address of court:
City, state, and zip code:
Telephone:
Fax:
I declare under penalty of perjury under the laws of the State of California that the foregoing and all attachments are true and correct.
Date:
(TYPE OR PRINT NAME)
(SIGNATURE OF DECLARANT)
Page 1 of 3
Family Code, § 177(a);
Form Approved for Optional Use
NOTICE OF PETITION AND PETITION TO TRANSFER CASE
Probate Code, § 1459.5(b);
Judicial Council of California
Welfare and Institutions Code, § 305.5;
INVOLVING AN INDIAN CHILD TO TRIBAL JURISDICTION
ICWA-050 [New January 1, 2008]
Cal. Rules of Court, rule 5.483
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