Notice Of Petition And Petition To Transfer Case To Tribal Jurisdiction Page 2
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3ICWA-050
CHILD'S NAME:
CASE NUMBER:
PROOF OF SERVICE
Notice of Petition and Petition to Transfer Case Involving an Indian Child to Tribal Jurisdiction ICWA-050 must be served on all other
parties or attorneys for the parties. After getting a hearing date from the court clerk and completing the form, anyone at least 18 years
of age EXCEPT A PARTY in this action may personally serve or mail the request. The person who serves the notice must fill out and
sign the proof of service. This form may not be filed with the court until all the parties or their attorneys are served. A request to
transfer cannot be heard for juvenile dependency cases until after the JV-100 or JV-110, Juvenile Dependency Petition has been filed,
for juvenile delinquency cases not until after the jurisdiction hearing, and for probate cases not until after the jurisdictional hearing.
1. At the time of service I was at least 18 years of age and not a party to the legal action.
2. I served a copy of form ICWA-050 and all attachments as follows (check either a or b below for each person served):
a.
Personal service. I personally delivered a copy of form ICWA-050 and all attachments as follows:
(1) Name of child's attorney (if applicable) served:
(2) Name of
parent (if self-represented)
or
parent's attorney (if applicable) served:
(a) Address:
(a) Address:
(b) Date of delivery:
(b) Date of delivery:
(c) Time of delivery:
(c) Time of delivery:
(3) Name of Appointed Special
(4) Name of
social worker (dependency only)
Advocate (if applicable) served:
or
probation officer (delinquency only)
(a) Address:
served:
(a) Address:
(b) Date of delivery:
(c) Time of delivery:
(b) Date of delivery:
(c) Time of delivery:
(5) Name of
child's caregiver
or
Indian custodian served:
(6) Attorney for child welfare services agency
(dependency only) served:
(a) Address:
(a) Address:
(b) Date of delivery:
(b) Date of delivery:
(c) Time of delivery:
(c) Time of delivery:
(7) Name of
parent (if self-represented)
or
parent's attorney (if applicable) served:
(8) District Attorney
(delinquency only) served:
(a) Address:
(a) Address:
(b) Date of delivery:
(b) Date of delivery:
(c) Time of delivery:
(c) Time of delivery:
Page 2 of 3
ICWA-050 [New January 1, 2008]
NOTICE OF PETITION AND PETITION TO TRANSFER CASE
INVOLVING AN INDIAN CHILD TO TRIBAL JURISDICTION
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