Sample Application Cover Letter Page 2
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2JV-210
CHILD'S NAME:
CASE NUMBER:
DECISION OF SOCIAL WORKER OR SOCIAL SERVICES AGENCY
8. Social worker information:
a. Name:
b. Agency:
c. Address:
d. Telephone number:
9. After consideration of the application above, the SOCIAL WORKER HAS DECIDED
a.
to commence proceedings in juvenile court on these allegations.
b.
not to commence proceedings in juvenile court on these allegations because (specify):
See attachment 9. Number of pages attached:
10. I declare I am a social worker of the county in which this application was submitted and am duly authorized to make this decision.
Date:
(SIGNATURE OF SOCIAL WORKER)
(TYPE OR PRINT NAME)
JV-210 [Rev. July 1, 2010)
Page 2 of 2
APPLICATION TO COMMENCE PROCEEDINGS BY AFFIDAVIT
AND DECISION BY SOCIAL WORKER
(Welf. & Inst. Code, § 329)
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