Request To Appoint Sacramento Court Appointed Special Advocates printable pdf download

Request To Appoint Sacramento Court Appointed Special Advocates

Application submitted by: (Name and Address)

FOR DEPARTMENT OR

Name:

COURT USE ONLY

Street Address

City, State:

Telephone Number:

SUPERIOR COURT OF CALIFORNIA, COUNTY OF SACRAMENTO

Street Address:

3341 Power Inn Road

City and Zip Code: Sacramento, CA 95826

Branch Name:

SITTING AS THE JUVENILE COURT

NAME OF CHILD/MINOR:

Date of Birth:

CASE NUMBER:

REQUEST TO APPOINT SACRAMENTO COURT APPOINTED

SPECIAL ADVOCATES (CASA)

(

Welfare & Institutions Code § 102, California Rules of Court, rule 5.655,

Standing Order SSC-JV-00-028)

I, ________________________________________________________________, do hereby declare that:

I am:

the Child

the CASA Executive Director/designee

the Child’s _____________________________________________________________

I believe the Child’s best interest would be served by appointing Sacramento Court Appointed

Special Advocates (CASA) to perform the duties described in Standing Order SSC-JV-00-028.

I therefore request this Court appoint CASA to assist the Child.

I declare under penalty of perjury that the above is true and correct.

Executed this _________ day of __________________________________ in Sacramento,

California.

Signature: __________________________________________________

ORDER

It is the order of this Court that Sacramento Court Appointed Special Advocates (CASA) is appointed

pursuant to Standing Order SSC-JV-00-028.

Date: ______________________________

________________________________

Judge/Referee of the Juvenile Court

JC\E-338

Request for Juvenile Court to Appoint CASA

Eff. 2/26/09

Request To Appoint Sacramento Court Appointed Special Advocates