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JV-570 Request for Disclosure of Juvenile Case File If you are requesting a court order to obtain the juvenile case file of a child who is alive, fill out all items on this form, and file it with the court. You must also fill out and file Proof of Service—Request for Disclosure (form JV-569). Clerk stamps date here when form is filed. 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 finished. If you are a member of the public requesting the juvenile case file of a child who is deceased, you can: a. Fill out items 1–4 and 7 on this form and file it with the court. You must then provide a copy of this form to the Custodian of Records of the county child welfare agency, who will then provide notice of this request. Fill in court name and street address: Superior Court of California, County of Or b. Do not complete the form and request the juvenile case file from the child welfare agency under Welfare and Institutions Code section 10850.4. 1 Fill in case number if known: Your name: Case Number: Relationship to child (if any): Street address: City: State: Zip: Telephone number: Lawyer (if any) (name, address, telephone numbers, and State Bar number): 2 Name of child (if known): 3 Child’s date of birth (if known): 4 a. A petition regarding the child in 2 has been filed under Welfare and Institutions Code section 300 Welfare and Institutions Code section 601 Welfare and Institutions Code section 602 or b. I believe the child in 2 died as a result of abuse or neglect. Approximate date of death: If you checked box b, you may skip items 5 and 6. Note: You must provide a copy of this form to all interested parties if you know their names and addresses. Judicial Council of California, www.courtinfo.ca.gov Revised January 1, 2009, Mandatory Form Welfare and Institutions Code, § 827; California Rules of Court, rules 5.552, 5.553 Request for Disclosure of Juvenile Case File JV-570, Page 1 of 2 Case Number: Your name: 5 The records I want are: (Describe in detail. Attach more pages if you need more space.) Continued on Attachment 5. 6 The reasons for this request are: a. Civil court case pending in (name of county): Case number: Criminal court case pending in (name of county): Case number: b Hearing date: Juvenile court case pending in (name of county): Case number: Other (specify): Case number: c. d. 7 Hearing date: Hearing date: Hearing date: I need the records because: (Describe in detail. Attach more pages if you need more space.) Continued on Attachment 7. 8 I declare under penalty of perjury under the laws of the State of California that the information in this form is true and correct. This means that if I lie on this form, I am guilty of a crime. Date: Type or print your name Revised January 1, 2009, Mandatory Form Sign your name Request for Disclosure of Juvenile Case File For your protection and privacy, please press the Clear This Form button after you have printed the form. Save This Form Print This Form JV-570, Page 2 of 2 Clear This Form