Fill and Sign the California Icpc Form

JV-567 ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address): FOR COURT USE ONLY ––––– ––––– ––––– TELEPHONE NO.: ––––– FAX NO. (Optional): ––––– E-MAIL ADDRESS (Optional): ––––– ATTORNEY FOR (Name): ––––– SUPERIOR COURT OF CALIFORNIA, COUNTY OF ––––– STREET ADDRESS: ––––– MAILING ADDRESS: ––––– CITY AND ZIP CODE: ––––– BRANCH NAME: ––––– CASE NAME: ––––– CASE NUMBER: INTERSTATE COMPACT ON THE PLACEMENT OF CHILDREN FINDINGS AND ORDERS ––––– 1. The child is within the jurisdiction of this court. 2. The home of (name and relationship to child): ––––– is available to the child for placement. 3. The placement recipient(s) under consideration for placement of the child is are qualified under statute. 4. The child qualifies for priority placement under Regulation 7, section 5a or section 5b of the ICPC. a. The receiving jurisdiction has been in possession of the completed placement request form for over 30 business days, and the sending jurisdiction has not received a notice indicating whether or not placement is contrary to the best interest of the child. b. The proposed placement recipient is a parent, stepparent, grandparent, adult sibling, adult aunt or uncle, or legal guardian of the child and (1) the child is under two years of age; (2) the child is in an emergency shelter; (3) the child has spent a substantial length of time in the home of the proposed placement recipient. 5. Subject to an approved home study and case plan, this placement would not be contrary to the best interest of the child. 6. Within three business days of receipt of this order, (sending agency): ––––– must transmit a copy of this order, a completed form ICPC-100A, and supporting documentation to the Compact Administrator of the sending jurisdiction with a cover notice of the priority status of this request for placement. 7. The Compact Administrator of the sending jurisdiction and all other persons to whom article VII of the ICPC applies must comply with Regulation 7 and must fully implement the procedures for the request for priority placement. 8. (Sending agency): ––––– must a. Take whatever additional steps are necessary, including follow-up contacts, to ensure that the process is completed in a timely manner so as to protect the best interest of the child; and b. Inform this court promptly and on a regular basis of the progress and results of this order. 9. Hearing for progress report further disposition other (specify): ––––– ––––– NOTE: Under article V(a) of the ICPC, the sending agency will retain jurisdiction over the child and will continue to assume financial responsibility for the support and maintenance of the child during the period of placement. ––––– Date: ––––– JUDICIAL OFFICER Page 1 of 1 Form Adopted for Mandatory Use Cal. Rules of Court, rule 5.616 Judicial Council of California Family Code, § 7900 et seq. JV-567 [Rev. January 1, 2007] INTERSTATE COMPACT ON THE PLACEMENT OF CHILDREN FINDINGS AND ORDERS electronic form ã 2005-7 WWW.LawCA.co m Law Publishers