Fill and Sign the Law Enforcement Agency 497299260 Form

JV-575 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: ––––– CHILD’S NAME: ––––– CASE NUMBER: CHILD’S DATE OF BIRTH: ––––– ––––– RELATED CASES (if any): PETITION TO OBTAIN REPORT OF LAW ENFORCEMENT AGENCY ––––– 1. Petitioner's name and address (if representing another person, organization, or agency, provide names and addresses): ––––– ––––– 2. Petitioner's relationship to child (if any): ––––– ––––– 3. Police department or law enforcement agency possessing records: ––––– ––––– Report number: ––––– 4. The reasons for this request are: ––––– (Describe in detail. Attach additional pages if necessary.) ––––– ––––– ––––– ––––– ––––– ––––– Continued in Attachment 4. 5. The Notice to Child and Parent/Guardian Re: Release of Juvenile Police Records and Objections (form JV-580) was served on the child or parent on (date): ––––– I declare under penalty of perjury under the laws of the State of California that the foregoing and all attachments are true and correct. Date: ––––– ––––– (TYPE OR PRINT NAME) (SIGNATURE OF PETITIONER) Number of pages attached: ––––– PETITION GRANTED PETITION DENIED ADDITIONAL ORDERS: ––––– ––––– Date: ––––– JUDICIAL OFFICER Page 1 of 1 Judicial Council of California PETITION TO OBTAIN REPORT OF LAW ENFORCEMENT AGENCY Cal. Rules of Court, rules 5.504, 5.552 Form Adopted for Mandatory Use Welfare and Institutions Code, §§ 827.9, 828 JV-575 [Rev. January 1, 2007] electronic form ã 2005 WWW.LawCA.co m Law Publishers