Fill and Sign the Notice of Intent to Remove Child and Proof of Notice Objection to Removal and Order After Hearing California Form

Notice of Intent to Remove Child and Clerk stamps date here when form is filed. JV-32 3 Proof of Notice, Objection to Removal, and Order After Hear i ng This notice must be s e rved wit h a blank copy of fo rm J V-321 , Request for Pros p ective A d o p ti v e Par e nt D esignation, Notice, and Order. 1 To: a. Court: b. D esignat e d prospe c t ive adoptive pare nt or caregiver who may fit the defi n iti on of pr os pecti v e ad o p t ive pa rent (name) : Fill in court name and street address: Sup e ri o r Co u r t o f Ca l if o rn i a, C o unty of c. Child’s attorne y (na m e): d. C h il d, if 1 0 y ears of a g e or old er (name): 2 Name of a g ency p ro p osi n g m o ve: F i ll in child's name and dat e of birth: Address : Child’ s Nam e : P h o n e n u mber: Date o f Birth: This age n cy is asking for a c o urt ord er t o re m ov e (name of child) : Clerk fills in case number when form is filed. Case N u mber: from hi s o r her current hom e becaus e (explain): I f more space is needed, att a ch a s h eet of pa p er a n d write “ J V- 3 2 3 , Item 2—Reas o ns fo r Rem o val” at t h e top. Num b er of p a ge s at t a ch e d: 3 If you d o not agree with the removal, you ma y r e quest a court h e aring . T o do this you must fi l l ou t pages 3 and 4 of this form , Objection to Removal , an d fil e i t with the c ourt within f i ve court days or sev e n calendar days, whichever is longer, from the date you received thi s notice . If th e cou r t has no t desig n ated y ou a s a prosp e cti v e a d o p tiv e p ar e nt, y ou m u st c om p l e t e fo r m J V- 3 2 1, Request for Prospective Adoptiv e P a rent Des i g n a t io n , N o tice, a n d Order , and fi l e it w i th th i s form. I d e clare un d er pe n alty of perj ur y u n der the laws of the Sta t e of Cal i fornia that the info r m at i o n in items 1 and 2 is tru e and correct, which means i f I l i e on this form, I a m committing a crime. Date: Ty pe or pri n t y o ur n ame Sig n yo u r n a me J u dici a l Co u ncil of Ca l if o rn i a , w ww. co ur t i n f o . ca. go v JV-32 3, Page 1 of 5 N e w J u ly 1 , 20 0 6 , Ma n d a t o r y For m Notice of Intent to Remov e Child and Proof of Notice, W el f ar e a n d I ns t i t u t i o n s C o d e , § 3 6 6 . 2 6 (n ) Objection to R emoval, and Order After Hearing C a l . R u l e s o f Co u rt, r u les 1 46 3 .1 , 1 4 6 3. 3 25 Case Num b er: Child’s name: PROOF OF NOTICE 4 Notice o f Intent to Remov e Chil d was m a ile d o n (date): By pla c ing copies in a sealed envelop e a n d d e positing the envelop e directly in the U.S. mail with po s t a ge pa i d or at my p l ace of business for same-day collection and mai l ing w i t h t h e U . S . ma il, f o l lo w i ng o ur ordinary business practice s , with which I a m re a dily famili ar . a . Place of d e posi t (city an d state): b . Addres s ed as follow s : (1) Cou r t: (2) Caregiver: o r confidential address in cour t file (3 ) Child’s attorney: ( 4) Child, if 1 0 year s of a ge or ol d er: or confidential address in cou r t fi l e (5 ) Child’s ident i fied I ndian tribe, if any: (6 ) Child’ s Indian custodian, if any: ( 7) Child’s Cour t Appointed Special Advocate (CAS A ) program, if any: 5 At the tim e o f the notice I w as at l e as t 18 years of ag e and not a party to this matter . I live or am employed in the count y w here the m a iling occurred . My residenc e or bu s i nes s addres s i s (specify): I d eclare u nd er pe n a l ty of perj u ry u n der the l aws o f t he S tate o f Calif o rn i a that the inf o rmati o n i n i tems 4 a n d 5 i s true and correc t , which means if I lie on t his f orm, I am committing a crime. Date: Ty pe or pri n t y o ur n ame Sig n yo ur n a m e New July 1, 2 0 0 6 Notice of Intent to Remov e Child and Proof of Notice , JV- 3 23 , Page 2 of 5 Objection to Removal, and Order After Hearing Case Num b er: Child’s name: OBJECTION TO REMOVA L Clerk stamps date here when form is filed. If you d o not agree with the removal, yo u c a n r e ques t a cour t hea r ing by filling out thi s form . Brin g this form to the clerk of t h e court. If you want to keep an addr e ss or phone numbe r confidential, fill ou t form JV-322, C onfidential Information—P r ospective Adoptive Parent , a n d d o n o t write the addre ss or phon e nu m ber on this form. If you ar e a c aregiver or th e c hild , the clerk of the court will set a hearing da te a n d let y o u k n ow wh a t i t is. If you ar e th e c hild’s atto r ney, yo u must provide notice of the h e aring . Fill in cou rt nam e and street address: S u p e ri o r C o urt of C a li f or n i a , Co u n t y of 6 I nf o rma t io n a b o u t t h e pers o n or p e rsons objecting t o the removal: a . Nam e : b . Nam e : c . Phone number: d. Address: 7 If y o u (th e perso n objecti n g to th e r e moval ) are not t he careg i ver, fill out below. a . My name: b . I am the ch i ld child’s attorney other (sp e cify role): c . My p h o n e nu m ber: d . My address: 8 If you are not the child’s attorney a n d y o u k no w w h o the c h il d ’s attorney i s , fill ou t below. a . Name of child’s attorney: b . Phone number of child’s attorney: c . Address of child’s attorney: 9 T he c hild is 10 y ears of ag e or ol der. Child’s p h o n e n u mb e r : 10 Th e c hild ha s a n identified Indian trib e (specif y tribe): Phone number of tribe: 11 Th e c hil d ha s a Cour t Appointed Special Advocat e (CASA) volunteer. Ph o n e n um b er of CAS A pr o g ram, if k n ow n : 12 The caregiver ha s bee n des i gnated by the judge as the child’s pro s pectiv e a d o p ti ve par e nt or pare nt s. New July 1, 2 0 0 6 Notice of Intent to Remov e Child and Proof of Notice , JV- 3 23 , Page 3 of 5 Objection to Removal, and Order After Hearing Case Num b er: Child’s name: 13 Th e c aregiv er m a y meet the d efi ni ti o n of pr o sp e cti v e ad o ptive p arent or p a rents. A f o rm JV-3 2 1 , R e qu e st for Prospe c t ive Adoptive Paren t D esig n atio n , Notice, a n d Or d er , w i ll be fil e d wit h t h is o b je c t i o n a n d req u est f o r hearing. 14 The socia l worker shoul d not remove th e c hild from the car e giver’s home becaus e (give reasons): I f y o u nee d more space, attach a sh ee t of p a p e r a nd write “JV-3 2 3 , It e m 14—Reasons to Not Re move Child” at the top . Number of page s attached: I d eclare u n der pe n a l ty of perj u ry u n der t he l aws o f t he S t a t e of California that th e i n formatio n on th i s for m i s true and correc t , which means if I lie on t his f orm, I am committing a crime. Date: Typ e o r print y o ur n a m e S ig n y o ur n ame What if I am de a f or hard of hearing? Requests for Ac c ommodations Assistiv e listenin g syst e ms, c omputer-as s iste d r e al-ti m e c a ptioning , o r sign languag e interpreter s ervices are avail a ble if yo u a s k a t le a st fiv e day s befor e the proce e ding. Contac t t h e clerk’s office or go to www.courtinfo.c a.gov/form s for a Request fo r Accommodations by Pers ons With Disabilities and Response (form MC-410) . (C i v il C o de , § 5 4 . 8 .) New July 1, 2 0 0 6 Notice of Intent to Remov e Child and Proof of Notice , JV- 3 23 , Page 4 of 5 Objection to Removal, and Order After Hearing Case Num b er: Child’s name: 15 This he a r i n g o n t h e child’s rem o v a l fro m t he h o m e of t h e pr o spe c t i ve Clerk stamps date here whe n for m is filed. a d o p ti v e paren t o r pare n ts t o o k p lace on (date): 16 The child’ s prospective adoptive paren t o r parents are: (name): (name): The court finds and orders: Fill in court na m e and street address: 17 N o ti ce w as give n as req u ir e d b y law . S u per i o r C o ur t of C a l i for n ia , Cou n ty o f 18 The intended removal is not i n t he best interest of the child. The ch i ld will r e main in the home of the prospectiv e adopt i ve p a r e nts. 19 Th e in t e nded removal i s i n the best interest of the child. Th e child i s or dere d r e mo v ed fro m t h e h o me of the pr os pecti v e ad op tive paren t o r pare n ts, a n d t he de s i g n a tion as prospectiv e a doptive p a r e nts i s terminated. The agenc y may place the child w i th (name): 20 Other or de rs (specify): Date: Judge (or Judicial Offic e r) New Ju l y 1 , 2 0 0 6 Notice of Intent to Remov e Child and Proof of Notice , JV-323 , P age 5 of 5 Objection to Removal , and Order After Hearing