Fill and Sign the Procedures for Obtaining Access to and Copies of Juvenile Form

1. Petit ioner's name and address ( if representing an oth er person, o rg anizat ion, or a g ency, 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 t he laws of the State of California that the foregoing and all attachments are true an d correct. Date: (TYPE OR PRINT NAME) (SIGNATURE OF PETITIONER) Number of pages attached: PETITION DENIED PETITION GRANTED ADDITIONAL ORDERS: Date: JUDICIAL OFFICERPage 1 of 1 Form Adopted for Mandatory Use Judicial Council of California JV-575 [Rev. January 1, 2007] PETITION TO OBTAIN REPORT OF LAW ENFORCEMENT AGENCY Welfare and Institutions Code, §§ 827.9, 828; Cal. Rules of Court, rules 5.504, 5.552 www.courtinfo.ca.gov JV-575 FOR COURT USE ONLY ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address): 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 NUMBER: CHILD’S NAME: CHILD’S DATE OF BIRTH: RELATED CASES (if any): PETITION TO OBTAIN REPORT OF LAW ENFORCEMENT AGENCY `