Fill and Sign the You Are the Form

Fill in child's name: Child’s information: JV-180, Page 1 of 3 Judicial Council of California, Revised January 1, 2009, Mandatory Form Welfare & Institutions Code, § 388 Cal. Rules of Court, rules 5.524, 5.570 Request to Change Court Order Clerk stamps date here when form is filed. Fill in court name and street address: Superior Court of California, County of Case Number: Fill in case number, if known: JV-180 Request to Change Court Order 4 a. Child’s name: b. Date of birth: c. Child’s attorney (if known): d. The child lives with or in (check all that apply): parent legal guardian relative foster home group home e. Name of person the child lives with or place where the child lives Child’s address : Your information: 1 1 a. You are the: This form can be used to request a change in a court order, to ask the court to dismiss your case, or to ask the court to establish a relationship with your sibling. After filling out this form, br ing it to the clerk of the court. Child's Name: child mother father legal guardian relative (specify): attorney social worker probation officer other b. Your name: c. Your address: e. Your telephone number: d. Your city, state, zip code: f. If you are an attorney: Your client’s name: Your client’s relationship to the child: Your State Bar number: Your client’s address (if confidential, see item 3): Type of request (check the appropriate box below and add specific details in items 6–9, as applicable): 2 I am asking the court to change a court order. a. b . I am asking the court to terminate jurisdiction. c. I am asking to have a relationship with my brother or sister and on the mother’s side on the father’s side. I am a blood relative relative by adoption relative by marriage. I am related to the child I don’t know Check here if unknown. If you want to keep your address confiden tial, fill out Confidential Information (Request to Change Court Order) (form JV-182) and do not write the address on this form. 1 3 Check here if form JV-182 is attached. foster parent Revised January 1, 2009 JV-180, Page 2 of 3 Request to Change Court Order Case Number: Child’s name: What order or orders do you want the judge to make now? 8 What changed after the judge’s order th at would change the judge’s mind? (Give new information that the judge did not have when the original decision was made): 7 Why would the changes you are re questing be better for the child? 9 On (date, if known): 6 the judge made the following order that you feel should be changed: If you are asking to have a relationship with a brother or sister but not asking for a changed court order, you may skip to item 8. d. Child’s Indian tribe (if applicable and known): e.Child’s Court Appointed Special Advocate (if applicable and known): f. Child’s education surrogate (if applicable and known): g. Child’s social worker (if applicable and known): a. Names of child’s parents or legal guardians: Address of parent/legal guardian: Address of parent/legal guardian: Check here if unknown. Check here if unknown. Check here if unknown. Information about parents, legal guardians, and others: 1 5 b. c. Check here if you need more space for an y of the answers. Attach a sheet of paper and write “JV-180” at the top of the page. Number of pages attached: 10 Revised January 1, 2009 JV-180, Page 3 of 3 Request to Change Court Order Case Number: Child’s name: 5I declare under penalty of perjury under the laws of the Stat e of California that the information in this form is true and correct to my knowledge. I understand that this means I am guilty of a crime if I lie on this form. 14 Date: Sign your name Type or print your name You can ask the judge to make a decisi on without a court hearing if all the people listed above agree with your request. Check here if you want a decision without a hearing. 12 If anyone disagrees with your request, please explain why (if known): 13 11 Child (if 10 years old, or older): Child’s attorney: Parent: Parent: Agree Disagree Don’t Know Legal guardian: Legal guardian: Social worker: Current caregiver/foster parent: Preadoptive parent: Court Appointed Special Advocate: Indian tribe: Indian custodian: Other: Not Applicable If you do not have an attorney, the clerk will send notice and copies of your request to all persons required to receive notice under Welfare and Institutions Code sections 297 and 386 and rules 5.524 and 5.570 of the California Rules of Court. I have sent a copy of my request to the people listed below, as applicable. I have check ed the correct boxes on the right to show whether these people agree with my request. Sibling (if dependent and over the age of 10): Sibling’s caregiver: Sibling’s attorney: Attorney for parent/legal guardian: Attorney for parent/legal guardian: County counsel: Name