Free JV-120.v3.092606.mc.ofm - California

JV-120
CHILD'S NAME:
CASE NUMBER:

SERIOUS PHYSICAL HARM
§ 300(a) The child has suffered, or there is a substantial risk that the child will suffer, serious physical harm inflicted nonaccidentally upon the child by the child's parent or guardian. (State supporting facts concisely and number them a-1, a-2, a-3, etc.):

Page Form Approved for Optional Use Judicial Council of California JV-120 [Rev. January 1, 2007]

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SERIOUS PHYSICAL HARM § 300(a)

Welfare and Institutions Code, § 300; Cal. Rules of Court, rule 5.504 www.courtinfo.ca.gov American LegalNet, Inc. www.FormsWorkflow.com