Free JV-121.v3.092606.mc.ofm - California


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Date: June 24, 2009
File Format: PDF
State: California
Category: Court Forms - State
Author: mcaamic
Word Count: 197 Words, 1,191 Characters
Page Size: Letter (8 1/2" x 11")
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http://www.courtinfo.ca.gov/forms/documents/jv121.pdf

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JV-121
CHILD'S NAME:
CASE NUMBER:

FAILURE TO PROTECT § 300(b)
The child has suffered, or there is a substantial risk that the child will suffer, serious physical harm or illness, as a result of the failure or inability of his or her parent or legal guardian to supervise or protect the child adequately. as a result of the willful or negligent failure of the child's parent or legal guardian to supervise or protect the child adequately from the conduct of the custodian with whom the child has been left. by the willful or negligent failure of the parent or legal guardian to provide the child with adequate food, clothing, shelter, or medical treatment. by the inability of the parent or legal guardian to provide regular care for the child due to the parent's or legal guardian's mental illness, developmental disability, or substance abuse. (State supporting facts concisely and number them b-1, b-2, b-3, etc.):

Page Form Approved for Optional Use Judicial Council of California JV-121 [Rev. January 1, 2007]

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FAILURE TO PROTECT § 300(b)

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