Free JV-124.v4.092606.mc.ofm - California

JV-124
CHILD'S NAME:
CASE NUMBER:

SEVERE PHYSICAL ABUSE (Child Under Five)
§ 300(e) The child is under the age of five and has suffered severe physical abuse by a parent, or by any person known by the parent, and the parent knew or reasonably should have known that the person was physically abusing the child. (State supporting facts concisely and number them e-1, e-2, e-3, etc.):

Page Form Approved for Optional Use Judicial Council of California JV-124 [Rev. January 1, 2007]

of

SEVERE PHYSICAL ABUSE
§ 300(e)

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