Free Request for Juvenile Court to Appoint CASA (JC\E-338) - California

Application submitted by: (Name and Address) Name: Street Address City, State: Telephone Number: SUPERIOR COURT OF CALIFORNIA, COUNTY OF SACRAMENTO Street Address: 3341 Power Inn Road City and Zip Code: Sacramento, CA 95826 SITTING AS THE JUVENILE COURT Branch Name: NAME OF CHILD/MINOR: Date of Birth:

FOR DEPARTMENT OR COURT USE ONLY

REQUEST TO APPOINT SACRAMENTO COURT APPOINTED SPECIAL ADVOCATES (CASA) (Welfare & Institutions Code § 102, California Rules of Court, rule 5.655,
Standing Order SSC-JV-00-028)

CASE NUMBER:

I, ________________________________________________________________, do hereby declare that:

I am:

the Child

the CASA Executive Director/designee

the Child's _____________________________________________________________ I believe the Child's best interest would be served by appointing Sacramento Court Appointed Special Advocates (CASA) to perform the duties described in Standing Order SSC-JV-00-028. I therefore request this Court appoint CASA to assist the Child. I declare under penalty of perjury that the above is true and correct. Executed this _________ day of __________________________________ in Sacramento, California. Signature: __________________________________________________

ORDER It is the order of this Court that Sacramento Court Appointed Special Advocates (CASA) is appointed pursuant to Standing Order SSC-JV-00-028.

Date: ______________________________

________________________________ Judge/Referee of the Juvenile Court

JC\E-338 Eff. 2/26/09

Request for Juvenile Court to Appoint CASA