Free FL-326 v1 091106 gs.ofm - California


File Size: 24.8 kB
Pages: 2
Date: June 24, 2009
File Format: PDF
State: California
Category: Court Forms - State
Author: mcaamic
Word Count: 723 Words, 4,590 Characters
Page Size: Letter (8 1/2" x 11")
URL

http://www.courtinfo.ca.gov/forms/documents/fl326.pdf

Download FL-326 v1 091106 gs.ofm ( 24.8 kB)


Preview FL-326 v1 091106 gs.ofm
FL-326
EVALUATOR (Name and address): FOR COURT USE ONLY

TELEPHONE NO.: E-MAIL ADDRESS (Optional):

FAX NO. (Optional):

SUPERIOR COURT OF CALIFORNIA, COUNTY OF
STREET ADDRESS: MAILING ADDRESS: CITY AND ZIP CODE: BRANCH NAME:

PETITIONER/PLAINTIFF: RESPONDENT/DEFENDANT:

DECLARATION OF PRIVATE CHILD CUSTODY EVALUATOR REGARDING QUALIFICATIONS
1. I, (name): to the truth of the facts in this declaration. 2. On (date): LICENSING REQUIREMENTS 3. a. b. c.

CASE NUMBER:

, declare that if I appeared in court and were sworn, I would testify , I was appointed by the court to perform a child custody evaluation in this case.

I am licensed as a psychologist, marriage and family therapist, or clinical social worker; I am licensed as a physician and I am a board-certified psychiatrist or I have completed a residency in psychiatry; or I am not licensed as indicated in 3a or 3b. NOTICE: If item 3c is checked, the court may not appoint the person to perform a child custody evaluation in this case unless, under Family Code section 3110.5(d) and rule 5.225(c)(2)(B) of the California Rules of Court, all the following criteria have been met: (1) The court determined that there are no evaluators who meet the licensing requirements who are willing and available, within a reasonable period of time, to perform child custody evaluations; (2) The parties have stipulated that the person may conduct the evaluation; and (3) The court approves the person's appointment.

EDUCATION AND TRAINING REQUIREMENTS 4. I have completed: a. b. The basic and advanced domestic violence training requirements for a private child custody evaluator under rule 5.225(e); and The 40 hours of education and training requirements for a private child custody evaluator under rule 5.225(d).

5. I have completed: a. b. The annual 8 hours of update training requirements for a private child custody evaluator under rule 5.225(h); and The annual 4 hours of domestic violence update training requirements for a private child custody evaluator under rules 5.225 and 5.230.

EXPERIENCE REQUIREMENTS 6. I have complied with the experience requirements for a private child custody evaluator in rule 5.225(g) because I participated in the completion of four court-appointed child custody evaluations in the preceding three years. I (specify): a. b. c. Independently conducted and completed the child custody evaluations as stated in rule 5.225(g)(1)(A); Materially assisted another evaluator as stated in rule 5.225(g)(1)(B); or Complied with the requirements stated in rule 5.225(g)(2), and I am deemed to meet the experience requirements of rule 5.225(g) until December 31, 2009.

Page 1 of 2 Form Adopted for Mandatory Use Judicial Council of California FL-326 [Rev. January 1, 2007]

DECLARATION OF PRIVATE CHILD CUSTODY EVALUATOR REGARDING QUALIFICATIONS

Family Code, 1816, 3110.5; Cal. Rules of Court, rules 5.225, 5.230 www.courtinfo.ca.gov American LegalNet, Inc. www.FormsWorkflow.com

FL-326
EVALUATOR'S NAME: PETITIONER/PLAINTIFF: RESPONDENT/DEFENDANT:
CASE NUMBER:

EXPERIENCE REQUIREMENTS (continued) 7. I have not complied with the experience requirements for child custody evaluators in rule 5.225(g)(1). NOTICE: If item 7 is checked, the court may not appoint a court-connected evaluator to perform a child custody evaluation unless, under rule 5.225(g)(3), all the following criteria have been met: a. The court determined that there are no child custody evaluators who meet the experience requirements for child custody evaluators who are willing and available, within a reasonable period of time, to perform child custody evaluations; b. The parties have stipulated that the person may conduct the evaluation; and c. The court approves the person's appointment. USE OF INTERNS 8. I intend to use interns to assist with the child custody evaluation in the manner disclosed and agreed to by the parties and attorneys in the case. Each intern will have complied with the criteria of rule 5.225(l) and will work under my supervision at all times.

NOTICE
Private child custody evaluators must complete this form and file it with the clerk's office no later than 10 days after notification of each appointment and before beginning any work on the child custody evaluation. (Cal. Rules of Court, rule 5.225(k)(1)(B))

I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Date:

(TYPE OR PRINT NAME)

(SIGNATURE OF DECLARANT)

FL-326 [Rev. January 1, 2007]

DECLARATION OF PRIVATE CHILD CUSTODY EVALUATOR REGARDING QUALIFICATIONS

Page 2 of 2