Form JV-365 "Termination of Juvenile Court Jurisdiction - Nonminor" - California

What Is Form JV-365?

This is a legal form that was released by the California Superior Court - a government authority operating within California. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on January 1, 2021;
  • The latest edition provided by the California Superior Court;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form JV-365 by clicking the link below or browse more documents and templates provided by the California Superior Court.

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Download Form JV-365 "Termination of Juvenile Court Jurisdiction - Nonminor" - California

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JV-365
ATTORNEY OR PARTY WITHOUT ATTORNEY:
STATE BAR NO:
NAME:
FOR COURT USE ONLY
FIRM NAME:
STREET ADDRESS:
CITY:
STATE:
ZIP CODE:
TELEPHONE NO.:
FAX NO.:
EMAIL ADDRESS:
ATTORNEY FOR (name):
SUPERIOR COURT OF CALIFORNIA, COUNTY OF
STREET ADDRESS:
MAILING ADDRESS:
CITY AND ZIP CODE:
BRANCH NAME:
NONMINOR'S NAME:
NONMINOR'S DATE OF BIRTH:
HEARING DATE AND TIME:
CASE NUMBER:
TERMINATION OF JUVENILE COURT JURISDICTION—NONMINOR
Directions for the social worker or probation officer: Check the appropriate boxes in items 1 through 6, complete item 7, attach
or submit to the court documents as required, and sign and date item 7.
Directions for the nonminor (if nonminor is available): Review the boxes checked by the social worker or probation officer in
items 1 through 6. If the box checked in item 1 is wrong, check the correct box and sign your initials next to the box. Sign your
initials on the lines after items 2a–i, 3a–l, 4, 5a–b, and 6a–h only if you received the information, document, or service described in
that item. Then sign and date item 7. You should give the form to the judge on the day of the hearing if you didn't give it to your
social worker, probation officer, or attorney before the hearing.
1.
a.
The nonminor wants to attend the termination hearing
in person
by telephone.
b.
The nonminor does not want to attend the termination hearing. The petitioner has attached verification that the nonminor
has been informed of the potential consequences of failure to attend the termination hearing.
The nonminor is unavailable or has refused to sign this form. Documentation of reasonable efforts to locate the nonminor
c.
and to obtain the nonminor's signature is attached.
2. An attached report or report submitted to the court verifies that the nonminor has received written information about the nonminor's
juvenile court case, including (check all that apply):
The nonminor's Indian heritage or tribal connections ________
a.
The nonminor's family history ________
b.
The nonminor's placement history ________
c.
The nonminor's educational history and medical history ________
d.
Any photographs of the nonminor or the nonminor's family in the possession of the county welfare department or
e.
probation department, other than forensic photographs ________
Contact information for all siblings under juvenile court jurisdiction, unless the court determines that sibling contact
f.
would jeopardize the safety or welfare of either sibling ________
Instructions on how the nonminor may exercise the right to inspect and receive a copy their juvenile case file,
g.
including how to access sealed records (see Welf. & Inst. Code, §§ 389(a), 781(a)(4), 786(g)(1)(F), 826.6, 827; Cal.
Rules of Court, rule 5.552) ________
h.
If the nonminor requests, assistance in completing a voluntary reentry agreement for care and placement pursuant to
Welf. & Inst. Code § 1140 and in filling a petition pursuant to Welf. & Inst. Code § 338(e) to resume dependency
jurisdiction ________
i.
The date on which the jurisdiction of the court would be terminated ________
3. The nonminor has been provided with the following documents (check all that apply):
a.
A certified copy of the nonminor's birth certificate ________
b.
Social security card ________
c.
California identification card or driver's license ________
d.
Proof of citizenship or lawful permanent resident status ________
e.
A copy of the death certificate of the nonminor's parent or parents ________
f.
Health and Education Passport ________
Page 1 of 2
Form Adopted for Mandatory Use
Welfare & Institutions Code, §§ 391, 607.2, 607.3
TERMINATION OF JUVENILE COURT JURISDICTION—NONMINOR
Judicial Council of California
Gov. Code § 18220
JV-365 [Rev. January 1, 2021]
Cal. Rules of Court, rule 5.555
www.courts.ca.gov
JV-365
ATTORNEY OR PARTY WITHOUT ATTORNEY:
STATE BAR NO:
NAME:
FOR COURT USE ONLY
FIRM NAME:
STREET ADDRESS:
CITY:
STATE:
ZIP CODE:
TELEPHONE NO.:
FAX NO.:
EMAIL ADDRESS:
ATTORNEY FOR (name):
SUPERIOR COURT OF CALIFORNIA, COUNTY OF
STREET ADDRESS:
MAILING ADDRESS:
CITY AND ZIP CODE:
BRANCH NAME:
NONMINOR'S NAME:
NONMINOR'S DATE OF BIRTH:
HEARING DATE AND TIME:
CASE NUMBER:
TERMINATION OF JUVENILE COURT JURISDICTION—NONMINOR
Directions for the social worker or probation officer: Check the appropriate boxes in items 1 through 6, complete item 7, attach
or submit to the court documents as required, and sign and date item 7.
Directions for the nonminor (if nonminor is available): Review the boxes checked by the social worker or probation officer in
items 1 through 6. If the box checked in item 1 is wrong, check the correct box and sign your initials next to the box. Sign your
initials on the lines after items 2a–i, 3a–l, 4, 5a–b, and 6a–h only if you received the information, document, or service described in
that item. Then sign and date item 7. You should give the form to the judge on the day of the hearing if you didn't give it to your
social worker, probation officer, or attorney before the hearing.
1.
a.
The nonminor wants to attend the termination hearing
in person
by telephone.
b.
The nonminor does not want to attend the termination hearing. The petitioner has attached verification that the nonminor
has been informed of the potential consequences of failure to attend the termination hearing.
The nonminor is unavailable or has refused to sign this form. Documentation of reasonable efforts to locate the nonminor
c.
and to obtain the nonminor's signature is attached.
2. An attached report or report submitted to the court verifies that the nonminor has received written information about the nonminor's
juvenile court case, including (check all that apply):
The nonminor's Indian heritage or tribal connections ________
a.
The nonminor's family history ________
b.
The nonminor's placement history ________
c.
The nonminor's educational history and medical history ________
d.
Any photographs of the nonminor or the nonminor's family in the possession of the county welfare department or
e.
probation department, other than forensic photographs ________
Contact information for all siblings under juvenile court jurisdiction, unless the court determines that sibling contact
f.
would jeopardize the safety or welfare of either sibling ________
Instructions on how the nonminor may exercise the right to inspect and receive a copy their juvenile case file,
g.
including how to access sealed records (see Welf. & Inst. Code, §§ 389(a), 781(a)(4), 786(g)(1)(F), 826.6, 827; Cal.
Rules of Court, rule 5.552) ________
h.
If the nonminor requests, assistance in completing a voluntary reentry agreement for care and placement pursuant to
Welf. & Inst. Code § 1140 and in filling a petition pursuant to Welf. & Inst. Code § 338(e) to resume dependency
jurisdiction ________
i.
The date on which the jurisdiction of the court would be terminated ________
3. The nonminor has been provided with the following documents (check all that apply):
a.
A certified copy of the nonminor's birth certificate ________
b.
Social security card ________
c.
California identification card or driver's license ________
d.
Proof of citizenship or lawful permanent resident status ________
e.
A copy of the death certificate of the nonminor's parent or parents ________
f.
Health and Education Passport ________
Page 1 of 2
Form Adopted for Mandatory Use
Welfare & Institutions Code, §§ 391, 607.2, 607.3
TERMINATION OF JUVENILE COURT JURISDICTION—NONMINOR
Judicial Council of California
Gov. Code § 18220
JV-365 [Rev. January 1, 2021]
Cal. Rules of Court, rule 5.555
www.courts.ca.gov
JV-365
NONMINOR'S NAME:
CASE NUMBER:
3.
g.
A blank advance health care directive form ________
h.
A letter prepared by the county welfare department that includes the nonminor's name and date of birth, the dates during
which the nonminor was within the jurisdiction of the juvenile court, and a statement that the nonminor was a foster child
in compliance with state and federal financial aid documentation requirements ________
i.
Written information notifying the nonminor of any financial literacy programs or other available resources provided
through the county or other community organizations to help the nonminor obtain financial literacy skills, including but not
limited to banking, credit card debt, student loan debt, credit scores, credit history, and personal savings ________
j.
Written information notifying the nonminor that state agencies, when hiring for internships and student assistant positions,
must give preference to qualified applicants up to 26 years of age who are or have been dependent children in foster
care, homeless youth, or formerly incarcerated youth ________
k.
The nonminor's 90-day Transition Plan _______
l.
A copy of each of the following: How to Ask to Return to Juvenile Court Jurisdiction and Foster Care
(form JV-464-INFO), a blank Request to Return to Juvenile Court Jurisdiction and Foster Care (form JV-466), and a blank
Confidential Information—Request to Return to Juvenile Court Jurisdiction and Foster Care (form JV-468) ________
The nonminor continues to be eligible for services or accommodations under the Individuals with Disabilities Education Act,
4.
the Americans with Disabilities Act, or section 504 of the Rehabilitation Act of 1973, and the nonminor has been provided with
the most recent service or accommodation plan. ________
The nonminor has been receiving services as provided in the Individuals with Disabilities Education Act
5.
(see 34 C.F.R. §§ 300.320(b)–(c) & 300.321(b)), and
a.
has received a copy of their transition service plan. ________
b.
has been informed of the rights that will transfer to them under this Act. ________
6.
The nonminor received the following assistance or services (check all that apply):
a.
Written verification of continued enrollment in Medi-Cal with no interruption in coverage ________
and provision of
1.
Medi-Cal Benefits Identification Card ________
2.
Information about eligibility for extended Medi-Cal benefits until age 26 ________
b.
Help applying to college, a vocational training program, or another educational or employment program ________
c.
Help obtaining financial aid for college, a vocational training program, or another educational or employment
program ________
d.
Referrals to transitional housing, if available, or assistance in securing other housing ________
e.
Assistance obtaining employment or other financial support ________
including completing enrollment in CalFresh ________
f.
Help maintaining relationships with individuals important to the nonminor, consistent with their best interests (required
only if the nonminor has been in an out-of-home placement for six months or longer) ________
g.
Help accessing the Independent Living Aftercare Program in the nonminor's county of residence ________
h.
Other services ordered by the court (specify):
7.
Number of pages attached:
I declare under penalty of perjury under the laws of the State of California that the foregoing and all attachments are true and correct.
Date:
(TYPE OR PRINT NAME)
(SIGNATURE OF SOCIAL WORKER OR PROBATION OFFICER)
I certify that I have received the information, documents, and services that I initialed above.
Date:
(TYPE OR PRINT NAME)
(SIGNATURE OF NONMINOR)
JV-365 [Rev. January 1, 2021]
Page 2 of 2
TERMINATION OF JUVENILE COURT JURISDICTION—NONMINOR
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