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, 2017;
  • 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;

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:
FOR COURT USE ONLY
NAME:
FIRM NAME:
STREET ADDRESS:
CITY:
STATE:
ZIP CODE:
TELEPHONE NO.:
FAX NO.:
E-MAIL 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 7, complete item 8, attach
documents as required, and sign and date item 9.
Directions for the nonminor (if nonminor is available): Review the boxes checked by the social worker or probation officer in
items 1 through 7. 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–h, 3a–j, 4, 5a–b, 6, and 7a–h only if you received the information, document, or service described
in that item. Then sign and date item 10. You may 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 his or her signature is attached.
2. An attached report verifies that the nonminor has received written information about his or her juvenile court case, including (check
all that apply):
a.
The nonminor's Indian heritage or tribal connections ________
b.
The nonminor's family history ________
c.
The nonminor's placement history ________
d.
The nonminor's educational history and medical history ________
e.
Any photographs of the nonminor or his or her family in the possession of the county welfare department or probation
department, other than forensic photographs ________
Contact information for all siblings under juvenile court jurisdiction, except for any siblings whose safety or welfare
f.
would be jeopardized by contact with the nonminor, as determined by the court ________
Instructions on how the nonminor may exercise his or her right to inspect, receive, and copy his or her juvenile case
g.
file, including how to access sealed records (see Welf. & Inst. Code, §§ 389(a), 781(a)(4), 786(f)(1)(F), 826.6 & 827;
Cal. Rules of Court, rule 5.552) ________
h.
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 his or her birth certificate ________
b.
His or her social security card ________
c.
His or her California identification card or driver's license ________
d.
Proof of his or her citizenship or lawful permanent resident status ________
e.
A copy of the death certificate of his or her parent or parents ________
f.
His or her Health and Education Passport ________
Page 1 of 2
Form Adopted for Mandatory Use
Welfare & Institutions Code, §§ 391,
TERMINATION OF JUVENILE COURT JURISDICTION—NONMINOR
Judicial Council of California
607.2, 607.3;
JV-365 [Rev. January 1, 2017]
Cal. Rules of Court, rule 5.555
www.courts.ca.gov
JV-365
ATTORNEY OR PARTY WITHOUT ATTORNEY
STATE BAR NO:
FOR COURT USE ONLY
NAME:
FIRM NAME:
STREET ADDRESS:
CITY:
STATE:
ZIP CODE:
TELEPHONE NO.:
FAX NO.:
E-MAIL 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 7, complete item 8, attach
documents as required, and sign and date item 9.
Directions for the nonminor (if nonminor is available): Review the boxes checked by the social worker or probation officer in
items 1 through 7. 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–h, 3a–j, 4, 5a–b, 6, and 7a–h only if you received the information, document, or service described
in that item. Then sign and date item 10. You may 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 his or her signature is attached.
2. An attached report verifies that the nonminor has received written information about his or her juvenile court case, including (check
all that apply):
a.
The nonminor's Indian heritage or tribal connections ________
b.
The nonminor's family history ________
c.
The nonminor's placement history ________
d.
The nonminor's educational history and medical history ________
e.
Any photographs of the nonminor or his or her family in the possession of the county welfare department or probation
department, other than forensic photographs ________
Contact information for all siblings under juvenile court jurisdiction, except for any siblings whose safety or welfare
f.
would be jeopardized by contact with the nonminor, as determined by the court ________
Instructions on how the nonminor may exercise his or her right to inspect, receive, and copy his or her juvenile case
g.
file, including how to access sealed records (see Welf. & Inst. Code, §§ 389(a), 781(a)(4), 786(f)(1)(F), 826.6 & 827;
Cal. Rules of Court, rule 5.552) ________
h.
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 his or her birth certificate ________
b.
His or her social security card ________
c.
His or her California identification card or driver's license ________
d.
Proof of his or her citizenship or lawful permanent resident status ________
e.
A copy of the death certificate of his or her parent or parents ________
f.
His or her Health and Education Passport ________
Page 1 of 2
Form Adopted for Mandatory Use
Welfare & Institutions Code, §§ 391,
TERMINATION OF JUVENILE COURT JURISDICTION—NONMINOR
Judicial Council of California
607.2, 607.3;
JV-365 [Rev. January 1, 2017]
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 he or she 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.
The nonminor's 90-day Transition Plan _______
j.
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 he or she has been provided with
his or her 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 his or her transition service plan. ________
b.
has been informed of the rights that will transfer to him or her under this Act. ________
6.
The nonminor was informed 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. ________
7.
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 ________
i.
His or her Medi-Cal Benefits Identification Card (BIC) ________
ii.
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.
A referral to transitional housing, if available, or assistance in securing other housing ________
e.
Help obtaining employment or other financial support ________
including completing enrollment in CalFresh ________
f.
Help maintaining relationships with individuals important to him or her, consistent with his or her 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):
8.
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:
u
(TYPE OR PRINT NAME)
(SIGNATURE OF SOCIAL WORKER OR PROBATION OFFICER)
I certify that I have received the information and services that I initialed above.
Date:
u
(TYPE OR PRINT NAME)
(SIGNATURE OF NONMINOR)
JV-365 [Rev. January 1, 2017]
Page 2 of 2
TERMINATION OF JUVENILE COURT JURISDICTION—NONMINOR
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