General Media Req. Form - Los Angeles County Probation ...
General Media Req. Form - Los Angeles County Probation ...
General Media Req. Form - Los Angeles County Probation ...
You also want an ePaper? Increase the reach of your titles
YUMPU automatically turns print PDFs into web optimized ePapers that Google loves.
Petitioner’s Name:<br />
Address:<br />
Telephone: Fax No.:<br />
SUPERIOR COURT OF CALIFORNIA, COUNTY OF LOS ANGELES<br />
JUVENILE DIVISION<br />
Office of the Presiding Judge<br />
201 Centre Plaza Drive, Suite 3<br />
Monterey Park, CA 91754-2158<br />
CHILD’S NAME:<br />
DATE OF BIRTH:<br />
MOTHER’S NAME:<br />
REQUEST FOR INTERVIEWING, PHOTOGRAPHING, VIDEOTAPING, OR<br />
VOICE RECORDING OF DEPENDENT OR DELINQUENT CHILDREN<br />
(WIC §827)<br />
1. Petitioner alleges the child whom he or she wishes to contact has been found to be within the jurisdiction of the<br />
Juvenile Court pursuant to:<br />
Welfare & Institutions Code section 300<br />
Welfare & Institutions Code section 601<br />
Welfare & Institutions Code section 602<br />
Unknown<br />
2. Petitioner requests contact with said child for purposes of:<br />
Interviewing<br />
Photographing<br />
Videotaping<br />
Voice recording<br />
(Specify whether Petitioner requests permission to reveal or show the identity or name of the child and reason<br />
why.)<br />
3. Petitioner requests contact with said child for purposes of:<br />
Newspaper article<br />
Television program<br />
Radio program<br />
Internet posting<br />
Other:<br />
(Describe in detail the reason for the request; attach additional pages if necessary.)<br />
Case Number:<br />
___________________________________________________________________________________________________________________________________<br />
REQUEST FOR INTERVIEWING, PHOTOGRAPHING, VIDEOTAPING, OR<br />
VOICE RECORDING OF DEPENDENT OR DELINQUENT CHILDREN
4. Petitioner provided notice of the request to the following parties:<br />
Child Date served: □ personal service/fax/email; □ US mail<br />
□ Child’s parent/guardian Date served: □ personal service/fax/email; □ US mail<br />
□ Child’s attorney Date served: □ personal service/fax/email; □ US mail<br />
□ <strong>County</strong> Counsel Date served: □ personal service/fax/email; □ US mail<br />
□ DCFS Date served: □ personal service/fax/email; □ US mail<br />
□ District Attorney Date served: □ personal service/fax/email; □ US mail<br />
□ <strong>Probation</strong> Date served: □ personal service/fax/email; □ US mail<br />
□ Other: Date served: □ personal service/fax/email; □ US mail<br />
□ Petitioner asserts that the following facts constitute good cause to shorten the time for the filing of objections<br />
to the request (Note: objections are due 15 days if request is served by personal service/facsimile/email and<br />
20 days if served by US mail, in the absence of good cause):<br />
I declare under penalty of perjury under the laws of the State of California that the foregoing and all attachments are<br />
true and correct.<br />
Date:<br />
Type or Print Name Signature of Petitioner<br />
1. □ <strong>Req</strong>uest Granted<br />
□ Additional Orders:<br />
2. □ <strong>Req</strong>uest Denied<br />
□ Reason for Denial:<br />
ORDER<br />
3. □ Set Hearing on request. Clerk to provide notice to parties and petitioner.<br />
Date:<br />
Judicial Officer<br />
___________________________________________________________________________________________________________________________________<br />
REQUEST FOR INTERVIEWING, PHOTOGRAPHING, VIDEOTAPING, OR<br />
VOICE RECORDING OF DEPENDENT OR DELINQUENT CHILDREN