Form Soc 820 - Notice Of Involuntary Child Custody Proceedings For An Indian Child (Juvenile Court)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address):
FOR COURT USE ONLY
TELEPHONE NO:
FAX NO. (Optional):
E-MAIL ADDRESS (Optional):
ATTORNEY FOR (Name):
SUPERIOR COURT OF CALIFORNIA, COUNTY OF
STREET ADDRESS:
MAILING ADDRESS:
CITY AND ZIP CODE:
TELEPHONE NUMBER:
BRANCH NAME:
CASE NAME:
CASE NUMBER:
NOTICE OF INVOLUNTARY CHILD CUSTODY PROCEEDINGS FOR
AN INDIAN CHILD (Juvenile Court)
NOTICE TO (check all that apply):
Parent
Tribe
Indian Custodian
Bureau of Indian Affairs (BIA)
1. a. Child’s name:
b. Date of birth:
c. Place of birth (city, state, and, if applicable, reservation) :
2. Child is reported to be eligible for the following tribe or band (name each) :
Based on a petition filed (date): ________________________________ the child has been temporarily placed in the custody of the
county welfare department, probation department, or Indian custodian named below:
3. County welfare department (address) :
4. Probation department (address) :
5. Indian custodian (name each) :
Tribe (name each) :
6. Name of social worker or probation officer:
Telephone Number:
E-mail address (optional):
HEARING INFORMATION
7.
Date of next hearing:
Dept:
Time:
Type of hearing:
Located at above address
Other:
NOTICE OF INVOLUNTARY CHILD CUSTODY PROCEEDINGS FOR AN INDIAN CHILD
25 U.S.C. § 1901 et. seq.
(Juvenile Court)
SOC 820 (10/04)
PAGE 1 OF 6

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