ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address):

FOR COURT USE ONLY

JV-575

TELEPHONE NO.:

FAX NO. (Optional):

SUPERIOR COURT OF CALIFORNIA, COUNTY OF

E-MAIL ADDRESS (Optional):

ATTORNEY FOR (Name):

STREET ADDRESS:

MAILING ADDRESS:

CITY AND ZIP CODE:

BRANCH NAME:

CHILD’S NAME:

CHILD’S DATE OF BIRTH:

PETITION TO OBTAIN REPORT OF LAW ENFORCEMENT AGENCY 

1.  Petitioner's name and address (if representing another person, organization, or agency, provide names and addresses):

CASE NUMBER:

RELATED CASES (if any):

2.  Petitioner's relationship to child (if any):

3.  Police department or law enforcement agency possessing records:

Report number:

4.  The reasons for this request are: 
      (Describe in detail. Attach additional pages if necessary.)

Continued in Attachment 4.

5.  

The Notice to Child and Parent/Guardian Re: Release of Juvenile Police Records and Objections (form JV-580) was served 
on the            child  or             parent on (date):

I declare under penalty of perjury under the laws of the State of California that the foregoing and all attachments are true and correct.

(TYPE OR PRINT NAME)

(SIGNATURE OF PETITIONER)

(cid:96)

Date:

Date:

Number of pages attached:

PETITION GRANTED 
ADDITIONAL ORDERS:

PETITION DENIED

Form Adopted for Mandatory Use 
Judicial Council of California
JV-575 [Rev. January 1, 2007]

Page 1 of 1
PETITION TO OBTAIN REPORT OF LAW ENFORCEMENT AGENCY Welfare and Institutions Code, §§ 827.9, 828;
Cal. Rules of Court, rules 5.504, 5.552
www.courtinfo.ca.gov

JUDICIAL OFFICER