The Legal Innovation & Technology Lab's Form Explorer ^Beta @ Suffolk Law School Last updated 2023-04-02

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EFS-005-JV/
JV-141

Electronic Service: Consent,
Withdrawal of Consent, Address
Change (Juvenile)

Use this form to tell the court and other parties in the case that you:
• Agree to receive notices and documents in your case electronically and give

the court an electronic service address;

• Want to change your electronic service or e-mail address; or
• Do not want to receive notices and documents in your case electronically

any more.

I agree to receive notices and documents electronically in this case.

I want to change my electronic service or e-mail address. I want to
receive notices and documents at the new address below starting on:
(date):
I want to stop receiving notices and documents electronically, starting
on (date):

My role in this juvenile case is (choose one of the following):

Clerk stamps date here when form is filed.

Fill in court name and street address:

Superior Court of California, County of

Child or nonminor dependent who is the subject of the hearing
I am:

18+ years old

10–15 years old
16 or 17 years old

Parent (biological, presumed, alleged, or adjudicated)
Legal guardian
(name of party or person represented):
Lawyer for

Fill in child's name and date of birth:

Child's Name:

Date of Birth:

Case Number:

the child or nonminor dependent

(relationship to child or nonminor dependent):
the sibling of the child

Grandparent/other adult relative
Caregiver for
Sibling of the child
Other

(age, if minor):

(relationship to child or nonminor dependent):

I agree to receive notices and documents at this electronic or e-mail address (please print carefully):

I do not want to receive notices and documents electronically anymore. I am attaching a copy of the Judicial
Council form, Notification of Mailing Address (JV-140), with my current mailing address.

Type or print name

Signature

If you are a child age 16 or 17 and you want to receive notices and documents in this case electronically, your
lawyer must consult with you and provide you with information before you make your decision.

Click here to confirm that you received a consultation and information from your attorney about electronic service.

If you are a child between the ages of 10 and 15 and you want to receive notices and documents in this case
electronically, your lawyer must also agree and sign this form below.

Type or print name of lawyer for child

Signature of lawyer for child

Judicial Council of California, www.courts.ca.gov
Revised January 1, 2019, Mandatory Form
Welfare and Institutions Code, § 290.1–295, 316.1

Electronic Service: Consent, Withdrawal
of Consent, Address Change
(Juvenile)

EFS-005-JV/JV-141, Page 1 of 2

Date:

Child’s name:

Case Number:

This document must be served on the other parties. If the party has consented to electronic service, this form may be served
electronically. Otherwise, mail service is required. If you need to serve additional parties, use the JV-510, Proof of Service–Juvenile.
PROOF OF SERVICE
Electronic Service: Consent, Withdrawal of Consent, Address Change (Juvenile)

1. I am at least 18 years old.

I served this form on behalf of a minor.

2. I am a resident of, or employed in the county where the service occurred. If service was made by mail, I am not a party
to the matter, and the document was placed in a sealed envelope and deposited in the mail with postage prepaid.

My residence or business address is:
My electronic service address is:

3. I served a copy of Electronic Service: Consent, Withdrawal of Consent, Address Change (Juvenile) as follows:

Name of person served:
On behalf of (name of party, if person served is attorney):

Mailing or electronic service address:

Name of person served:
On behalf of (name of party, if person served is attorney):

Mailing or electronic service address:

Date of service:

Method of service:

Date of service:

Method of service:

Date of service:

Method of service:

Date of service:

Method of service:

I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
Date:

Type or print name of declarant

Signature of declarant

If your court and social services agency offer electronic service:
•

You can (but do not have to) agree to receive notices and documents electronically (electronic service). If you want to
receive notices and documents electronically, fill out and sign this form, the EFS-005-JV/JV-141, and file it with the
court. You may also use this form to change your electronic service address or tell the court and other parties that you
no longer want to receive notices and documents electronically.
You must file this form with the court and have it served on the other parties and their attorneys of record. The parties
include the social services agency, the child, parents, guardians, and Court Appointed Special Advocates. The judge
may require you to serve more parties.
If you are under 18 years old, you can ask your attorney or another person who is older than 18 to serve the form for
you. If you need to serve additional parties, use form JV-510, Proof of Service–Juvenile.
The e-mail or electronic service address you provide will be used to serve notices and documents electronically in your
case unless and until you tell the court that you have changed your e-mail or electronic service address or that you no
longer want to receive electronic service of notices and documents.
Electronic service of psychological and medical documentation related to a minor is not permitted, other than the
summary required pursuant to section 16010 when included as a part of a required report to the court.
If a social worker will recommend terminating parental rights over a child at the hearing, you will still receive the
hearing notice by mail or in person. You will also receive the hearing notice electronically.

•

Revised January 1, 2019

EFS-005-JV/JV-141, Page 2 of 2

Electronic Service: Consent, Withdrawal
of Consent, Address Change
(Juvenile)

E-Mail Notice of Hearing: Consent, Withdrawal of Consent, Address Change

This info page is part of the LIT Lab's Form Explorer project. It is not associated with the California state courts. To learn more about the project, check out our about page.

Downloads: You can download both the original form (last checked 2023-03) and the machine-processed form with normalized data fields.

About This Form:

Sourced from selfhelp.courts.ca.gov (2023-03)
Page(s): 2
Fields(s): 61
Average fields per page: 30
Reading Level: Grade 7
LIST Grouping(s): FA-00-00-00-00.

Use our Rate My PDF tool to learn more. Go beyond the above insights and learn more about this or any pdf form at RateMyPDF.com, includes: counts of difficult words used, passive voice decetion, and suggestions for how to make the form more usable.

Identified Data Fields:

We have done our best to automaticly identify and name form fields according to our naming conventions. When possible, we've used names tied to our question library. See e.g., user1_name. If we think we've found a match to a question in our library, it is highlighted in green. Novel names are auto generated. So, you will probably need to edit some of them if you're trying to stick to the convention.

Here are the fields we could identify.

ef_j_c_v_page_name_ft__1 was EFS-005-JC_JV-141[0].Page1[0].YourName_ft[0] (0.52 conf)
j_c_v_page_date_time_field__1 was EFS-005-JC_JV-141[0].Page1[0].DateTimeField1[0] (0.39 conf)
j_c_page_right_court_info was EFS-005-JC_JV-141[0].Page1[0].RightCaption[0].CourtInfo[0] (0.37 conf)
j_c_page_right_case_number was EFS-005-JC_JV-141[0].Page1[0].RightCaption[0].CaseNumber[0] (0.36 conf)
j_page_right_caption_child_name was EFS-005-JC_JV-141[0].Page1[0].RightCaption[0].ChildName[0] (0.35 conf)
j_c_v_page_right_child_b was EFS-005-JC_JV-141[0].Page1[0].RightCaption[0].ChildDoB[0] (0.36 conf)
ef_j_c_v_page_notice_cb__1 was EFS-005-JC_JV-141[0].Page1[0].notice_cb[0] (0.35 conf)
j_c_v_page_field_name_cb__1 was EFS-005-JC_JV-141[0].Page1[0].FieldName_cb[0] (0.36 conf)
j_c_v_page_field_name_cb__2 was EFS-005-JC_JV-141[0].Page1[0].FieldName_cb[1] (0.36 conf)
j_c_v_page_field_name_cb__3 was EFS-005-JC_JV-141[0].Page1[0].FieldName_cb[2] (0.36 conf)
ef_j_c_v_page__1 was EFS-005-JC_JV-141[0].Page1[0].T123[0] (0.35 conf)
ef_j_c_v_page__2 was EFS-005-JC_JV-141[0].Page1[0].T132[0] (0.35 conf)
ef_j_c_v_page__3 was EFS-005-JC_JV-141[0].Page1[0].T141[0] (0.35 conf)
j_c_v_page_field_name_cb__4 was EFS-005-JC_JV-141[0].Page1[0].FieldName_cb[3] (0.36 conf)
j_c_v_page_field_name_cb__5 was EFS-005-JC_JV-141[0].Page1[0].FieldName_cb[4] (0.36 conf)
j_c_v_page_field_name_cb__6 was EFS-005-JC_JV-141[0].Page1[0].FieldName_cb[5] (0.36 conf)
j_c_v_page_field_name_cb__7 was EFS-005-JC_JV-141[0].Page1[0].FieldName_cb[6] (0.36 conf)
j_c_v_page_field_name_cb__8 was EFS-005-JC_JV-141[0].Page1[0].FieldName_cb[7] (0.36 conf)
j_c_v_page_field_name_cb__9 was EFS-005-JC_JV-141[0].Page1[0].FieldName_cb[8] (0.36 conf)
j_c_v_page_field_name_cb__10 was EFS-005-JC_JV-141[0].Page1[0].FieldName_cb[9] (0.36 conf)
j_c_v_page_field_name_cb__11 was EFS-005-JC_JV-141[0].Page1[0].FieldName_cb[10] (0.36 conf)
j_c_v_page_field_name_cb__12 was EFS-005-JC_JV-141[0].Page1[0].FieldName_cb[11] (0.36 conf)
ef_j_c_v_page_agree_tf was EFS-005-JC_JV-141[0].Page1[0].agree_tf[0] (0.35 conf)
ef_j_c_v_page_notice_cb__2 was EFS-005-JC_JV-141[0].Page1[0].NoNotice_cb[0] (0.38 conf)
ef_j_c_v_page_field__1 was EFS-005-JC_JV-141[0].Page1[0].#field[20] (0.35 conf)
ef_j_c_v_page_age_cb__1 was EFS-005-JC_JV-141[0].Page1[0].age_cb[0] (0.35 conf)
ef_j_c_v_page_age_cb__2 was EFS-005-JC_JV-141[0].Page1[0].age_cb[1] (0.35 conf)
ef_j_c_v_page_age_cb__3 was EFS-005-JC_JV-141[0].Page1[0].age_cb[2] (0.35 conf)
j_c_v_page_field_name_cb__13 was EFS-005-JC_JV-141[0].Page1[0].FieldName_cb[12] (0.36 conf)
ef_j_c_v_page_name_ft__2 was EFS-005-JC_JV-141[0].Page1[0].YourName_ft[1] (0.36 conf)
j_c_v_page_date_time_field__2 was EFS-005-JC_JV-141[0].Page1[0].DateTimeField1[1] (0.39 conf)
ef_j_c_v_page__4 was EFS-005-JC_JV-141[0].Page1[0].T123[1] (0.35 conf)
ef_j_c_v_page_field__2 was EFS-005-JC_JV-141[0].Page1[0].#field[28] (0.35 conf)
ef_j_c_v_page_check_box__1 was EFS-005-JC_JV-141[0].Page1[0].CheckBox1[0] (0.35 conf)
j_c_v_page_caption_child_name was EFS-005-JC_JV-141[0].Page2[0].PxCaption[0].ChildName[0] (0.34 conf)
j_c_v_page_px_case_number was EFS-005-JC_JV-141[0].Page2[0].PxCaption[0].CaseNumber[0] (0.34 conf)
ef_j_c_v_page__5 was EFS-005-JC_JV-141[0].Page2[0].T132[0] (0.35 conf)
ef_j_c_v_page__6 was EFS-005-JC_JV-141[0].Page2[0].T132[1] (0.35 conf)
ef_j_c_v_page__7 was EFS-005-JC_JV-141[0].Page2[0].T132[2] (0.35 conf)
ef_j_c_v_page_name_ft__3 was EFS-005-JC_JV-141[0].Page2[0].YourName_ft[0] (0.36 conf)
j_c_v_page_date_time_field__3 was EFS-005-JC_JV-141[0].Page2[0].DateTimeField1[0] (0.39 conf)
ef_j_c_v_page_check_box__2 was EFS-005-JC_JV-141[0].Page2[0].CheckBox2[0] (0.35 conf)
ef_j_c_v_page__8 was EFS-005-JC_JV-141[0].Page2[0].T154[0] (0.35 conf)
ef_j_c_v_page__9 was EFS-005-JC_JV-141[0].Page2[0].T154[1] (0.35 conf)
ef_j_c_v_page_drop_list__1 was EFS-005-JC_JV-141[0].Page2[0].DropDownList1[0] (0.39 conf)
j_c_v_page_date_time_field__4 was EFS-005-JC_JV-141[0].Page2[0].DateTimeField1[1] (0.39 conf)
ef_j_c_v_page__10 was EFS-005-JC_JV-141[0].Page2[0].T132[3] (0.35 conf)
ef_j_c_v_page__11 was EFS-005-JC_JV-141[0].Page2[0].T154[2] (0.35 conf)
j_c_v_page_date_time_field__5 was EFS-005-JC_JV-141[0].Page2[0].DateTimeField1[2] (0.39 conf)
ef_j_c_v_page_drop_list__2 was EFS-005-JC_JV-141[0].Page2[0].DropDownList1[1] (0.39 conf)
ef_j_c_v_page__12 was EFS-005-JC_JV-141[0].Page2[0].T154[3] (0.35 conf)
ef_j_c_v_page__13 was EFS-005-JC_JV-141[0].Page2[0].T132[4] (0.35 conf)
ef_j_c_v_page__14 was EFS-005-JC_JV-141[0].Page2[0].T154[4] (0.35 conf)
j_c_v_page_date_time_field__6 was EFS-005-JC_JV-141[0].Page2[0].DateTimeField1[3] (0.39 conf)
ef_j_c_v_page_drop_list__3 was EFS-005-JC_JV-141[0].Page2[0].DropDownList1[2] (0.39 conf)
ef_j_c_v_page__15 was EFS-005-JC_JV-141[0].Page2[0].T154[5] (0.35 conf)
ef_j_c_v_page__16 was EFS-005-JC_JV-141[0].Page2[0].T132[5] (0.35 conf)
ef_j_c_v_page__17 was EFS-005-JC_JV-141[0].Page2[0].T154[6] (0.35 conf)
j_c_v_page_date_time_field__7 was EFS-005-JC_JV-141[0].Page2[0].DateTimeField1[4] (0.39 conf)
ef_j_c_v_page_drop_list__4 was EFS-005-JC_JV-141[0].Page2[0].DropDownList1[3] (0.39 conf)
ef_j_c_v_page__18 was EFS-005-JC_JV-141[0].Page2[0].T154[7] (0.35 conf)

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The Legal Innovation & Technology Lab's Form Explorer Beta @ Suffolk Law School Last updated 2023-04-02

E-Mail Notice of Hearing: Consent, Withdrawal of Consent, Address Change

About This Form:

Identified Data Fields:

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The Legal Innovation & Technology Lab's Form Explorer ^Beta @ Suffolk Law School Last updated 2023-04-02