DV-178

Response to Request for Release of 
Minor's Confidential Information

Clerk stamps date here when form is filed.

CONFIDENTIAL

PUBLIC VERSION (REDACTED)

Instructions 
When should this form be used?  

If someone is asking the court for information about a minor that has been made 
confidential, you can use this form to let the court know if you agree or disagree 
with the request. 

ho should use this form? 

You should use this form if you are a minor, parent, or legal guardian who made 
a request to keep information confidential.  

Fill in court name and street address:

Superior Court of California, County of

hat do I need to complete and file this form? 

     You will need three documents that you should have received with this form: 

Fill in case number:

Case Number:

Form DV-176, Request for Release of Minor's Confidential Information; 

Form DV-177, Notice of Request for Release of Minor's Confidential Information; and 
Form DV-175, Cover Sheet for Confidential Information. 

You will need to give the court form DV-175 and two copies of your completed form DV-178. Make 
sure you take these forms to the court for filing by the deadline listed on form DV-177.

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1 Parties in This Case 

a.

Protected party 

Name:

Name:

b. Restrained party

2

Information About the Request to Release Confidential Information 

Name of person requesting minor's confidential information

(This is the person listed on form DV-176, item      ):

2

This is not a Court Order.

Judicial Council of California, www.courts.ca.gov 
New September 1, 2020, Mandatory Form  
Family Code, § 6301.5

Response to Request for  
Release of Minor's Confidential Information 
(Domestic Violence Prevention)

DV-178, Page 1 of 3

Case Number:

3

My Information 
a.
Your name:

b.

My contact information 

Address where I can receive mail:  
This address will be used by the court and other parties in this case to send you notices of court dates and 
documents. If you want to keep your home address private, you can use another address like a post office 
box or another person's address if you have their permission. If you have a lawyer, give your lawyer s 
address and contact information.

’

State:

Zip:

Lawyer's information  (skip if you do not have one):

Address:

City:

Name:  

State Bar No.:

4

Do You Agree to the Request to Release Minor's Confidential Information? 

a.

No, I do NOT agree to the request and do not want the court to give any confidential information to 
the person listed in       because:

2

New September 1, 2020

DV-178, Page 2 of 3

This is not a Court Order.

Response to Request for  
Release of Minor's Confidential Information 
(Domestic Violence Prevention)

Case Number:

b.

No, to some of the request. I agree to the person listed in item       having some information but do  
NOT want the person to have access to (check everything that you do NOT want the person in        to have):

2

2

Minor's name

Minor's address

Other information about the minor 

I do not want the person to have the information checked above because: 

c.

Yes, I agree to the request and want the court to give the person listed in       all the confidential 
information they requested on form DV-176.

2

5

Serve the Person Making the Request 
You must have your server mail a redacted copy of this form (with no confidential information) to the person listed 
in      . Have your server complete form DV-250, Proof of Service by Mail, after this form is mailed and file the 
completed form DV-250 with the court.

2

6

Signature

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

Type or print your name

Sign your name

7

Lawyer's Signature (skip if you do not have one)

Date:

New September 1, 2020

Lawyer's signature

This is not a Court Order.

Response to Request for  
Release of Minor's Confidential Information 
(Domestic Violence Prevention)

DV-178, Page 3 of 3