Here is the text we could read:
Clerk stamps date here when form is filed.
Fill in court name and street address:
Superior Court of California, County of
Court fills in case number when form is filed.
Case Number:
DV-176
Request for Release of
Minor's Confidential Information
Instructions
Who should complete this form?
Use this form if you want to ask the court to give you information about a
minor that has been made confidential in a domestic violence restraining order
case. After you file this form with the court, the court will provide a copy of
this request to the person who made the request to keep the minor's information
confidential. That person will have an opportunity to disagree with your
request before the court makes a decision on your request.
hat do I do if I received a completed copy of this form?
2
3
The person in is asking the court for access to information that has been
made confidential (see item on page 2 of this form). If you do NOT agree
with this request, complete and file form DV-178, Response to Request for
Release of Minor's Confidential Information, by the deadline listed on item
4
on form DV-177, Notice of Request for Release of Minor's Confidential
Information.
W
1
Parties in This Case
a.
Protected party (check one):
Name of protected party is:
Name of protected party is confidential in this case.
b. Restrained party (check one):
Name of restrained party is:
Name of restrained party is confidential in this case.
2
My Information
My full name is:
I am applying on behalf of (name of entity):
Address:
City:
How do you know the minor?
State:
Zip:
My contact information (optional):
Telephone:
Fax:
E-Mail Address:
Lawyer's information (skip if you do not have a lawyer):
Name:
State Bar Number:
Judicial Council of California, www.courts.ca.gov
New September 1, 2020, Mandatory Form
Family Code, ยง 6301.5
This is not a Court Order.
Request for Release of Minor's
Confidential Information
(Domestic Violence Prevention)
DV-176, Page 1 of 3
Case Number:
3
My Request Involves One Minor
I ask the court to release the confidential information below (check all that apply):
Minor's name
Minor's address
a.
b.
c.
Other information about the minor
(Please describe the information that you want released to you. For example, you can describe where the
information is located by providing the form #, page #, and item # of where the information is located.)
Check this box if you need more space for your answer. Attach a piece of paper to this form and write
"Attachment 3c" at the top.
4
My Request Involves More Than One Minor
a.
The information I ask the court to release is the same for all minors.
Minors' names
Minors' address(es)
(1)
(2)
(3)
Other information about the minors
(Please describe the information that you want released to you. For example, you can describe where the
information is located by providing the form #, page #, and item # of where the information is located.)
b.
The information I ask the court to release is not the same for all minors.
(Please describe the confidential information that you want released to you by the court for each minor. If
the minor's name was made confidential use the initials or name used by the court to identify each minor.)
Check this box if you need more space for your answer. Attach a piece of paper to this form and write
"Attachment 4" at the top.
New September 1, 2020
DV-176, Page 2 of 3
This is not a Court Order.
Request for Release of Minor's
Confidential Information
(Domestic Violence Prevention)
Case Number:
5
Reasons I Want Access to Minor's Confidential Information
To grant your request, the court must find that giving you the minor's confidential information is needed to prevent
abuse or is in the best interest of the minor.
ith that in mind, why should the court give you the minor's confidential information you asked
for on page 2?
W
6
Number of pages attached to this form, if any:
7 Signature
I declare under penalty of perjury under the laws of the State of California that the information above and in all
attached papers is true and correct.
Date:
Type or print your name
Sign your name
8
Lawyer's Signature (skip if you do not have one)
Date:
Lawyer's signature
New September 1, 2020
DV-176, Page 3 of 3
This is not a Court Order.
Request for Release of Minor's
Confidential Information
(Domestic Violence Prevention)
Request for Release of Minor's Confidential Information
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): 3
- Fields(s): 43
- Average fields per page: 14
- Reading Level: Grade 6
- LIST Grouping(s):
CO-07-00-00-00, CO-00-00-00-00.
Use our Rate My PDF tool to learn more.
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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.
v_page_court_info_ft was DV-176[0].Page1[0].CourtInfo_ft[0] (0.47 conf)v_page_case_number_ft was DV-176[0].Page1[0].CaseNumber_ft[0] (0.34 conf)page_protected_lawyer_name_ft__1 was DV-176[0].Page1[0].ProtectedLawyerName_ft[0] (0.35 conf)page_protected_lawyer_name_ft__2 was DV-176[0].Page1[0].ProtectedLawyerName_ft[1] (0.35 conf)v_page_protected_lawyer_bar was DV-176[0].Page1[0].ProtectedLawyerBar_no[0] (0.35 conf)v_page_protected_street_ft was DV-176[0].Page1[0].ProtectedStreet_ft[0] (0.32 conf)v_page_protected_phone_ft__1 was DV-176[0].Page1[0].ProtectedPhone_ft[0] (0.35 conf)v_page_protected_state_ft was DV-176[0].Page1[0].ProtectedState_ft[0] (0.42 conf)v_page_protected_zip_ft was DV-176[0].Page1[0].ProtectedZip_ft[0] (0.28 conf)v_page_protected_email_ft was DV-176[0].Page1[0].ProtectedEmail_ft[0] (0.34 conf)v_page_protected_city_ft was DV-176[0].Page1[0].ProtectedCity_ft[0] (0.34 conf)v_page_protected_phone_ft__2 was DV-176[0].Page1[0].ProtectedPhone_ft[1] (0.35 conf)page_protected_lawyer_name_ft__3 was DV-176[0].Page1[0].ProtectedLawyerName_ft[2] (0.35 conf)v_page_protected_description__1 was DV-176[0].Page1[0].ProtectedDescription[0] (0.34 conf)v_page_protected_description__2 was DV-176[0].Page1[0].ProtectedDescription[1] (0.34 conf)v_page_protected_description__3 was DV-176[0].Page1[0].ProtectedDescription1[0] (0.34 conf)v_page_protected_description__4 was DV-176[0].Page1[0].ProtectedDescription1[1] (0.34 conf)v_page_protected_description__5 was DV-176[0].Page1[0].ProtectedDescription3[0] (0.34 conf)v_page_text_field__1 was DV-176[0].Page1[0].TextField[0] (0.33 conf)v_page_text_field__2 was DV-176[0].Page1[0].TextField[1] (0.33 conf)v_page_text_field__3 was DV-176[0].Page1[0].TextField[2] (0.33 conf)v_page_p_e_case_number_ft__1 was DV-176[0].Page2[0].PE_P2Header\.grp[0].CaseNumber_ft[0] (0.36 conf)v_page_check_box__1 was DV-176[0].Page2[0].CheckBox4[0] (0.35 conf)v_page_check_box__2 was DV-176[0].Page2[0].CheckBox4[1] (0.35 conf)v_page_check_box__3 was DV-176[0].Page2[0].CheckBox1[0] (0.35 conf)v_page_check_box__4 was DV-176[0].Page2[0].CheckBox1[1] (0.35 conf)v_page_check_box__5 was DV-176[0].Page2[0].CheckBox1[2] (0.35 conf)v_page_multiline_check_box__1 was DV-176[0].Page2[0].MultilineCheckBox[0] (0.33 conf)v_page_check_box__6 was DV-176[0].Page2[0].CheckBox1[3] (0.35 conf)v_page_check_box__7 was DV-176[0].Page2[0].CheckBox1[4] (0.35 conf)v_page_check_box__8 was DV-176[0].Page2[0].CheckBox1[5] (0.35 conf)v_page_check_box_right_caption was DV-176[0].Page2[0].CheckBoxRightCaption[0] (0.38 conf)v_page_multiline_check_box__2 was DV-176[0].Page2[0].MultilineCheckBox[1] (0.33 conf)v_page_multiline_check_box__3 was DV-176[0].Page2[0].MultilineCheckBox[2] (0.33 conf)v_page_text_field__4 was DV-176[0].Page2[0].TextField[0] (0.33 conf)v_page_text_field__5 was DV-176[0].Page2[0].TextField[1] (0.33 conf)v_page_text_field__6 was DV-176[0].Page2[0].TextField[2] (0.33 conf)v_page_p_e_case_number_ft__2 was DV-176[0].Page3[0].PE_P2Header\.grp[0].CaseNumber_ft[0] (0.36 conf)v_page_sig_date__1 was DV-176[0].Page3[0].SigDate[0] (0.30 conf)v_page was DV-176[0].Page3[0].T14[0] (0.26 conf)v_page_sig_date__2 was DV-176[0].Page3[0].SigDate[1] (0.30 conf)v_page_text_field__7 was DV-176[0].Page3[0].TextField[0] (0.33 conf)v_page_text_field__8 was DV-176[0].Page3[0].TextField[1] (0.33 conf)
We've done our best to group similar variables togther to avoid overwhelming the user.
Suggested Screen 0:
page_protected_lawyer_name_ft__1page_protected_lawyer_name_ft__2v_page_protected_lawyer_barpage_protected_lawyer_name_ft__3
Suggested Screen 1:
v_page_court_info_ftv_page_protected_street_ftv_page_protected_state_ftv_page_protected_zip_ftv_page_protected_email_ftv_page_protected_city_ft
Suggested Screen 2:
v_page_case_number_ftv_page_protected_phone_ft__1v_page_protected_phone_ft__2v_page_protected_description__1v_page_protected_description__2v_page_protected_description__3v_page_protected_description__4v_page_protected_description__5v_page_p_e_case_number_ft__1v_page_p_e_case_number_ft__2
Suggested Screen 3:
v_page_text_field__1v_page_text_field__2v_page_text_field__3v_page_text_field__4v_page_text_field__5v_page_text_field__6v_page_text_field__7v_page_text_field__8
Suggested Screen 4:
v_page_check_box__1v_page_check_box__2v_page_check_box__3v_page_check_box__4v_page_check_box__5v_page_check_box__6v_page_check_box__7v_page_check_box__8v_page_check_box_right_caption
Suggested Screen 5:
v_page_multiline_check_box__1v_page_multiline_check_box__2v_page_multiline_check_box__3
Suggested Screen 6:
Suggested Screen 7:
v_page_sig_date__1v_page_sig_date__2
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