JV-323

Notice of Intent to Remove Child 

This notice must be served with a blank copy of form JV-321, Request for 
Prospective Adoptive Parent Designation, and a blank copy of form JV-325, 
Objection to Removal.

1

To:
a.

Court:

Clerk stamps date here when form is filed.

b.

Designated prospective adoptive parent or caregiver who may fit the 
definition of "prospective adoptive parent" (name):

Fill in court name and street address:

Superior Court of California, County of

c.

Child’s attorney (name):

d.

e.

Child, if 10 years of age or older (name):

Child’s identified Indian tribe, if any (name):

f.

Child’s Indian custodian, if any (name):

Fill in child's name and date of birth:

Child’s Name:

Date of Birth:

Fill in case number:

Case Number:

g.

Child’s Court Appointed Special Advocate (CASA) program, if any 
(name of person notified):

2

Name of agency proposing move:
Address:
Phone number:
This agency is asking for a court order to remove (name of child):
                                                                                                                  
from his or her current home because (explain):                                             

If more space is needed, attach a sheet of paper and write “JV-323, Item 2—Reasons for Removal” at the top.  
Number of pages attached:

Judicial Council of California, www.courtinfo.ca.gov 
Revised January 1, 2008, Mandatory Form
Welfare and Institutions Code,  § 366.26(n)
Cal. Rules of Court, rules 5.726, 5.727

Notice of Intent to Remove Child 

JV-323, Page 1 of 2

Case Number:

3

If you do not agree with the removal, you may request a court hearing.  To do this, you must fill out form JV-325, 
Objection to Removal, and file it with the court within five court days or seven calendar days, whichever is longer, 
from the date you received this notice. If the court has not designated you as a prospective adoptive parent, you 
must complete form JV-321, Request for Prospective Adoptive Parent Designation, and file it with this form.

I declare under penalty of perjury under the laws of the State of California that the information in items 1 and 2 is 
true and correct, which means that if I lie on this form, I am committing a crime.

Child’s name:

Date:

Type or print your name

Sign your name 

Revised January 1, 2008

Notice of Intent to Remove Child

JV-323, Page 2 of 2