Here is the text we could read:
DV-179
Order on Request for Release
of Minor's Confidential Information
Clerk stamps date here when form is filed.
CONFIDENTIAL
PUBLIC VERSION (REDACTED)
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
Person Asking for Release of Minor's Confidential
Information
Full Name:
On behalf of
(name of entity):
(The court will complete item if request is denied or
items if request is granted or partially granted.)
–
9
4
3
3
Court Denied Request or More Information Is Needed
The court denied the request by the person in to release
minor s confidential information.
2
’
Fill in court name and street address:
Superior Court of California, County of
Court fills in case number when form is filed.
Case Number:
3
Instructions to Clerk
If item is checked, file page 1 in a
public file with all confidential
information redacted, and discard pages
–
2 4. If item is checked, file the
original in a confidential file and a
redacted copy in a public file.
4
The court needs more information before making a decision.
The person in must go to court on the date and time below to give more information why the court
should release minor's confidential information.
2
Name and address of court, if different from above:
Court
Date
Ł
Date:
Dept.:
Time:
Room:
The court will mail a copy of this order to the person who made the request to keep minor s information
confidential.
’
d.
If is checked, only page 1 of this order will be issued. All other pages may be discarded.
3
a.
b.
c.
Date:
Judicial Council of California, www.courts.ca.gov
New September 1, 2020, Mandatory Form
Family Code, § 6301.5
DV-179, Page 1 of 4
Judge (or Judicial Officer)
This is a Court Order.
Order on Request for Release of
Minor's Confidential Information
(Domestic Violence Prevention)
Case Number:
4
Court Granted Request
a.
The request made by the person in is:
2
(1)
(2)
Completely granted.
Partially granted.
The court, on its own motion, releases minor s confidential information as described in item .
6
’
b.
c.
Details of the order are stated below in items .
5
9
–
5
Court's Findings
a.
In granting the request made by the person in the court finds that the:
2
(1)
person who made the request to keep the minor s information confidential has been properly served and
has had sufficient time to respond; and
’
(2)
release of the minor s confidential information is (check at least one):
(A)
’
necessary to prevent abuse.
(B)
’
in the minor s best interest.
b.
The court, on its own motion, releases minor s confidential information as described in item because it
is (check at least one):
6
’
(A)
(B)
necessary to prevent abuse.
’
in the minor s best interest.
6
Release of Confidential Information
a.
The following persons/entities may have access to the information listed in b (check all that apply):
6
. . . . .
(1)
(2)
(3)
(4)
(5)
(6)
The person listed in .2
Minor's school
(name):
Minor's after-school program
(name):
Minor's childcare provider
(name):
Supervised visitation provider
(name):
Other
(name of person or entity):
New September 1, 2020
DV-179, Page 2 of 4
This is a Court Order.
Order on Request for Release of
Minor's Confidential Information
(Domestic Violence Prevention)
Case Number:
b.
This order releases minor's confidential information as follows:
(use fictitious name if not releasing confidential name)
Minor 1:
(1)
Minor's name:
Minor's address:
Other information about the minor:
(2)
(3)
(2)
(3)
(2)
(3)
(use fictitious name if not releasing confidential name)
Minor 2:
(1)
Minor's name:
Minor's address:
Other information about the minor:
(use fictitious name if not releasing confidential name)
Minor 3:
(1)
Minor's name:
Minor's address:
Other information about the minor:
Check this box if you need more space to include more minors or more information. Attach a sheet of
paper and write "Attachment 6b" for a title.
New September 1, 2020
DV-179, Page 3 of 4
This is a Court Order.
Order on Request for Release of
Minor's Confidential Information
(Domestic Violence Prevention)
Case Number:
7 All other information made confidential by the court and not released with the court's permission must be kept
confidential. Any person who misuses or discloses the minor's confidential information to anyone other than law
enforcement may be sanctioned up to $1,000 or face other court penalties. See Family Code section 6301.5
for the limited situations when confidential information can be disclosed without the court's permission.
8
Service
a.
b.
9
Other Orders
The court will send a copy of this order to the person listed in and the minor or legal guardian who
2
made the request to keep the minor's information confidential.
2
The person in must have a server mail a copy of this order to the minor or legal guardian who made
the request for confidential information. Have the server complete and file form , Proof of
Service by Mail, after the copy has been mailed.
Date:
Judge (or Judicial Officer)
Request for Accommodations
Assistive listening systems, computer-assisted real-time captioning, or sign language interpreter services
are available if you ask at least five days before the hearing. Contact the clerk’s office or go to
www.courts.ca.gov/forms.htm for Request for Accommodations by Persons With Disabilities and
Response (form MC-410). (Civ. Code, § 54.8.)
—Clerk's Certificate—
Clerk’s Certificate
[seal]
I certify that this Order on Request for Release of Minor's Confidential Information
(form DV-179) is a true and correct copy of the original on file in the court.
Date:
Clerk, by
, Deputy
New September 1, 2020
DV-179, Page 4 of 4
This is a Court Order.
Order on Request for Release of
Minor's Confidential Information
(Domestic Violence Prevention)
Order on 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): 4
- Fields(s): 80
- Average fields per page: 20
- Reading Level: Grade 7
- LIST Grouping(s):
Unknown
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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.
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(0.35 conf)v_page_check_box_right_caption__1 was DV-179[0].Page1[0].CheckBoxRightCaption11[0] (0.38 conf)v_page_protected_description__2 was DV-179[0].Page1[0].ProtectedDescription[0] (0.34 conf)v_page_protected_description__3 was DV-179[0].Page1[0].ProtectedDescription[1] (0.34 conf)v_page_protected_description__4 was DV-179[0].Page1[0].ProtectedDescription1[0] (0.34 conf)v_page_protected_description__5 was DV-179[0].Page1[0].ProtectedDescription1[1] (0.34 conf)v_page_text_field__2 was DV-179[0].Page1[0].TextField[0] (0.33 conf)v_page_check_box_right_caption__2 was DV-179[0].Page1[0].CheckBoxRightCaption[0] (0.38 conf)v_page_text_field__3 was DV-179[0].Page1[0].TextField[1] (0.33 conf)v_page_text_field__4 was DV-179[0].Page1[0].TextField[2] (0.33 conf)v_page_p_e_case_number_ft__1 was DV-179[0].Page2[0].PE_P2Header\.grp[0].CaseNumber_ft[0] (0.36 conf)v_page_check_box__2 was DV-179[0].Page2[0].CheckBox4[0] (0.35 conf)v_page_check_box__3 was DV-179[0].Page2[0].CheckBox4[1] (0.35 conf)v_page_check_box__4 was DV-179[0].Page2[0].CheckBox45[0] (0.35 conf)v_page_check_box__5 was DV-179[0].Page2[0].CheckBox4[2] (0.35 conf)v_page_check_box__6 was DV-179[0].Page2[0].CheckBox4[3] (0.35 conf)v_page_check_box__7 was DV-179[0].Page2[0].CheckBox45[1] (0.35 conf)v_page_check_box__8 was DV-179[0].Page2[0].CheckBox4[4] (0.35 conf)v_page_check_box__9 was DV-179[0].Page2[0].CheckBox4[5] (0.35 conf)v_page_check_box__10 was DV-179[0].Page2[0].CheckBox4[6] (0.35 conf)v_page_check_box__11 was DV-179[0].Page2[0].CheckBox4[7] (0.35 conf)v_page_check_box__12 was DV-179[0].Page2[0].CheckBox4[8] (0.35 conf)v_page_check_box__13 was DV-179[0].Page2[0].CheckBox4[9] (0.35 conf)v_page_check_box__14 was DV-179[0].Page2[0].CheckBox4[10] (0.35 conf)v_page_check_box__15 was DV-179[0].Page2[0].CheckBox4[11] (0.35 conf)v_page_multiline_check_box__2 was DV-179[0].Page2[0].MultilineCheckBox[0] (0.33 conf)v_page_check_box__16 was DV-179[0].Page2[0].CheckBox4[12] (0.35 conf)v_page_check_box__17 was DV-179[0].Page2[0].CheckBox4[13] (0.35 conf)v_page_text_field__5 was DV-179[0].Page2[0].TextField[0] (0.33 conf)v_page_text_field__6 was DV-179[0].Page2[0].TextField[1] (0.33 conf)v_page_text_field__7 was DV-179[0].Page2[0].TextField[2] (0.33 conf)v_page_text_field__8 was DV-179[0].Page2[0].TextField[3] (0.33 conf)v_page_text_field__9 was DV-179[0].Page2[0].TextField[4] (0.33 conf)v_page_p_e_case_number_ft__2 was DV-179[0].Page3[0].PE_P2Header\.grp[0].CaseNumber_ft[0] (0.36 conf)v_page_check_box__18 was DV-179[0].Page3[0].CheckBox1[0] (0.35 conf)v_page_multiline_check_box__3 was DV-179[0].Page3[0].MultilineCheckBox[0] (0.33 conf)v_page_text_field__10 was DV-179[0].Page3[0].TextField2[0] (0.33 conf)v_page_field_name_cb__3 was DV-179[0].Page3[0].FieldName_cb[0] (0.32 conf)v_page_text_field__11 was DV-179[0].Page3[0].TextField2[1] (0.33 conf)v_page_field_name_cb__4 was DV-179[0].Page3[0].FieldName_cb[1] (0.32 conf)v_page_check_box__19 was DV-179[0].Page3[0].CheckBox1[1] (0.35 conf)v_page_text_field__12 was DV-179[0].Page3[0].TextField2[2] (0.33 conf)v_page_field_name_cb__5 was DV-179[0].Page3[0].FieldName_cb[2] (0.32 conf)v_page_text_field__13 was DV-179[0].Page3[0].TextField2[3] (0.33 conf)v_page_field_name_cb__6 was DV-179[0].Page3[0].FieldName_cb[3] (0.32 conf)v_page_check_box__20 was DV-179[0].Page3[0].CheckBox1[2] (0.35 conf)v_page_text_field__14 was DV-179[0].Page3[0].TextField2[4] (0.33 conf)v_page_field_name_cb__7 was DV-179[0].Page3[0].FieldName_cb[4] (0.32 conf)v_page_text_field__15 was DV-179[0].Page3[0].TextField2[5] (0.33 conf)v_page_field_name_cb__8 was DV-179[0].Page3[0].FieldName_cb[5] (0.32 conf)v_page_text_field__16 was DV-179[0].Page3[0].TextField3[0] (0.33 conf)v_page_text_field__17 was DV-179[0].Page3[0].TextField3[1] (0.33 conf)v_page_text_field__18 was DV-179[0].Page3[0].TextField3[2] (0.33 conf)v_page_text_field__19 was DV-179[0].Page3[0].TextField[0] (0.33 conf)v_page_text_field__20 was DV-179[0].Page3[0].TextField22[0] (0.33 conf)v_page_text_field__21 was DV-179[0].Page3[0].TextField22[1] (0.33 conf)v_page_check_box__21 was DV-179[0].Page4[0].CheckBox4[0] (0.35 conf)v_page__7 was DV-179[0].Page4[0].T66[0] (0.26 conf)v_page__8 was DV-179[0].Page4[0].T188[0] (0.26 conf)v_page__9 was DV-179[0].Page4[0].T56[0] (0.26 conf)v_page__10 was DV-179[0].Page4[0].T58[0] (0.26 conf)v_page_check_box__22 was DV-179[0].Page4[0].CheckBox4[1] (0.35 conf)v_page_multiline_check_box__4 was DV-179[0].Page4[0].MultilineCheckBox[0] (0.33 conf)v_page_multiline_check_box__5 was DV-179[0].Page4[0].MultilineCheckBox[1] (0.33 conf)v_page_p_e_case_number_ft__3 was DV-179[0].Page4[0].PE_P2Header\.grp[0].CaseNumber_ft[0] (0.36 conf)v_page_text_field__22 was DV-179[0].Page4[0].TextField[0] (0.33 conf)
We've done our best to group similar variables togther to avoid overwhelming the user.
Suggested Screen 0:
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