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

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Here is the text we could read:

CASE NUMBER:

ICWA-010(A)

CHILD'S NAME:

Name of child:
(Check one)

I have not yet been able to complete the inquiry about the child's Indian status because:

I understand that I have an affirmative and continuing duty to complete this inquiry. I will do it as soon as possible and
advise the court of my efforts.
I have asked or I am advised by and on information and belief confirm that
this person has completed inquiry by asking the child, the child's parents, and other required and available persons about
the child's Indian status. The person(s) questioned are:

Name:

Address:

City, state, zip:

Telephone:

Date questioned:

Relationship to child:

Name:

Address:

City, state, zip:

Telephone:

Date questioned:

Relationship to child:

Additional persons questioned and their information is attached.

This inquiry (check one):

gave me reason to believe the child is or may be an Indian child. (If yes, continue to 4.)
gave me no reason to believe the child is or may be an Indian child.

I contacted the tribe(s) that the child may be affiliated with and worked with them to establish whether the child is a
member or eligible for membership in the tribe(s). Information detailing the tribes contacted, the names of the individuals
contacted, and the manner of the contacts is attached.

5. Based on inquiry and tribal contacts (check all that apply):

The child is or may be a member of or eligible for membership in a tribe.
Name of tribe(s):
Location of tribe(s):
The child's parents, grandparents, or great-grandparents are or were members of a tribe.
Name of tribe(s):
Location of tribe(s):

The residence or domicile of the child, child's parents, or Indian custodian is on a reservation, rancheria, Alaska Native
village or other tribal trust land.

The child or the child's family has received services or benefits from a tribe or services that are available to Indians from
tribes or the federal government, such as the Indian Health Service or Tribal Temporary Assistance to Needy Families
(TANF).

The child is or has been a ward of a tribal court.
Name of tribe(s):
Location of tribe(s):

Either parent or the child possesses an Indian Identification card indicating membership or citizenship in an Indian tribe.
Name of tribe(s):
Location of tribe(s):

If this is a delinquency proceeding under Welfare and Institutions Code section 601 or 602:

The child is in foster care.
It is probable the child will be entering foster care.

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)

(SIGNATURE)

Form Adopted for Mandatory Use
Judicial Council of California
ICWA-010(A) [Rev. January 1, 2020]

INDIAN CHILD INQUIRY ATTACHMENT

Page 1 of 1

www.courts.ca.gov

Indian Child Inquiry Attachment

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): 1
Fields(s): 42
Average fields per page: 42
Reading Level: Grade 8
LIST Grouping(s): Unknown

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.

icw_page_indian_status_tf was ICWA-010A[0].Page1[0].IndianStatus_tf[0] (0.59 conf)
icw_page_childs_name_tf was ICWA-010A[0].Page1[0].ChildsName_tf[0] (0.33 conf)
icw_page_indian_status_cb was ICWA-010A[0].Page1[0].IndianStatus_cb[0] (0.38 conf)
icw_page_date_tf was ICWA-010A[0].Page1[0].Date_tf[0] (0.26 conf)
icw_page_print_name_tf was ICWA-010A[0].Page1[0].PrintName_tf[0] (0.30 conf)
icw_page_px_caption_title_party_name_childs_tf was ICWA-010A[0].Page1[0].PxCaption[0].TitlePartyName[0].ChildsName_tf[0] (0.40 conf)
icw_page_px_caption_case_number_tf was ICWA-010A[0].Page1[0].PxCaption[0].CaseNumber[0].CaseNumber_tf[0] (0.33 conf)
icw_page_indian_status_ques_cb was ICWA-010A[0].Page1[0].IndianStatusQues_cb[0] (0.35 conf)
icw_page_text_field was ICWA-010A[0].Page1[0].TextField6[0] (0.33 conf)
icw_page_checkbox was ICWA-010A[0].Page1[0].Checkbox[0] (0.31 conf)
icw_page_name_tf__1 was ICWA-010A[0].Page1[0].Name_tf[0] (0.31 conf)
icw_page_address_tf__1 was ICWA-010A[0].Page1[0].Address_tf[0] (0.31 conf)
icw_page_city_state_zip_tf__1 was ICWA-010A[0].Page1[0].CityStateZip_tf[0] (0.37 conf)
icw_page_telephone_tf__1 was ICWA-010A[0].Page1[0].Telephone_tf[0] (0.42 conf)
icw_page_date_questioned_tf__1 was ICWA-010A[0].Page1[0].DateQuestioned_tf[0] (0.33 conf)
icw_page_relationship_child_tf__1 was ICWA-010A[0].Page1[0].RelationshipChild_tf[0] (0.35 conf)
icw_page_name_tf__2 was ICWA-010A[0].Page1[0].Name_tf[1] (0.31 conf)
icw_page_address_tf__2 was ICWA-010A[0].Page1[0].Address_tf[1] (0.31 conf)
icw_page_city_state_zip_tf__2 was ICWA-010A[0].Page1[0].CityStateZip_tf[1] (0.37 conf)
icw_page_telephone_tf__2 was ICWA-010A[0].Page1[0].Telephone_tf[1] (0.42 conf)
icw_page_date_questioned_tf__2 was ICWA-010A[0].Page1[0].DateQuestioned_tf[1] (0.33 conf)
icw_page_relationship_child_tf__2 was ICWA-010A[0].Page1[0].RelationshipChild_tf[1] (0.35 conf)
icw_page_area_add_person_cb was ICWA-010A[0].Page1[0].#area[0].AddPerson_cb[0] (0.33 conf)
icw_page_reason_cb__1 was ICWA-010A[0].Page1[0].Reason_cb[0] (0.35 conf)
icw_page_reason_cb__2 was ICWA-010A[0].Page1[0].NoReason_cb[0] (0.37 conf)
icw_page_item_cb__1 was ICWA-010A[0].Page1[0].item4_cb[0] (0.28 conf)
icw_page_item_cb__2 was ICWA-010A[0].Page1[0].item5a_cb[0] (0.28 conf)
icw_page_item_name_tf was ICWA-010A[0].Page1[0].item5aName_tf[0] (0.31 conf)
icw_page_item_location_tf was ICWA-010A[0].Page1[0].item5aLocation_tf[0] (0.34 conf)
icw_page_item_b_cb was ICWA-010A[0].Page1[0].item5b_cb[0] (0.28 conf)
icw_page_item_b_name_cb__1 was ICWA-010A[0].Page1[0].item5bName_cb[0] (0.31 conf)
icw_page_item_b_location_tf__1 was ICWA-010A[0].Page1[0].item5bLocation_tf[0] (0.34 conf)
icw_page_item_c_cb was ICWA-010A[0].Page1[0].item5c_cb[0] (0.28 conf)
icw_page_item_cb__3 was ICWA-010A[0].Page1[0].item5d_cb[0] (0.28 conf)
icw_page_item_e_cb was ICWA-010A[0].Page1[0].item5e_cb[0] (0.28 conf)
icw_page_item_f_cb was ICWA-010A[0].Page1[0].item5f_cb[0] (0.28 conf)
icw_page_item_fostercare_cb was ICWA-010A[0].Page1[0].item6fostercare_cb[0] (0.28 conf)
icw_page_item_probable_f_c_cb was ICWA-010A[0].Page1[0].item6probableFC_cb[0] (0.30 conf)
icw_page_item_f_name_tf was ICWA-010A[0].Page1[0].item5fName_tf[0] (0.31 conf)
icw_page_item_b_name_cb__2 was ICWA-010A[0].Page1[0].item5bName_cb[1] (0.31 conf)
icw_page_item_b_location_tf__2 was ICWA-010A[0].Page1[0].item5bLocation_tf[1] (0.34 conf)
icw_page_item_b_location_tf__3 was ICWA-010A[0].Page1[0].item5bLocation_tf[2] (0.34 conf)

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

Indian Child Inquiry Attachment

About This Form:

Identified Data Fields:

Create an Interactive Version of this Form:

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