The California JV-195 form is an essential document within the juvenile dependency legal process, specifically designed for parents or guardians faced with the possibility of having a child removed from their custody. This form, titled "Waiver of Reunification Services," serves as a critical juncture where the individual can knowingly and voluntarily decide not to receive reunification services that are normally provided to help families reunite. It outlines the rights of the parent or guardian in the context of juvenile dependency cases, emphasizing the importance of understanding the implications of waiving these rights. Detailed within the form are various scenarios that a parent or guardian might be facing, whether they are the presumed mother or father, an alleged biological father, or a legal guardian, and it offers them the chance to declare their choice regarding reunification services, custody, or the placement of the child. Additionally, the form includes provisions for those who need an interpreter due to language barriers, ensuring that all parties involved fully comprehend the gravity of their decision and its potential impact on future parental rights and the child's placement. The JV-195 form encapsulates a pivotal decision-making process, highlighting the intersection of legal responsibility, parental rights, and the welfare of the child within the California court system.
| Question | Answer |
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| Form Name | California Form Jv 195 |
| Form Length | 1 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 15 sec |
| Other names | ca reunification services, jv 195 ca form, jv195, service rpp local online |
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ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, state bar number, and address): |
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FOR COURT USE ONLY |
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TELEPHONE NO.: |
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FAX NO.: |
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ATTORNEY FOR (Name): |
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SUPERIOR COURT OF CALIFORNIA, COUNTY OF |
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STREET ADDRESS: |
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MAILING ADDRESS: |
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CITY AND ZIP CODE: |
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BRANCH NAME: |
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CHILD'S NAME: |
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WAIVER OF REUNIFICATION SERVICES |
CASE NUMBER: |
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(Juvenile Dependency) |
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To parent or guardian of child: Read this form carefully. The judge will ask you if you understand your rights and are voluntarily |
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giving up those rights. |
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1. |
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I am the |
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mother |
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legally presumed father |
of the child, and I understand that if my child is removed from my |
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custody that I have a right to receive services to help me reunify with my child. |
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2.
I am an alleged biological father of the child, and I understand that if I have been or am judged to be the biological father of the child, the court may order service to help me obtain custody of the child.
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I am the legal guardian. |
For items 4 through 9, initial each box that applies unless you have a question.
4.The types of services that may be available have been explained to me.
5.I do not wish to receive services of any kind.
6.I do not wish to reunify with the child or have the child placed in my custody.
7.I understand that if no services are ordered, the court may
a.order services to the other parent.
b.set the matter for a hearing to decide on the best permanent plan for the child.
8.I understand that if I sign this form and the court is satisfied that I understand my rights and the consequences of giving them up, at the hearing to select a permanent plan for the child, the court may terminate parental rights and have the child placed for adoption.
9.I have discussed my rights with my attorney, and I knowingly and intelligently waive these services.
Date:
Initial
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(TYPE OR PRINT NAME) |
(SIGNATURE OF PARENT OR GUARDIAN) |
Declaration of Interpreter
10. The parent or guardian is unable to read or understand this form of waiver because his or her primary language is
Spanish
other (specify):
11.I declare under penalty of perjury under the laws of the State of California that I have, to the best of my ability, read or translated this form of waiver to the parent or guardian. The parent or guardian said he or she understood the form before signing it.
Date:
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(TYPE OR PRINT NAME) |
(SIGNATURE OF INTERPRETER) |
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Declaration of Attorney (Required)
12.I am the attorney for the parent or guardian. I have explained to the parent or guardian the nature of reunification services, including the statutory time limits for such services. I have advised the parent or guardian of the parent's or guardian's right to such services and the potential consequences of waiving them, including the likelihood that parental rights will be terminated and the child placed for adoption. I am satisfied that the parent or guardian understands these rights and is voluntarily waiving them.
Date:
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(TYPE OR PRINT NAME) |
(SIGNATURE OF ATTORNEY) |
Form Adopted by the
Judicial Council of California
WAIVER OF REUNIFICATION SERVICES
(Juvenile Dependency)
Welfare & Institutions Code, § 361.5