Form Icwa 030 PDF Details

Form I-cwa 030 is used to apply for a waiver from one or more grounds of inadmissibility. A waiver may be granted if the applicant can show that denying entry would cause undue hardship, and that their presence in the United States is justified on other grounds. This form must be completed by the person seeking admission to the United States, and must include detailed information about the reasons for requesting the waiver. There are several grounds of inadmissibility that can be waived, including criminal convictions, public health concerns, and national security risks. In order to have a successful application, it is important to provide clear and compelling evidence supporting your case. For more information on waivers and how to complete Form I-cwa 030, please contact our office today.

QuestionAnswer
Form NameForm Icwa 030
Form Length10 pages
Fillable?No
Fillable fields0
Avg. time to fill out2 min 30 sec
Other namesicwa 030 a, notice child custody, icwa 030 ca, form icwa 030

Form Preview Example

CONFIDENTIAL

ICWA-030

 

 

 

ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address):

TELEPHONE NO.:

FAX NO. (Optional):

E-MAIL ADDRESS (Optional):

 

ATTORNEY FOR (Name):

 

SUPERIOR COURT OF CALIFORNIA, COUNTY OF

STREET ADDRESS:

MAILING ADDRESS:

CITY AND ZIP CODE:

BRANCH NAME:

TELEPHONE NO.:

CASE NAME:

NOTICE OF CHILD CUSTODY PROCEEDING FOR INDIAN CHILD (check all that apply):

JUVENILE

 

Dependency

 

 

Delinquency

 

 

 

 

 

 

 

 

 

 

 

ADOPTION

 

CONSERVATORSHIP*

 

 

CUSTODY (Fam. Code, § 3041)

 

 

 

DECLARATION OF FREEDOM FROM CONTROL OF PARENT

 

GUARDIANSHIP

 

TERMINATION OF PARENTAL RIGHTS

 

 

 

 

VOLUNTARY RELINQUISHMENT

 

 

 

 

 

 

 

 

 

 

 

 

 

OF CHILD BY PARENT

NOTICE TO (check all that apply):

FOR COURT USE ONLY

CASE NUMBER:

HEARING DATE:

DEPT.:

 

 

Parents or Legal Guardians

Secretary of the Interior

Tribes

Indian Custodians

Sacramento Area Director, BIA

1.NOTICE is given that based on the petition, a copy of which is attached to this notice, a child custody proceeding under the Indian Child Welfare Act (25 U.S.C. § 1901 et seq.) has been initiated for the following child (a separate notice must be filed for each child):

Name

Date of Birth

Place of Birth

2.HEARING INFORMATION

a. Date:

Time:

Type of hearing:

Dept.:

Room:

b.Address and telephone number of court

same as noted above

is (specify):

3. The child is or may be eligible for membership in the following Indian tribes (list each):

*Use this form in a conservatorship only if the proposed conservatee is a formerly married minor.

 

 

 

Page 1 of 10

 

 

 

 

Form Adopted for Mandatory Use

NOTICE OF CHILD CUSTODY PROCEEDING FOR INDIAN CHILD

25 U.S.C. § 1901 et seq.;

Judicial Council of California

Welfare & Institutions Code, §§ 224.2, 224.3;

 

 

ICWA-030 [New January 1, 2008]

(Indian Child Welfare Act)

 

Probate Code, §§ 1449, 1459.5; 1460.2;

 

 

Cal. Rules of Court, rules 5.480–5.487 and 7.1015

www.courtinfo.ca.gov

ICWA-030

CASE NAME:

CASE NUMBER:

4.Under the Indian Child Welfare Act (ICWA) and California law:

a.The child's parents, Indian custodian, and the child's tribe have the right to be present at all hearings.

b.The child's Indian custodian and the child's tribe have the right to intervene in the proceedings when ICWA applies.

c.The child's parent, Indian custodian, or tribe may petition the court to transfer the case to the tribal court of the Indian child's tribe. The child's parent or tribe also have the right to refuse to have the case transferred to the tribal court.

d.With the limited exceptions of the detention hearing in juvenile cases and the jurisdiction and disposition hearings in delinquency cases as identified in rule 5.482, the court will give up to 20 days from the time of the scheduled hearing if the child's parent, Indian custodian, or tribe request such time to prepare for the hearing.

e.The proceedings could lead to the removal of the child from the custody of the parent or Indian custodian and possible adoption of the child.

f.If the child's parents or Indian custodian have a right to be represented by a lawyer and if they cannot afford to hire one, a lawyer will be appointed for them.

g.The information contained in this notice and all attachments is confidential. Any tribal representative or agent or any other person or entity receiving this information must maintain the confidentiality of this information and not reveal it to anyone who does not need the information in order to exercise the tribe's rights under the Indian Child Welfare Act (25 U.S.C. § 1901 et seq.).

h.An Indian custodian is any person who has legal custody of the child under tribal law or custom or state law, or to whom temporary physical custody, care, and control of the child has been transferred by a parent.

5.INFORMATION ON THE CHILD NAMED IN 1

a.

The child's birth certificate is

 

 

attached

 

 

unavailable

 

b.

A copy of the tribal registration card of

 

 

the child

 

 

the parent

is attached.

 

 

 

 

c.Biological relative information is listed below. (Indicate if any of the information requested below is unknown or does not apply. Do not use the abbreviation "N/A".) (Required by Fam. Code, § 180; Prob. Code, § 1460.2; and Welf. & Inst. Code, § 224.2.)

Biological Mother

Biological Father

 

 

Name (include maiden, married, and former names or aliases):

Name (include former names or aliases):

 

 

Current address:

Current address:

 

 

Former address:

Former address:

 

 

Birth date and place:

Birth date and place:

 

 

Tribe or band, and location:

Tribe or band, and location:

 

 

Tribal membership or enrollment number, if known:

Tribal membership or enrollment number, if known:

 

 

If deceased, date and place of death:

If deceased, date and place of death:

 

 

Additional information:

Additional information:

 

 

 

 

ICWA-030 [New January 1, 2008]

NOTICE OF CHILD CUSTODY PROCEEDING FOR INDIAN CHILD

Page 2 of 10

(Indian Child Welfare Act)

ICWA-030

CASE NAME:

CASE NUMBER:

5.c. INFORMATION ON THE CHILD NAMED IN 1

(Indicate if any of the information requested below is unknown or does not apply; do not use the abbreviation "N/A".)

Mother's Biological Mother

Father's Biological Mother

(Child's Maternal Grandmother)

(Child's Paternal Grandmother)

 

 

Name (include maiden, married, and former names or aliases):

Name (include maiden, married, and former names or aliases):

 

 

Current address:

Current address:

 

 

Former address:

Former address:

 

 

Birth date and place:

Birth date and place:

 

 

Tribe or band, and location:

Tribe or band, and location:

 

 

Tribal membership or enrollment number, if known:

Tribal membership or enrollment number, if known:

 

 

If deceased, date and place of death:

If deceased, date and place of death:

 

 

Mother's Biological Father

Father's Biological Father

(Child's Maternal Grandfather)

(Child's Paternal Grandfather)

 

 

Name (include former names or aliases):

Name (include former names or aliases):

 

 

Current address:

Current address:

 

 

Former address:

Former address:

 

 

Birth date and place:

Birth date and place:

 

 

Tribe or band, and location:

Tribe or band, and location:

 

 

Tribal membership or enrollment number, if known:

Tribal membership or enrollment number, if known:

 

 

If deceased, date and place of death:

If deceased, date and place of death:

 

 

 

 

ICWA-030 [New January 1, 2008]

NOTICE OF CHILD CUSTODY PROCEEDING FOR INDIAN CHILD

 

Page 3 of 10

(Indian Child Welfare Act)

ICWA-030

CASE NAME:

CASE NUMBER:

5.d. INFORMATION ON THE CHILD NAMED IN 1

(Indicate if any of the information requested below is unknown or does not apply; do not use the abbreviation "N/A".)

Mother's Biological Grandmother

Mother's Biological Grandmother

(Child's Maternal Great-grandmother)

(Child's Maternal Great-grandmother)

 

 

Name (include maiden, married, and former names or aliases):

Name (include maiden, married, and former names or aliases):

 

 

Current address:

Current address:

 

 

Former address:

Former address:

 

 

Birth date and place:

Birth date and place:

 

 

Tribe or band, and location:

Tribe or band, and location:

 

 

Tribal membership or enrollment number, if known:

Tribal membership or enrollment number, if known:

 

 

If deceased, date and place of death:

If deceased, date and place of death:

 

 

Mother's Biological Grandfather

Mother's Biological Grandfather

(Child's Maternal Great-grandfather)

(Child's Maternal Great-grandfather)

 

 

Name (include former names or aliases):

Name (include former names or aliases):

 

 

Current address:

Current address:

 

 

Former address:

Former address:

 

 

Birth date and place:

Birth date and place:

 

 

Tribe or band, and location:

Tribe or band, and location:

 

 

Tribal membership or enrollment number, if known:

Tribal membership or enrollment number, if known:

 

 

If deceased, date and place of death:

If deceased, date and place of death:

 

 

 

 

ICWA-030 [New January 1, 2008]

NOTICE OF CHILD CUSTODY PROCEEDING FOR INDIAN CHILD

(Indian Child Welfare Act)

Page 4 of 10

ICWA-030

CASE NAME:

CASE NUMBER:

5.e. INFORMATION ON THE CHILD NAMED IN 1

(Indicate if any of the information requested below is unknown or does not apply; do not use the abbreviation "N/A".)

Father's Biological Grandmother

Father's Biological Grandmother

(Child's Paternal Great-grandmother)

(Child's Paternal Great-grandmother)

 

 

Name (include maiden, married, and former names or aliases):

Name (include maiden, married, and former names or aliases):

 

 

Current address:

Current address:

 

 

Former address:

Former address:

 

 

Birth date and place:

Birth date and place:

 

 

Tribe or band, and location:

Tribe or band, and location:

 

 

Tribal membership or enrollment number, if known:

Tribal membership or enrollment number, if known:

 

 

If deceased, date and place of death:

If deceased, date and place of death:

 

 

Father's Biological Grandfather

Father's Biological Grandfather

(Child's Paternal Great-grandfather)

(Child's Paternal Great-grandfather)

 

 

Name (include former names or aliases):

Name (include former names or aliases):

 

 

Current address:

Current address:

 

 

Former address:

Former address:

 

 

Birth date and place:

Birth date and place:

 

 

Tribe or band, and location:

Tribe or band, and location:

 

 

Tribal membership or enrollment number, if known:

Tribal membership or enrollment number, if known:

 

 

If deceased, date and place of death:

If deceased, date and place of death:

 

 

 

 

ICWA-030 [New January 1, 2008]

NOTICE OF CHILD CUSTODY PROCEEDING FOR INDIAN CHILD

 

Page 5 of 10

(Indian Child Welfare Act)

ICWA-030

CASE NAME:

CASE NUMBER:

5.f. INFORMATION ON THE CHILD NAMED IN 1

(Indicate if any of the information requested below is unknown or does not apply; do not use the abbreviation "N/A".)

Indian Custodian Information

Indian Custodian Information

 

 

Name (include maiden, married, and former names or aliases):

Name (include maiden, married, and former names or aliases):

 

 

Current address:

Current former address:

 

 

Former address:

Former address:

 

 

Birth date and place:

Birth date and place:

 

 

Tribe or band, and location:

Tribe or band, and location:

 

 

Tribal membership or enrollment number, if known:

Tribal membership or enrollment number, if known:

 

 

6.ADDITIONAL INFORMATION ON CHILD NAMED IN 1

(Indicate if any of the information requested below is unknown.)

a.

 

 

Biological birth father is named on birth certificate.

 

 

 

 

 

Biological birth father has acknowledged parentage.

b.

 

 

 

 

 

There has been a judicial declaration of parentage.

c.

 

 

 

 

 

Other alleged father (name each):

d.

 

 

Unknown

Unknown

Unknown

Unknown

The following optional questions may be helpful in tracing the ancestry of the child in 1.

7. Has the child in 1 or any members of his or her family ever (if "yes," provide the information requested below):

a. Attended an Indian school?

 

Yes

 

No

 

Unknown

 

 

 

Name/relationship to child

Type of school

Dates attended

Name and location of school

ICWA-030 [New January 1, 2008]

NOTICE OF CHILD CUSTODY PROCEEDING FOR INDIAN CHILD

Page 6 of 10

(Indian Child Welfare Act)

Roll of 1924

ICWA-030

CASE NAME:

CASE NUMBER:

b.Received medical treatment at an Indian health clinic or U.S. Public Health Service hospital?

Yes No Unknown

Name/relationship to child

Type of treatment

Dates of treatment

Location where treatment given

 

 

 

 

 

 

 

 

 

 

 

 

c. Lived on federal trust land, a reservation or rancheria, or an allotment?

 

Yes

 

No

 

Unknown

 

 

 

 

 

 

Name/relationship to child

Name/description of property and address

 

 

 

Dates of residence

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

d.Other relative information (e.g., aunts, uncles, siblings, first and second cousins, stepparents, etc.)

Name/relationship to child

Current and former address

Birth date and place

Tribe, band, and location

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

8.

a.

b.

c.

Tribal affiliation and location of child in 1 (check all that apply):

1906 Final Roll Name of relative listed on roll: Relationship to child in 1:

Name of relative listed on roll:

Relationship to child in 1:

California Judgment Roll. Roll number, if known:

ICWA-030 [New January 1, 2008]

NOTICE OF CHILD CUSTODY PROCEEDING FOR INDIAN CHILD

Page 7 of 10

(Indian Child Welfare Act)

ICWA-030

CASE NAME:

CASE NUMBER:

9.Additional party information (list the name, mailing address, and telephone number of all parties notified) :

Name

Mailing Address

Telephone Number

DECLARATION

(To be completed, dated, and signed in all cases by each petitioner named in companion petition.)

I am the petitioner or we are all of the petitioners in this proceeding. In response to items 5–9 of this form, I/we have given all information I/we have about the relatives and, if applicable, the Indian custodian, of the child named in item 1 of this form.

I/We declare under penalty of perjury under the laws of the State of California that the foregoing and all attachments are true and correct.

Date:

(TYPE OR PRINT NAME )

(SIGNATURE)

Date:

(TYPE OR PRINT NAME )

(SIGNATURE)

Date:

(TYPE OR PRINT NAME )

(SIGNATURE)

ICWA-030 [New January 1, 2008]

NOTICE OF CHILD CUSTODY PROCEEDING FOR INDIAN CHILD

Page 8 of 10

(Indian Child Welfare Act)

ICWA-030

CASE NAME:

CASE NUMBER:

CERTIFICATE OF MAILING—JUVENILE COURT PROCEEDINGS (To be completed by social worker or probation officer.)

I certify that a copy of the Notice of Child Custody Proceeding for Indian Child, with a copy of the petition identified on page 1 of this

 

 

form, was mailed as follows. Each copy was enclosed in an envelope with postage for registered or certified mail, return receipt

 

 

requested, fully prepaid. The envelopes were addressed to each person, tribe, or agency as indicated below. (Except that the

 

 

telephone numbers shown below were not placed on the envelopes. They are shown below because they must be disclosed in the

 

 

Notice under Family Code section 180, Probate Code section 1460.2, and Welfare and Institutions Code section 224.2.) Each

 

 

envelope was sealed and deposited with the United States Postal Service at (place):

 

 

 

on (date):

.

 

 

 

 

 

 

 

Date:

Title:

Department:

 

 

 

 

 

 

 

 

 

 

 

 

(TYPE OR PRINT NAME)

(SIGNATURE )

 

 

 

 

DECLARATION OF MAILING—ADOPTION, FAMILY LAW, AND PROBATE PROCEEDINGS

 

 

 

 

(To be completed by the attorney for Petitioner if Petitioner is represented.)

 

 

I am an attorney at law, admitted to practice in the courts of the State of California, and attorney for Petitioner in this matter. I declare

 

 

that a copy of the Notice of Child Custody Proceeding for Indian Child, with a copy of the petition identified on page 1 of this form, was

 

 

mailed as follows. Each copy was enclosed in an envelope with postage for registered or certified mail, return receipt requested, fully

 

 

prepaid. The envelopes were addressed to each person, tribe, or agency as indicated below. (Except that the telephone numbers

 

 

shown below were not placed on the envelopes. They are shown below because they must be disclosed in the Notice under Family

 

 

Code section 180, Probate Code section 1460.2, and Welfare and Institutions Code section 224.2.) Each envelope was sealed and

 

 

deposited with the United States Postal Service at (place):

on (date):

.

 

 

 

 

 

 

 

 

 

 

I declare under penalty of perjury under the laws of the State of California that the foregoing and all attachments are true and correct.

 

 

Date:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(TYPE OR PRINT NAME )

(SIGNATURE OF ATTORNEY)

 

 

CERTIFICATE OF MAILING—PROBATE PROCEEDINGS

(To be completed by the clerk of the court if Petitioner is unrepresented.)

I certify that a copy of the Notice of Child Custody Proceeding for Indian Child, with a copy of the petition, was mailed as follows. Each copy was enclosed in an envelope with postage for registered or certified mail, return receipt requested, fully prepaid. The envelopes were addressed to each person, tribe, or agency as indicated below. (Except that the telephone numbers shown below were not placed on the envelopes. They are shown below because they must be disclosed in the Notice under Family Code section 180,

Probate Code section 1460.2, and Welfare and Institutions Code section 224.2.)

Each envelope was sealed and deposited with the

United States Postal Service at (place):

on (date):

Date:

.

 

 

Department:

Title:

 

 

 

 

 

 

(TYPE OR PRINT NAME )

(SIGNATURE)

This form and all return receipts must be filed with the court.

ICWA-030 [New January 1, 2008]

NOTICE OF CHILD CUSTODY PROCEEDING FOR INDIAN CHILD

 

Page 9 of 10

(Indian Child Welfare Act)

ICWA-030

CASE NAME:

CASE NUMBER:

NAMES, ADDRESSES, AND TELEPHONE NUMBERS OF ALL PERSONS,

TRIBES, OR AGENCIES TO WHOM NOTICE WAS MAILED

1.

 

Parent (Name):

 

 

 

 

 

 

 

 

 

Street address:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Mailing address:

 

 

 

 

City, state and zip code:

 

 

 

 

 

Telephone number:

 

 

 

3.

 

Guardian (Name):

 

 

 

 

 

 

 

 

 

 

 

 

 

Street address:

 

 

 

 

 

Mailing address:

 

 

 

 

City, state and zip code:

 

 

 

 

 

Telephone number:

 

 

 

 

 

 

 

 

 

 

5.

 

Indian Custodian

 

 

 

 

 

 

 

 

 

 

(Name):

 

 

 

 

Street address:

 

 

 

 

Mailing address:

 

 

 

City, state and zip code:

 

 

 

 

Telephone number:

 

 

 

 

 

 

 

 

 

7.

 

Sacramento Area Director

 

 

 

 

 

Bureau of Indian Affairs

 

 

 

Street address:

2800 Cottage Way

 

 

City and zip code:

Sacramento, CA 95825

 

 

Telephone number:

 

9.

 

Tribe (Name):

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Addressee (Name):

 

 

 

 

 

Title:

 

 

 

 

 

Street address:

 

 

 

 

 

Mailing address:

 

 

 

 

City, state and zip code:

 

 

 

 

 

Telephone number:

 

 

 

11.

 

Tribe (Name):

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Addressee (Name):

 

 

 

 

 

Title:

 

 

 

 

 

Street address:

 

 

 

 

 

Mailing address:

 

 

 

 

City, state and zip code:

 

 

 

 

 

Telephone number:

 

 

 

 

 

 

 

 

 

 

2.

 

Parent (Name):

 

 

 

 

 

 

 

 

 

Street address:

 

 

 

 

Mailing address:

 

 

 

City, state and zip code:

 

 

 

 

Telephone number:

 

 

4.

 

Guardian (Name):

 

 

 

 

 

 

 

 

 

 

Street address:

 

 

 

 

Mailing address:

 

 

 

City, state and zip code:

 

 

 

 

Telephone number:

 

 

6.

 

Indian Custodian

 

 

 

 

 

 

 

 

 

 

 

 

 

(Name):

 

 

 

 

Street address:

 

 

 

 

Mailing address:

 

 

 

City, state and zip code:

 

 

 

 

Telephone number:

 

 

 

 

 

 

 

 

8.

 

Secretary of the Interior

 

 

 

 

 

U.S. Department of the Interior

 

 

Street address:

1849 C Street, N.W.

 

City, state and zip code:

Washington D.C. 20240

 

 

Telephone number:

 

 

 

 

 

 

 

10.

 

Tribe (Name):

 

 

 

 

Addressee (Name):

 

 

 

 

 

 

 

 

 

 

Title:

 

 

 

 

 

Street address:

 

 

 

 

 

Mailing address:

 

 

 

 

City, state and zip code:

 

 

 

 

 

Telephone number:

 

 

 

12.

 

Tribe (Name):

 

 

 

 

 

 

 

 

 

 

 

Addressee (Name):

 

 

 

 

 

Title:

 

 

 

 

 

Street address:

 

 

 

 

 

Mailing address:

 

 

 

 

City, state and zip code:

 

 

 

 

 

Telephone number:

 

 

 

 

 

 

 

 

 

Note: Notice to the tribe must be sent to the tribe chairman or designated authorized agent for service.

Additional tribes served listed on attached form ICWA-030(A)

ICWA-030 [New January 1, 2008]

NOTICE OF CHILD CUSTODY PROCEEDING FOR INDIAN CHILD

Page 10 of 10

(Indian Child Welfare Act)

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Step # 1 for submitting icwa 020 form

2. Now that the last segment is complete, you're ready include the required particulars in NOTICE TO check all that apply, Parents or Legal Guardians, Tribes, Indian Custodians, Sacramento Area Director BIA, Secretary of the Interior, NOTICE is given that based on the, Name Date of Birth Place of Birth, HEARING INFORMATION, Date, Time, Dept, Room, Type of hearing, and Address and telephone number of so you can move on to the next part.

Dept, Indian Custodians, and NOTICE is given that based on the inside icwa 020 form

3. This 3rd step is generally pretty simple, ICWA New January, Indian Child Welfare Act, and USC et seq Welfare - all these blanks will need to be filled out here.

Guidelines on how to prepare icwa 020 form part 3

Concerning Indian Child Welfare Act and USC et seq Welfare, be sure that you double-check them in this current part. These are the most significant ones in this page.

4. Filling in CASE NAME, CASE NUMBER, ICWA, Under the Indian Child Welfare Act, The childs parents Indian, b The childs Indian custodian and, The childs parent Indian custodian, With the limited exceptions of the, The proceedings could lead to the, If the childs parents or Indian, The information contained in this, temporary physical custody care, INFORMATION ON THE CHILD NAMED IN, b A copy of the tribal, and Do not use the abbreviation NA is key in this step - make sure you invest some time and take a close look at every single blank area!

Part no. 4 for completing icwa 020 form

5. Finally, the following last part is precisely what you will need to finish before closing the PDF. The fields in question include the following: Name include maiden married and, Name include former names or, Current address, Current address, Former address, Former address, Birth date and place, Birth date and place, Tribe or band and location, Tribe or band and location, Tribal membership or enrollment, Tribal membership or enrollment, If deceased date and place of death, If deceased date and place of death, and Additional information.

icwa 020 form completion process outlined (part 5)

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