Sonoma — Request & Order to Appoint CASA

Source: https://sonoma.courts.ca.gov/system/files/forms-and-filings/jc-109.pdf

JC-109 Application submitted by: (Name and Address) FOR COURT USE ONLY Name: Street Address: City, State: Telephone Number:

SUPERIOR COURT OF CALIFORNIA, COUNTY OF SONOMA

DEPENDENCY COURT: JUVENILE JUSTICE COURT: 600 Administration Drive, 7425 Rancho Los Guilicos Road 106J Dept. C Santa Rosa, CA 95403 Santa Rosa, CA 95409

NAME OF CHILD / MINOR: DATE OF BIRTH: CASE NUMBER: DEPARTMENT:

REQUEST AND ORDER TO APPOINT SONOMA CASA (COURT APPOINTED SPECIAL ADVOCATES) (Welfare & Institutions Code § 102, California Rules of Court, rule 5.655)

I am: the Child the CASA Executive Director/designee

the Child’s ________________________________

I believe the Child’s best interest would be served by appointing Sonoma Court Appointed Special Advocates (CASA).

I therefore request this Court appoint CASA to assist the Child.

I declare under penalty of perjury that the above is true and correct.

Executed this _________ day of ____________________________ in Sonoma, California.

Signature: ____________________________________________

ORDER

It is the order of this Court that Sonoma Court Appointed Special Advocates (CASA) is appointed.

Date: ______________________________ ________________________________ Judge/ Co mmissioner of the Juvenile Court

Adopted for Mandatory Use REQUEST AND ORDER TO APPOINTMENT Page 1 of 1 Welfare and Institutions Eff. 09/05/2025 SONOMA CASA Code §102, CRC 5.655 JC-109 (COURT APPOINTED SPECIAL ADVOCATE)