San Bernardino — 13-16504-360

Source: https://sanbernardino.courts.ca.gov/system/files/13-16504-360certificationofcompetencydependency.pdf

LAW FIRM (Name and address): STATE BAR NO: For Court Use Only FILED Date FIRM NAME: STREET ADDRESS: STREET ADDRESS:

CITY: STATE: ZIP CODE:
TELEPHONE NO: FAX NO:
E-MAIL ADDRESS:

SUPERIOR COURT OF CALIFORNIA, COUNTY OF SAN BERNARDINO STREET ADDRESS: 860 EAST GILBERT STREET MAILING ADDRESS: 860 EAST GILBERT STREET CITY AND ZIP CODE: SAN BERNARDINO, CA 92415-0955 BRANCH NAME: JUVENILE DEPENDENCY COURT ATTORNEY’S NAME:

CERTIFICATION OF COMPETENCY DEPENDENCY Certification for: Guardian Ad Litem Dependency Counsel

Training and Education Initial Certification Recertification (Every three years) (Attach copies of MCLE certificates or other documentation of training and/or attendance)

Date Completed Course Title Provider Hours

I hereby certify that am an attorney licensed to practice in the State of California and I meet the minimum standards of competency for practice before a Juvenile Court set forth in the California Rules of Court, Rules 5.660 – 5.664 and Superior Court of California, County of San Bernardino Local Rules 1692.4 through 1692.8 and have completed the minimum requirements for training, education and/or experience as required as set forth above.

Dated: Signed:

For Court Use Only

□Approved ☐ Denied

Dated: Signed: Presiding Judge of the Juvenile Court

13-16504-360 [Rev. Oct. 12, 2022] Optional Form CERTIFICATION OF COMPETENCY – DEPENDENCY Page 1 of 1