San Bernardino — SB-13548

Source: https://sanbernardino.courts.ca.gov/system/files/sb-13548fillable.pdf

CONFIDENTIAL SUPERIOR COURT OF CALIFORNIA, COUNTY OF SAN BERNARDINO REFERRAL FOR CII/CARPOS/ICMS REPORT (GUARDIANSHIP/CONSERVATORSHIP)

Case Number Ex Parte Hearing Date Department

This Section to be Completed by Filing Party

Petitioner Name: Male Petitioner Former Name:

Female

Petitioner AKAs, if any: Petitioner Date of Birth: Petitioner SSN:

Second Petitioner Name: Male Second Petitioner Former Name:

Female

Second Petitioner AKAs, if any: Second Petitioner Date of Birth: Second Petitioner SSN:

Other Member of Household 18 Years Old & Older: Date of Birth: SSN: MALE FEMALE

NAME: Other Member of Household 18 Years Old & Older: Date of Birth: SSN: MALE FEMALE

NAME: Other Member of Household 18 Years Old & Older: Date of Birth: SSN: MALE FEMALE

NAME: Name of Minor’s Natural Mother: Date of Birth: SSN:

Name of Minor’s Natural Father: Date of Birth: SSN:

COURT ORDER:

■ This matter is referred to Family Law Processing for a CARPOS (CLETS) history report and a

Criminal History Inquiry (CII) pursuant to Family Code 6306 and/or California Rule of Court 5.445.

■ This matter is referred to Family Law Processing for a search of the Superior Court of California,

County of San Bernardino Integrated Case Management System for a history report regarding

existing custody and visitation orders pursuant to CRC 5.445.

Form A1 This form is required with all Guardianship/Conservatorship filings

SB-13548 (Rev. 01/18/13) Mandatory