California > Local County > Santa Clara > Probate
Authorization For Release Of Information PB-4014 - California
| Authorization For Release Of Information Form. This is a California form and can be used in Probate Santa Clara Local County . |
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ATTACHMENT PB-4014 ATTORNEY OR PARTY WITHOUT ATTORNEY (Name and Address): TELEPHONE NUMBER: FOR COURT USE ONLY ATTORNEY FOR (Name): Self-Represented 191 North First Street, San José, California 95113 (408) 882-2651 (408) 882-2693 Downtown Courthouse Probate Division SUPERIOR COURT OF CALIFORNIA, COUNTY OF SANTA CLARA COURT ADDRESS: PHONE NUMBER: FAX NUMBER: BRANCH NAME: In the Matter of Conservatorship of the Estate of: Conservatee CASE NUMBER: AUTHORIZATION FOR RELEASE OF INFORMATION Probate Code Section 1513 requires that a probate court investigator conduct interviews and write a report and recommendation to the Court concerning the appropriateness of establishing a guardianship for the above-named children. In order to assist in the gathering of pertinent information, I/we, / specifically authorize the release of school records, counseling records, probation records, public and private social service records, summaries of medical and psychological records, and records from any private or public agency which would assist in determination of our petition for guardianship. Dated: Dated: Original to: Probate Court Investigator PB-4014 REV 7/01/12 AUTHORIZATION FOR RELEASE OF INFORMATION Page 1 of 1 American LegalNet, Inc. www.FormsWorkFlow.com
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