Juvenile Appellate Referral Form

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Oregon Judicial Department

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Juvenile Dependency Appellate Referral

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Juvenile Dependency Appellate Referral

FORM INSTRUCTIONS:

Use this form only if (a) your client wants to appeal a judgment entered by the juvenile court, and you do not want to act as the attorney on appeal, or (b) you or your client has been served with a notice of appeal by another party and your client wishes to participate in the appellate process, and you do not want to act as the attorney on appeal.

Pursuant to ORS 419A.200(4), OPDS provides this webpage case referral form to facilitate filing the notice of appeal. To comply with OPDS policies and procedures, referring counsel must satisfy the following conditions:

Electronically complete and submit the referral form to OPDS at least five (5) business days prior to the due date for the notice of appeal. (If the referral is within fewer than 5 business days of the notice of appeal due date, trial counsel reamains responsible for filing the notice of appeal and should contact OPDS for assistance in locating counsel on appeal.)

Fax (503.378.4462) or email (juvenile@opds.state.or.us) to OPDS a copy of the judgment being appealed.

When OPDS receives the information necessary for the notice of appeal, OPDS will prepare, file and serve the notice of appeal and related documents.

If OPDS must refer a case to non-OPDS counsel due to a conflict or workload issues, the following procedures apply:

Procedures for Cases Referred to Appellate Counsel Outside the OPDS Juvenile Section

1.	OPDS will prepare a draft notice of appeal and related documents in trial counsel’s name.
2.	OPDS will email the draft documents to trial counsel for review and approval — but not for filing. If counsel notes a defect in the form of the documents, counsel should notify OPDS immediately by email at juvenile@opds.state.or.us or by telephone at 503.378.6236.
3.	If trial counsel does not contact OPDS within two business days of document transmission, OPDS will assume that counsel has reviewed and approved the documents.
4.	An OPDS attorney will sign the notice of appeal and related documents in trial counsel’s name, file the notice of appeal and motion to appoint appellate counsel with the Court of Appeals, serve the parties, and initiate transcript production. OPDS will also forward a copy of the documents to the client with a cover letter that includes the name and contact information of the appellate attorney appointed to represent the client on appeal.

Referral Sender Information

Client Information

Case Information

Attorney Information

Additional Information

Items in red are required fields and are necessary for the submission of this form.

REFERRAL SENDER INFORMATION

Referral Sender's Name:
Referral Sender's Telephone:
Referral Sender's Email:

CLIENT INFORMATION

Client's First Name and Middle Name(s):
Client's Last Name:
Client's AKA Name(s):
Date of Birth (mm/dd/yy):
Client's Primary Language:

Name(s) of Other Parties (parents, child(ren), CASA, intervenors or persons with rights of limited participation under ORS 419B.116, tribe in cases subject to the Indian Child Welfare Act (ICWA) if the tribe has intervened)
Client's Address If client is a minor child, please list name and address of guardian (e.g., DHS) and person having physical custody of the child (e.g., foster parent, relative), if available.
Address:
City:
State:
Zip:
Client/guardian/custodian contact numbers: Home Telephone:
Work Telephone:

CASE INFORMATION

Select County:
Enter case number(s) including petition number(s):
Select Case Type:
Judge's Name:
Judgment entry date:
Is this a State's appeal?
Date State Filed Notice of Appeal:
Does the Indian Child Welfare Act (ICWA) apply to this case?

ATTORNEY INFORMATION

Attorney Last Name:
Attorney Bar Number:
Attorney designation:

ADDITIONAL INFORMATION

Please list the dates of all court proceedings to be transcribed for the record.


Please check issues on appeal (up to four):

Child removed/not returned Visitation denied/inadequate Services/evaluation ordered/denied Placement disputed, including out-of-state placement Plan changed Burden of proof/sufficiency of evidence ICWA requirements not met Reasonable/active efforts Procedural motions allowed/denied Motion to set aside default denied Evidence admitted/excluded Discovery violation Due process/other Constitutional violation Waiver of trial/counsel Adequacy of counsel Other
If expert witnesses were called, please enter their name(s), organization(s), and city of origin. Also, indicate whether they were state or defense witnesses, and indicate the nature of their testimony.

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