Skip to content
LitigationForms
JV-124Optional

Severe Physical Abuse (§ 300 (e))

California · Judicial Council of California · Effective January 1, 2007

This form is used by a social worker to tell the court that they believe a child under the age of five is at risk of serious physical harm. It requires stating facts about the abuse according to a specific section of the law.

The court describes it as: The social worker uses this to tell the court what they believe puts a child under the age of five at risk of serious physical harm.

Open the official PDFfrom Judicial Council of California

Where this fits in a case

Motions

Stage: Motions

This form is used when a social worker needs to inform the court about a child under five who has suffered severe physical abuse by a parent or someone the parent knows about.

Prepared by the court or clerk.

Official instructions

How-to guides published by the court for this form.

Common questions

Who fills out this form?
The social worker uses this form to provide information to the court.
What is this form about?
It is used to report severe physical abuse for a child who is under the age of five.

Revision history

No changes recorded since we started tracking this form on October 9, 2026. The current version took effect January 1, 2007.

Related forms

  • ICWA-010(A)

    Indian Child Inquiry Attachment

    This form is used to tell the court what steps were taken to find out if a child involved in a case might have Indian ancestry. It asks the person filling it out to report on the information gathered from the child, parents, and tribal contacts.

    MandatoryFillable PDF1 translation
  • ICWA-040

    Notice of Designation of Tribal Representative in a Court Proceeding Involving an Indian Child

    This form is used by an Indian tribe to officially tell the court which person is authorized to represent the tribe in a case involving an Indian child. It allows the designated person to attend hearings, speak to the court, and review case documents.

    OptionalFillable PDF
  • ICWA-042

    Request for Tribal Participation

    This form is a request asking the court for a tribe to be allowed to participate in a case. It asks for details about the child, the tribe, and why the tribe wants to be involved in the court proceedings.

    OptionalFillable PDF
  • ICWA-070

    Request for Ex Parte Hearing to Return Physical Custody of an Indian Child

    This form asks the court for a hearing without a full trial (ex parte) to get the physical custody of an Indian child back. It is used when the child was taken out of the person's care because of immediate danger, but new information shows the child is no longer in danger.

    MandatoryFillable PDF
  • ICWA-080

    Order on Request for Ex Parte Hearing to Return Physical Custody of an Indian Child

    This form is used by the court to make a decision about a request for a hearing outside of normal court time to return the physical custody of an Indian child. The court uses it to decide if the evidence provided is enough to hold that hearing.

    MandatoryFillable PDF
  • ICWA-090

    Order After Hearing on Ex Parte Request to Return Physical Custody of an Indian Child

    This form is used by the court to make a decision after a hearing about asking to return an Indian child to the physical care of a parent or an Indian custodian. It records the court's findings and orders regarding the child's physical custody.

    MandatoryFillable PDF
  • ICWA-100

    Tribal Information Form

    This form is used by a child's tribe to give written information to the court about the tribe's view on issues in a case involving the custody of an Indian child. It asks for details about the child, the tribe's contact information, and input on case planning and services.

    OptionalFillable PDF
  • ICWA-100-INFO

    Instructions Sheet for Tribal Information Form

    This document is an instruction sheet that explains how a tribe's authorized representative should fill out and file the Tribal Information Form (form ICWA-100) with the court. It provides details on what information to include about the child, the tribe, and the case.

    OptionalFillable PDF