Acknowledgment of Juvenile Record Sealed
California · Judicial Council of California · Effective July 1, 2016
This form is used by agencies to tell the court that they have followed a court order to keep a child's juvenile records private (sealed). It requires the agency to confirm that the records have been sealed and that a copy of this acknowledgment has been sent to the court.
The court describes it as: Agencies use this to tell the court that they have obeyed the court’s order to keep private (seal) a child’s juvenile delinquency records.
Where this fits in a case
General & infoInformation / general use — not tied to one step of a case
This form is used when an agency needs to show the court that it has completed the action of sealing a child's juvenile delinquency records, as required by a court order.
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 form is for an agency to complete and return to the court. The form has sections for the agency's name and representative's signature.
- What does this form confirm?
- It confirms that the records that the court ordered to be sealed have actually been sealed. It also confirms that a copy of this acknowledgment has been sent to the court.
- Is a filing fee needed?
- The provided text does not mention any filing fees for this form.
Revision history
No changes recorded since we started tracking this form on October 9, 2026. The current version took effect July 1, 2016.
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