On January 10, 2023 a
Exhibit,Appendix
was filed
involving a dispute between
Martinez, Jalissa Andrena,
and
for Guardianship of Person Only
in the District Court of San Bernardino County.
Preview
ICWA-010(A
1.
CHILD'S NAME:
Mafiw/w NaH/m
Nameofchildzmafiww
Wm Wda‘
Mmmu
Mama“ MMYHNI—
CASE WMBER:
C1. Awe; 17> 00 0 \O
2.
E(Check one)
| have not yet been able to complete the inquiry about the child's Indian status because:
|understand that have an affirmative and continuing duty to complete
I this inquiry. l will do it as soon as possib|e and
advise the court of my efforts.
m l
this
have asked or am advised by E
person has completed inquiry by asking the
I
child, the child's parents,
and on information and belief confirm that
and other required and available persons about
the child's Indian status. The person(s) questioned are:
Name: 65”“qu \,i( 0n Name: SUPER, '
L ., L; F E
Address: fl 9'30 Ch n 0 n Yra‘ (4’. Address: COUNSER COURT
SAN R Y 0F SAN OF CALIF
City. state. zip: VVUJCHN W 41y“ City- Sta‘e- Zip: EPNA ’ %E§IVARD?I5MH
Telephone:
7 Q c G IL' jgfi Telephone: Q’CT
Date questioned:
'
6 ‘7 L Date questioned: JUN 2 3
Relationship to child: mam rm \ and RAW Relationship to child:
2023
E
I
c3
' // '
Additional persons questioned and their information is attached. .
AM GA
3.
E
E
This inquiry (check one):
gave me reason to believe the child is
gave me no reason to believe the child
or may be an Indian
is or may be an Indian
child. (Ifyes,
child.
continue to 4.)
-"?EYE
u.
DEpllw
4.
E l
member
may be affiliated with and worked with them to establish whether the child is a
contacted the tribe(s) that the child
membership in the tribe(s). Information detailing the tribes contacted, the names of the individuals
or eligible for
contacted. and the manner of the contacts is attached.
Based on and
5.
E
a.
inquiry
The
Name
child is or
of tribe(s):
tribal contacts (check
may be a member
all that apply):
of or eligible for membership in a tribe.
E
b.
Location of
The
Name
child's parents,
of tribe(s):
tribe(s):
grandparents. or great-grandparents are or were members of a tn'be.
Location of
E
c. The residence
tribe(s):
or domicile of the child, child's parents, or Indian custodian
village or other tribal trust land.
is on a reservation, rancheria, AIaska Native
E
d. The child or the child's family
tribes or the federal
has received services or benefits from a tribe or services mat are available to Indians from
government, such as the Indian Health Service or Tn'bal Temporary Assistance to Needy Families
(TANF).
D
e. The
Name
child is or
of tribe(s):
has been a ward of a tn‘bal court.
Location of tribe(s):
E
f. Either parent or the child
Name of tribe(s):
possesses an Indian Identification card indicating membership or citizenship in an Indian tribe.
Location of tribe(s):
a delinquency proceeding under Welfare and Institutions Code section 601 or 602:
6.
E
If
E
this is
The
It is
child is in
probable the child
foster care.
will be entering foster care.
l declare under penalty of perjury under the laws of the Siate of California that the foregoing is true and correct.
Date: 0h Lb l
(Tansy!
Form Mopiod
NM COW.[Rud cm”
ICWA-ouxA)
10v Mandatory
January
U"
1,
Thls Form bunon anor you have prlntod tho form.
MmhML
(TVPE
2020]
For your protoctlon and prlvacy, plus. pron tho Cloar
0R PRINT NAME)
INDIAN CHILD INQUIRY
I
Pflnt‘hl. farm
ATTACHMENT
I I
savg
V
“1|; formJ
WE) I
_ PM).
www.courhfia‘gov
Document Filed Date
June 23, 2023
Case Filing Date
January 10, 2023
Category
Guardianship of Person Only
Status
Under Court Supervision
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ICWA-010(A 1. CHILD'S NAME: Mafiw/w NaH/m Nameofchildzmafiww Wm Wda‘ Mmmu Mama“ MMYHNI— CASE WMBER: C1. Awe; 17> 00 0 \O 2. E(Check one) | have not yet been able to complete the inquiry about the child's Indian status because: |understand that have an affirmative and continuing duty to complete I this inquiry. l will do it as soon as possib|e and advise the court of my efforts. m l this have asked or am advised by E person has completed inquiry by asking the I child, the child's parents, and on information and belief confirm that and other required and available persons about the child's Indian status. The person(s) questioned are: Name: 65”“qu \,i( 0n Name: SUPER, ' L ., L; F E Address: fl 9'30 Ch n 0 n Yra‘ (4’. Address: COUNSER COURT SAN R Y 0F SAN OF CALIF City. state. zip: VVUJCHN W 41y“ City- Sta‘e- Zip: EPNA ’ %E§IVARD?I5MH Telephone: 7 Q c G IL' jgfi Telephone: Q’CT Date questioned: ' 6 ‘7 L Date questioned: JUN 2 3 Relationship to child: mam rm \ and RAW Relationship to child: 2023 E I c3 ' // ' Additional persons questioned and their information is attached. . AM GA 3. E E This inquiry (check one): gave me reason to believe the child is gave me no reason to believe the child or may be an Indian is or may be an Indian child. (Ifyes, child. continue to 4.) -"?EYE u. DEpllw 4. E l member may be affiliated with and worked with them to establish whether the child is a contacted the tribe(s) that the child membership in the tribe(s). Information detailing the tribes contacted, the names of the individuals or eligible for contacted. and the manner of the contacts is attached. Based on and 5. E a. inquiry The Name child is or of tribe(s): tribal contacts (check may be a member all that apply): of or eligible for membership in a tribe. E b. Location of The Name child's parents, of tribe(s): tribe(s): grandparents. or great-grandparents are or were members of a tn'be. Location of E c. The residence tribe(s): or domicile of the child, child's parents, or Indian custodian village or other tribal trust land. is on a reservation, rancheria, AIaska Native E d. The child or the child's family tribes or the federal has received services or benefits from a tribe or services mat are available to Indians from government, such as the Indian Health Service or Tn'bal Temporary Assistance to Needy Families (TANF). D e. The Name child is or of tribe(s): has been a ward of a tn‘bal court. Location of tribe(s): E f. Either parent or the child Name of tribe(s): possesses an Indian Identification card indicating membership or citizenship in an Indian tribe. Location of tribe(s): a delinquency proceeding under Welfare and Institutions Code section 601 or 602: 6. E If E this is The It is child is in probable the child foster care. will be entering foster care. l declare under penalty of perjury under the laws of the Siate of California that the foregoing is true and correct. Date: 0h Lb l (Tansy! Form Mopiod NM COW.[Rud cm” ICWA-ouxA) 10v Mandatory January U" 1, Thls Form bunon anor you have prlntod tho form. MmhML (TVPE 2020] For your protoctlon and prlvacy, plus. pron tho Cloar 0R PRINT NAME) INDIAN CHILD INQUIRY I Pflnt‘hl. farm ATTACHMENT I I savg V “1|; formJ WE) I _ PM). www.courhfia‘gov