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U entered on your form, please press the Clear This Form button at the end of the form when finished. CHILD'S NAME: SUPERIOR COURT OF CALIFORNIA, COUNTY OF STREET ADDRESS: MAILING ADDRESS: CITY AND ZIP CODE: BRANCH NAME: CASE NUMBER: CERTIFIED REQUEST FOR PUPIL RECORDS TRUANCY This request is made pursuant to Education Code section 49076(a)(10). 1. Child's name: 2. Child's home address: 3. Date of birth: 4. Child's school district: 5. Child's school: 6. School address: 7. The requester is a.

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