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Informal Disposition Agreement In Need Of Protection Or Services JC-1607 - Wisconsin
| Informal Disposition Agreement In Need Of Protection Or Services Form. This is a Wisconsin form and can be used in Juvenile Circuit Court Statewide . |
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FORM SUMMARY Name of Form: Informal Disposition Agreement (In Need of Protection or Services) JC-1607 §48.245, Wisconsin Statutes JV 2 A written agreement outlining the conditions and obligations to be met in order to defer the filing of a petition to the court. This form also includes various notices and warnings. Intake worker. Shall also be signed by the child and parent/guardian/legal custodian. Original to file. Copies to child/parents/legal custodian/guardian and district attorney or corporation counsel. None Modification, last update 9/96. Added a statement on the bottom indicating that the form shall not be modified. None. This form is the product of the Wisconsin Records Management Committee, a committee of the Director of State Court's Office and a mandate of the Wisconsin Judicial Conference. If you have additional information that does not change the meaning of the form, attach it on a separate page. The form itself shall not be altered. Form Number: Statutory Reference: Benchbook Reference: Purpose of Form: Who Completes It: Distribution of Form: Accompanying Forms: New Form/Modification: Modifications: Comments: About this form: Date: 05/31/00 Page 1 American LegalNet, Inc. www.FormsWorkflow.com State of Wisconsin Circuit Court In the interest of: Name of Child 5. Child's Address Informal Disposition Agreement (In Need of Protection or Services) 1. Intake Case Number 2. County 4. Date of Birth Zip Code 6. Date Referral Received An inquiry has been conducted into this matter. It has been determined that at this time neither the interests of the child named above nor of the public require filing of a petition for circumstances relating to §48.13, Wisconsin Statutes. It is this intake worker's belief, however, that the facts are sufficient that court action could be sought, and this conclusion is undisputed by the child and parents, guardian or legal custodian. 7. Summary of Undisputed Facts: 8. Obligations - Check all appropriate boxes for any combination of obligations A. B. C. D. E. F. G. H. I. Case held open for No new referrals to intake. Counseling: Terms: Child Parent/guardian Family months or until . Date . A.O.D.A. Assessment: Terms: Parent participation in parenting skills training Youth participation in a court approved pupil assistance program Curfew: Daily school attendance; no unexcused absences; obey school rules Other specific obligations/conditions: The child and parents, guardian and legal custodian are notified of their right to object at any time to the facts or terms of this agreement. If there are objections, the intake worker may alter the terms of the agreement or recommend that a petition be filed. This agreement may be terminated at any time upon the request of the child, parents, guardian or legal custodian. If the informal disposition is terminated, the intake worker may recommend to the district attorney/corporation counsel that a petition be filed. If at any time during the period of this agreement the intake worker determines that the stated obligations are not being met, the intake worker may cancel this agreement and recommend that a petition be filed. Upon agreement of all parties the Informal Disposition Agreement may be extended up to 6 months. The district attorney or corporation counsel may file a petition within 20 days after receipt of this agreement. Filing of a petition will cancel this agreement. 9. Date Agreement Effective 10. Date Agreement Terminates Print or Type Names Child Signatures Date Signed Father/Guardian/Legal Custodian Mother Intake Worker JC-1607, 05/00 Informal Disposition Agreement (In Need of Protection or Services) §48.245, Wisconsin Statutes. American LegalNet, Inc. www.FormsWorkflow.com This form shall not be modified. It may be supplemented with additional material. Page 1 of 1
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