Free jc59.pmd - Michigan

Approved, SCAO

JIS CODE: ODH

STATE OF MICHIGAN
JUDICIAL CIRCUIT - FAMILY DIVISION

COUNTY
Court address ORI MI-

ORDER OF ADJUDICATION (DELINQUENCY PROCEEDINGS) PAGE 1

CASE NO. PETITION NO.

Court telephone no.

CTN/TCN

SID

DOB

1. In the matter of
name(s), alias(es)

2. Date of hearing: Judge/Referee: 3. A petition has been filed in this matter and notice of hearing on the petition has been served as required by law. 4. The juvenile has appeared in court in person with parent(s), guardian, legal custodian, or guardian ad litem, and was represented by an attorney. waived representation by an attorney. 5. THE COURT FINDS: The following material allegations of the petition are sustained or dismissed:
ADJUDICATED BY Count Plea* Court Jury DISMISSED BY* ALLEGATIONS CHARGE CODE(S) MCL Citation/PACC Code

Bar no.

*For plea, insert "A" for admission or "NC" for nolo contendere. For dismissal, insert "D" for dismissed by court or "NP" for dismissed by prosecutor/plaintiff.

6. A fingerprintable juvenile offense was committed pursuant to MCL 28.243 or MCL 28.727. Fingerprints have have not been taken. 7. The offense is abstractable to the Secretary of State (pursuant to MCL 257.625[20][a], 257.732, 324.80131, 324.81134[12], 324.81135[7], 324.82157, 333.7408a[12], or 436.1703). The juvenile's driver's license number is . 8. It is contrary to the welfare of the juvenile to remain in the home because . 9. a. Reasonable efforts to prevent removal of the juvenile from the home were not made. b. Reasonable efforts were made before the placement of the juvenile in foster or other out-of-home care, to prevent or eliminate the need for removing the juvenile from his/her home. Those efforts include: (Specify.)

10.

a. Reasonable efforts shall be made to preserve and reunify the family to make it possible for the juvenile to safely return home. b. Reasonable efforts shall not be made to preserve and reunify the family because it would be detrimental to the juvenile's health and safety.

11. Other:

NOTE: If the juvenile had been previously removed from the home, was then returned to the home, and is being removed again through this order, contrary to the welfare and reasonable efforts findings must be made even though the findings had been made at a prior hearing.
Do not write below this line - For court use only

(SEE SECOND PAGE)

JC 59 (9/08)

ORDER OF ADJUDICATION (DELINQUENCY PROCEEDINGS), PAGE 1

MCL 712A.18, MCR 3.942

Approved, SCAO

JIS CODE: ODH

STATE OF MICHIGAN
JUDICIAL CIRCUIT - FAMILY DIVISION

COUNTY
Court address

ORDER OF ADJUDICATION (DELINQUENCY PROCEEDINGS) PAGE 2

CASE NO. PETITION NO.

Court telephone no.

In the matter of IT IS ORDERED: 12. The matter is adjourned for 13. The next hearing is set for
Date, time, and place

dispositional hearing.

additional testimony.

other good cause. .

14.

Pending disposition, the juvenile shall be under the supervision of this court and shall

a. remain in the care and custody of , and be subject to the reasonable and lawful commands of the parent(s), guardian, or legal custodian and those terms and conditions required by the probation officer. b. be placed with the Michigan Department of Human Services for care and supervision, subject to the rules and conditions of foster care. Parenting time shall be as approved by the probation officer. The parent(s) shall reimburse the Child Care Fund for costs of placement. c. be referred to the Michigan Department of Human Services for placement and care pursuant to MCL 400.55(h). d. be placed at . Parenting time shall be as approved by the probation officer. The parent(s) shall reimburse the Child Care Fund for the costs of placement. e. cooperate with and participate in services, evaluations, tests, and the dispositional investigation as requested by the probation officer. Parent(s) shall pay the costs of professional testing and evaluations. f. cooperate with an evaluation to determine the need for psychiatric or psychological treatment as prescribed by MCL 712A.18l. 15. 16. Parent(s) shall file appropriate financial statements with this court not later than
Date

.

Other:

Recommended by:

Referee signature

Date

Judge

JC 59 (9/08)

ORDER OF ADJUDICATION (DELINQUENCY PROCEEDINGS), PAGE 2