Free jc14b.p65 - Michigan

Approved, SCAO

JIS CODE: DSP

STATE OF MICHIGAN
JUDICIAL CIRCUIT - FAMILY DIVISION

COUNTY
Court address ORI MI-

ORDER OF DISPOSITION, OUT-OF-HOME (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:
Bar no.

3. Notice of hearing for the disposition was given as required by law. 4. The juvenile has appeared in court in person with parent(s), guardian, legal custodian, guardian ad litem, and was represented by an attorney. waived representation by an attorney. 5. An adjudication was held and the court determined that the juvenile committed the following offense(s) and/or the following offense(s) has/have been dismissed:
ADJUDICATED BY DISMISSED BY* Count Plea* Court Jury ALLEGATIONS CHARGE CODE(S) MCL Citation/PACC Code

*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. Specific findings of fact and law regarding this proceeding have been made on the record.

7.

HIV testing and sex offender registration is completed.

Chemical testing for DNA identification profiling is completed.

8. The juvenile has been fingerprinted according to MCL 28.243. 9. The offense adjudicated is abstractable to the Secretary of State (under MCL 257.625[20][a], 257.732, 324.80131, 324.81134[12], 324.81135[7], 324.82157, or 333.7408a[12]). The juvenile's driver's license number is 10. The licensing sanction is reportable to the State Police (under MCL 333.7408a[12] or 257.625[20][b]). Revoked. Suspended days. Restricted days. 11. The juvenile must be placed in an institution outside Michigan because a. institutional care is in the best interests of the juvenile, b. equivalent facilities to meet the juvenile's needs are not available within Michigan, and c. the placement will not cause undue hardship.

.

(SEE SECOND PAGE)

Do not write below this line - For court use only

Upon disposition of a juvenile offense as defined under MCL 28.241a(f), the clerk of the court shall advise the Michigan State Police Criminal Justice Information Center of the disposition as required by MCL 712A.18(11).
MCL 28.241a, MCL 600.2950h; 600.2950m, MCL 712A.18; 712A.18k; 712A.20, MCL 764.15b, MCL 769.1f, MCL 769.16a, MCR 3.936, MCR 3.943 JC 14b (9/06) ORDER OF DISPOSITION, OUT-OF-HOME (DELINQUENCY PROCEEDINGS), PAGE 1

Approved, SCAO

JIS CODE: DSP

STATE OF MICHIGAN
JUDICIAL CIRCUIT - FAMILY DIVISION

COUNTY
Court address

ORDER OF DISPOSITION, OUT-OF-HOME (DELINQUENCY PROCEEDINGS), PAGE 2

CASE NO. PETITION NO.

Court telephone no.

In the matter of 12. It is contrary to the welfare of the juvenile to remain in the home because

13.

a. Reasonable efforts to prevent removal of the juvenile from the home were not made. b. Reasonable efforts were made prior to 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)

14.

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. c. Reasonable efforts to preserve and reunify the family were not previously required, but due to a change in circumstances, reasonable efforts are now required. Those reasonable efforts have begun and include: (specify
reasonable efforts, and if applicable, the reasons for return)

The juvenile should be released to IT IS ORDERED:

Name(s) of parent(s), guardian, or legal custodian

.

15. The juvenile is referred to the Michigan Department of Human Services for placement and care under MCL 400.55(h). 16. Other: (include reimbursement as required by MCL 712A.18[2] or as permitted by MCL 769.1f)

17. Juvenile shall pay 18. The review date is Recommended by:
Date

$20.00 for Crime Victim's Rights Fund.

State minimum costs .

specify for each count

.

Referee signature Judge

*Note: Contrary to the welfare findings (item 12) must be made when the juvenile is initially removed, and if returned home, at any subsequent removal(s). Reasonable efforts findings (items 13 and 14) must be made within 60 days of the removal of the juvenile from the home, and if returned home, at any subsequent removal(s).
JC 14b (9/06)

ORDER OF DISPOSITION, OUT-OF-HOME (DELINQUENCY PROCEEDINGS), PAGE 2