Free JC05a.pmd - Michigan

Approved, SCAO

JIS CODE: OTC

STATE OF MICHIGAN
JUDICIAL CIRCUIT - FAMILY DIVISION

COUNTY
Court address

ORDER TO APPREHEND AND DETAIN (DELINQUENCY PROCEEDINGS/ MINOR PERSONAL PROTECTION), PAGE 1

CASE NO. PETITION NO.

Court telephone no.

1. In the matter of
name(s), alias(es), DOB (See reverse side for other identifying information.)

2. Date of entry of order:

Judge/Referee:
Bar no.

Upon the presentation of a petition, together with further proofs as required by the court, IT APPEARS: 3. There are reasonable grounds to apprehend the juvenile in compliance with MCL 712A.2, MCR 3.933(B), or MCR 3.983 because a. the juvenile is eluding the parent, guardian, or legal custodian. There is probable cause to believe the juvenile can be found at . b. the juvenile is charged with committing an offense that would provide authority for issuance of a warrant were the juvenile an adult. Date of offense: Offense:

c. the juvenile is absent without leave from an institution or facility to which s/he was committed pursuant to MCL 712A.18. d. the juvenile has violated probation. e the juvenile has failed to appear for a hearing on a petition charging violation of MCL 712A.2. f. the juvenile is alleged to have violated a valid minor personal protection order issued pursuant to MCL 712A.2(h) or out-ofstate law and it appears there is a substantial likelihood of retaliation or continued violation. Further, the court finds it is contrary to the welfare of the juvenile to remain in the home because: (Specify.)

4.

a. Reasonable efforts to prevent removal of the juvenile from the home were not made. b. Reasonable efforts were made to prevent removal of the juvenile from the home. Those efforts include: (Specify.)

Do not write below this line - For court use only

(SEE SECOND PAGE)

JC 05a (9/08)

ORDER TO APPREHEND AND DETAIN (DELINQUENCY PROCEEDINGS/MINOR PERSONAL PROTECTION), MCL 712A.2c, MCL 712A.15, MCR 3.933(B), (C), MCR 3.934(B), MCR 3.944(A), MCR 3.983(B), (D) PAGE 1

Approved, SCAO

JIS CODE: OTC

STATE OF MICHIGAN
JUDICIAL CIRCUIT - FAMILY DIVISION

COUNTY
Court address

ORDER TO APPREHEND AND DETAIN (DELINQUENCY PROCEEDINGS/ MINOR PERSONAL PROTECTION), PAGE 2

CASE NO. PETITION NO.

Court telephone no.

In the matter of IT IS ORDERED: TO ANY PEACE OFFICER OR: 5. The juvenile shall be apprehended and a. brought before this court or temporarily detained at pending preliminary hearing. b. placed at treatment until medically released to for detention at c. other: 6. To effect this order, you are authorized to enter the premises located at 7. The parent(s), guardian, or legal custodian of the juvenile shall be directed to appear for a preliminary hearing in this matter to be held on at . pending preliminary hearing. for medical observation and

Date

Judge

If you require special accommodations to use the court because of a disability or if you require a foreign language interpreter to help you fully participate in court proceedings, please contact the court immediately to make arrangements.

Enter on LEIN
Date ORDER EXPIRES:

JC 05a (9/08)

ORDER TO APPREHEND AND DETAIN (DELINQUENCY PROCEEDINGS/MINOR PERSONAL PROTECTION), PAGE 2

IDENTIFYING INFORMATION
Name Name Name Name Home address Father's name Mother's name Address Address City Race Race Race Race Sex Sex Sex Sex Height Height Height Height City City City Weight Weight Weight Weight Hair color Hair color Hair color Hair color State State State Eye color Eye color Eye color Eye color Zip Zip Zip State Court ORI Date of birth Date of birth Date of birth Date of birth Telephone number Telephone number Telephone number

Juvenile's place of birth
Pickup radius

Statewide

Other:

MI

Reason for apprehending is stated in item 3 on page 1 of the order to apprehend and detain. OFFICER'S STATEMENT AND RECORD OF NOTIFICATION 1. I certify and return that I have apprehended and have delivered the juvenile to
Place of temporary detention Juvenile's name

. the parent(s), guardian, or legal custodian listed below that the juvenile has been taken

2. I

notified

attempted to notify

into custody and that a preliminary/detention hearing will be held on
Date and time

at
Place

.

METHODS USED NAME
Father Mother Guardian/Legal custodian Other

(reasons for failure to notify must be noted)

DATE

TIME

I declare that this statement has been examined by me and that its contents are true to the best of my information, knowledge, and belief.

Date

Signature Agency name