Free PETITION - Connecticut


File Size: 336.5 kB
Pages: 2
Date: January 28, 2009
File Format: PDF
State: Connecticut
Category: Court Forms - State
Author: MPiela
Word Count: 878 Words, 5,139 Characters
Page Size: Letter (8 1/2" x 11")
URL

http://www.jud2.ct.gov/webforms/forms/jm144.pdf

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Preview PETITION
PETITION: YOUTH IN CRISIS
JD-JM-144 Rev. 9-02 C.G.S. §§ 46b-120, 46b-121, 46b-128, 46b-150f Public Act 02-109, Sec. 1

STATE OF CONNECTICUT

SUPERIOR COURT
JUVENILE MATTERS www.jud.ct.gov
DOCKET NO. SEX DATE OF BIRTH

ADDRESS OF COURT NAME OF YOUTH ADDRESS OF YOUTH NAME OF PETITIONER RELATIONSHIP TO YOUTH ADDRESS OF PETITIONER

INDIAN RESERVATION, IF ANY

PROBATION OFFICER
NAME OF MOTHER NAME OF FATHER NAME OF GUARDIAN, IF ANY INDIAN TRIBE/RESERVATION, IF ANY

PARENT

OTHER (Specify):
ADDRESS OF MOTHER ADDRESS OF FATHER ADDRESS OF GUARDIAN

The Petitioner represents that the above youth is a youth in crisis, because said youth is sixteen or seventeen years of age and within the last two years: has without just cause run away from parental home or other properly authorized and lawful place of abode on or about (date(s)) . at was beyond the control of parents, guardian, or other custodian on or about (date(s)) . at has four unexcused absences from school in any one month or ten unexcused absences in any school year on or about (date(s)) . Petitioner prays that process issue to bring said youth and parent/guardian before the Court.
PETITIONER DATED SIGNED (Judge, Asst. Clerk, Notary, Comm. Sup. Crt)

ORDER FOR HEARING AND SUMMONS
Upon the foregoing petition, it is hereby ORDERED, that said petition be heard and determined at the Court Location shown below on the Hearing Date and time indicated, AND FURTHER ORDERED, that the youth and parent/guardian named in this petition be and hereby are summoned to appear before the court on the Hearing Date and at the Court Location shown below by having a proper officer leave a true and attested copy of this order and summons with said respondent(s) or at the usual place or abode, or, if so ordered, by mail on or before the date for service shown below and return same to the court:

HEARING DATE COURT LOCATION

DATE NO., STREET AND TOWN SERVICE BY (Date)

TIME OF HEARING

.m.
TELEPHONE 1ST CLASS/RESTRICTED MAIL, RETURN RECEIPT: DATE SIGNED

BY ORDER OF THE COURT (Signed - Judge/Clerk)

NOTICE TO PARENTS AND GUARDIANS An appearance in court as a result of first class mail notice may subject the appearing party to court jurisdiction. Since said youth is a minor, he or she must be accompanied by a parent or adult guardian. Failure to appear and obey court orders may result in your being held in contempt and you may be FINED or JAILED or both. See C.G.S. § 46b-121 and § 51-33. RIGHT TO COUNSEL: You have a right to be represented by an attorney and, if you wish an attorney but are unable to pay for one, upon proof that you qualify, the court will provide one for you. Any such request should be made immediately at the court office where your hearing is to be held. The Judicial Branch of the State of Connecticut complies with the Americans with Disabilities Act (ADA). If you need a reasonable accommodation in accordance with the ADA, contact the court clerk at the number listed above.

(Continued...)

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RETURN OF SERVICE
STATE OF CONNECTICUT
COUNTY OF SS. NAME OF PERSON(S) SERVED. DOCKET NO. DATE OF SERVICE

FEES

Then and there, I duly served the foregoing petition, order and summons on the above-named respondent(s), by either (check one): leaving with (for in hand); or leaving at the usual place of abode (for abode) at The within and foregoing is a true and attested copy of the original petition, order, and summons.
ATTEST (Signature and title of proper officer)

COPY ENDORSEMENT SERVICE TRAVEL

TOTAL

STATE OF CONNECTICUT
COUNTY OF SS. NAME OF PERSON(S) SERVED. DATE OF SERVICE

FEES

Then and there, I duly served the foregoing petition, order and summons on the above-named respondent(s), by either (check one): leaving with (for in hand); or leaving at the usual place of abode (for abode) at The within and foregoing is a true and attested copy of the original petition, order, and summons.
ATTEST (Signature and title of proper officer)

COPY ENDORSEMENT SERVICE TRAVEL

TOTAL

STATE OF CONNECTICUT
COUNTY OF SS. NAME OF PERSON(S) SERVED. DATE OF SERVICE

FEES

Then and there, I duly served the foregoing petition, order and summons on the above-named respondent(s), by either (check one): leaving with (for in hand); or leaving at the usual place of abode (for abode) at The within and foregoing is a true and attested copy of the original petition, order, and summons.
ATTEST (Signature and title of proper officer)

COPY ENDORSEMENT SERVICE TRAVEL

TOTAL

STATE OF CONNECTICUT
COUNTY OF SS.

FOR MAIL SERVICE
UNITED STATES POST OFFICE AT (Town) DATE OF SERVICE

Then and there, by virtue hereof, I made service of the within petition, order and summons by depositing a true and attested copy by United States Post mail, postage prepaid, addressed to , by (check one): restricted delivery, return receipt requested; or first class mail; or certified mail, return receipt requested. The within and foregoing is the original petition, order and summons with my doings thereon endorsed.
ATTEST (Signature and title of proper officer)

FEES
COPY ENDORSEMENT SERVICE TRAVEL

TOTAL

JD-JM-144 Rev. 9-02 (Back)

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