WASHINGTON PATTERN FORMS COMMITTEE
JUVENILE
COURT
FORMS
For
optional use in the courts of Washington
Published
by
The
Pattern Forms Committee,
The
Juvenile Forms Subcommittee and
The
Administrative Office of the Courts
Olympia, Washington
Fall
2000, Updated March, 2007
Juvenile
Court Forms
Table of Forms
Page
JU-1. Reserved
JU-2. Shelter
Care Proceedings............................................................................. 1
JU-3. Dependency
Proceedings............................................................................. 1
JU-4. Proceedings
to Terminate Parent-Child Relationship................................... 1
JU-5. Proceedings
for Children in Need of Services (CHINS)/ At-Risk Youth ....... 1
JU-6. Juvenile
Offense Proceedings - Diversion Agreements............................... 2
JU-7. Juvenile
Offense Proceedings in Juvenile Court........................................... 2
JU-8. Declining
Juvenile Court Jurisdiction............................................................. 3
JU-9. Right
to Lawyer and Experts in All Juvenile Court Proceedings................... 3
JU-10. Juvenile
Court Records................................................................................. 3
JU-11. Miscellaneous................................................................................................ 3
JU-12. Petition For Review of
Out-of-Home Placement........................................... 3
JU-13. Truancy Proceedings..................................................................................... 3
EM-1. Emancipation
of Minors................................................................................. 4
1. RESERVED - JU-1
2. SHELTER CARE PROCEEDINGS
- JU-2
|
Form
Number
|
Form
Title
|
Last
Revised
|
|
JU-02.0100
|
Motion
for Order to Take Child into Custody (MT)
|
7/2003
|
|
JU-02.0110
|
Order
Taking Child into Custody and Placement in Shelter Care (ORTCC)
|
9/2000
|
|
JU-02.0150
|
Declaration
of Shelter Care Placement Notification (DCLR)
|
9/2000
|
|
JU-02.0200
|
Shelter
Care Hearing Order q
Agreed q Contested (SCOR)
|
6/2006
|
|
JU-02.0220
|
Order
Authorizing Continued Shelter Care (OACSC)
|
9/2000
|
|
JU-02.0240
|
Order
and Authorization Re Health Care and Education (ORHCE)
|
3/2007
|
3.
DEPENDENCY PROCEEDINGS - JU-3
|
JU-03.0100
|
Dependency
Petition (DPP)
|
9/2001
|
|
JU-03.0200
|
Notice
and Summons/Order (Dependency/Guardianship/Termination of Parent-Child
Relationship) (NTSM)
|
9/2000
|
|
JU-03.0210
|
Motion
and Declaration to Publish Notice and Summons (MTAF)
|
9/2000
|
|
JU-03.0220
|
Order
to Publish Notice and Summons (ORPUB)
|
9/2000
|
|
JU-03.0300
|
Order
Appointing Guardian Ad Litem (ORAPGL)
|
9/2000
|
|
JU-03.0400
|
Order
of Dependency (OROD)
|
6/2004
|
|
JU-03.0410
|
Order
of Disposition on Dependency (ORD)
|
6/2004
|
|
JU-03.0500
|
Dependency
Review Hearing Order/ q
Permanency Planning Hearing (DPRHO)
|
6/2006
|
|
JU-03.0600
|
Order
of Financial Support (ORS)
|
9/2000
|
|
JU-03.0700
|
Guardianship
Petition (PTAPGD)
|
6/2004
|
|
JU-03.0710
|
Statement
and Certification of Proposed Guardian (DCLR)
|
9/2000
|
|
JU-03.0720
|
Statement
of Parent Waiving Presentation of Order of Guardianship (WV)
|
9/2000
|
|
JU-03.0730
|
Hearing,
Findings, Conclusions and Order Appointing Guardian (ORAPGD)
|
6/2004
|
|
JU-03.0800
|
Declaration
of Petitioner for Nonparental Custody Order (DCLR)
|
9/2000
|
4. PROCEEDINGS TO TERMINATE PARENT-CHILD
RELATIONSHIP - JU-4
|
JU-04.0100
|
Petition for Termination of Parent-Child Relationship
(PTPCR)
|
6/2004
|
|
JU-04.0110
|
Hearing,
Findings, and Order Terminating Parent-Child Relationship (ORTPCR)
|
6/2004
|
5. PROCEEDINGS FOR CHILDREN IN NEED OF
SERVICES (CHINS) / AT-RISK-YOUTH - JU-5
|
JU-05.0100
|
Child
in Need of Services (CHINS) Petition (PTCIN)
|
6/2004
|
|
JU-05.0200
|
Notice
of Hearing on Child in Need of Services (CHINS) Petition (NTHG)
|
9/2000
|
|
JU-05.0250
|
Indian
Child Welfare Act Notice 25 U.S.C §
1912 (a) (BIAN)
|
6/2005
|
|
JU-05.0255
|
Proof
of Mailing ICWA Notice (AFML)
|
6/2005
|
|
JU-05.0300
|
Order
on Child in Need of Services (CHINS) Petition (ORCIN)
|
6/2004
|
|
JU-05.0400
|
Order
of Disposition (CHINS) (ORD)
|
6/2004
|
|
JU-05.0500
|
Order
on Review Hearing (CHINS) (ORRVH)
|
6/2004
|
|
JU-05.0600
|
Petition
for At-Risk-Youth (PTARY)
|
6/2004
|
|
JU-05.0650
|
Notice
of Hearing on At-Risk-Youth Petition (NTHG)
|
9/2000
|
|
JU-05.0700
|
Order
on At-Risk-Youth Petition (ORARY)
|
6/2004
|
|
JU-05.0710
|
Order
of Disposition (At-Risk-Youth) (ORD)
|
6/2004
|
|
JU-05.0800
|
Order
on Review Hearing (At-Risk-Youth) (ORRVH)
|
6/2004
|
|
JU-05.0900
|
Motion
to Set Show Cause Hearing - Contempt (CHINS/At-Risk-Youth) (MT)
|
6/2002
|
|
JU-05.0910
|
Order
to Set Show Cause Hearing – Contempt (CHINS/At-Risk-Youth) (NTHG)
|
9/2000
|
|
JU-05.0920
|
Order
on Hearing re Contempt q
Review Hearing (CHINS/At-Risk-Youth) (ORCN)
|
6/2002
|
6. JUVENILE OFFENSE PROCEEDINGS --
DIVERSION AGREEMENTS - JU-6
|
JU-06.0100
|
Advice
about Diversion (When Confinement is Possible)
|
6/2004
|
|
JU-06.0120
|
Diversion
Agreement
|
6/2002
|
|
JU-06.0150
|
Advice
about Diversion (When Confinement is not Possible)
|
6/2004
|
|
JU-06.0200
|
Waiver
of Right to Lawyer (Diversion (WVC)
|
9/2000
|
|
JU-06.0300
|
Interpreter’s
Declaration (Attachment)
|
9/2000
|
7. JUVENILE OFFENSE
PROCEEDINGS IN JUVENILE COURT - JU-7
|
JU-07.0100
|
Information (INFO)
|
9/2001
|
|
JU-07.0200
|
Notice
and Summons/Order (NTSM)
|
9/2000
|
|
JU-07.0210
|
Declaration
of Service (AFSR)
|
9/2000
|
|
JU-07.0300
|
Motion
and Declaration for Order for Warrant of Arrest (MTADPC)
|
9/2000
|
|
JU-07.0310
|
Order
for Issuance of Warrant of Arrest (ORW)
|
9/2000
|
|
JU-07.0320
|
Warrant
of Arrest (WA)
|
9/2000
|
|
JU-07.0330
|
Motion
and Declaration for Order to Detain Material Witness (MTAF)
|
9/2000
|
|
JU-07.0400
|
Acknowledgment
of Advice of Rights (AKAR)
|
6/2002
|
|
JU-07.0500
|
Order
of Detention (ORDT)
|
9/2000
|
|
JU-07.0510
|
Order
of Release (ORRL)
|
9/2000
|
|
JU-07.0520
|
Sexual
Assault Protection Order (ORSXP)
|
6/2006
|
|
JU-07.0530
|
Order
Setting Hearing q
Change of Plea q
Adjudicatory Hearing (ORH)
|
9/2000
|
|
JU-07.0600
|
Statement
on Plea of Guilty (STJOPG) (Published separately)
|
|
|
JU-07.0600A
|
“Offender
Registration” Attachment (Published separately)
|
|
|
JU-07.0700
|
Judgment
and Order on Information (HFDIJ)
|
9/2000
|
|
JU-07.0800
|
Order
on Adjudication and Disposition (ORD)
|
6/2006
|
|
JU-07.0820
|
Advice
of Rights Regarding Juvenile Records (ADR)
|
6/2004
|
|
JU-07.0900
|
Record
of Advice of Right to Appeal (ADR)
|
9/2000
|
|
JU-07.0910
|
Advice
of Rights to Revision (ADR)
|
9/2000
|
|
JU-07.0920
|
Notice
of Appeal q
Court of Appeals q
Supreme Court (NACA)(NTASC)
|
9/2000
|
|
JU-07.0930
|
Motion
for Revision (MTFR)
|
9/2000
|
|
JU-07.1000
|
Motion
and Declaration for Hearing on Modification of Court Order (MTAF)
|
6/2002
|
|
JU-07.1010
|
Notice
of Hearing on Modification of Court Order (NTHG)
|
9/2000
|
|
JU-07A.1020
|
Order
Modifying Disposition (OMD)
|
6/2002
|
|
JU-07B.1020
|
Order
Modifying Disposition (OMD)
|
9/2000
|
|
JU-07.1100
|
Motion
and Declaration for Order Transferring Case (MTAF)
|
9/2000
|
|
JU-07.1110
|
Order
Transferring Case (ORTR)
|
9/2000
|
|
JU-07.1300
|
Motion
for Deferred Disposition (MT)
|
9/2001
|
|
JU-07.1310
|
Statement
of Juvenile for Deferred Disposition (STJDD)
|
6/2002
|
|
JU-07.1320
|
Order
of Deferred Disposition (ORDFD)
|
6/2004
|
8. DECLINING JUVENILE COURT JURISDICTION - JU-8
|
JU-08.0100
|
Motion
and Declaration for Declination Hearing (MTAF)
|
6/2005
|
|
JU-08.0110
|
Hearing,
Findings and Conclusions on Declination Hearing (FNFCL)
|
6/2005
|
|
JU-08.0120
|
Order
on Declination Hearing (ORDJ)
|
6/2005
|
9. RIGHT
TO LAWYER AND EXPERTS IN ALL JUVENILE COURT PROCEEDINGS - JU-9
|
JU-09.0100
|
Motion
for Assignment of Lawyer (MT)
|
9/2000
|
|
JU-09.0120
|
Order
Assigning Lawyer (OAPAT)
|
9/2000
|
|
JU-09.0200
|
Waiver
of Lawyer by Parent/Guardian/Custodian (WVC)
|
9/2000
|
|
JU-09.0210
|
Waiver
of Lawyer (Juvenile/Child) (WVC)
|
9/2000
|
10. JUVENILE COURT RECORDS -
JU-10
|
JU-10.0100
|
Motion
and Declaration for Order Authorizing Inspection of Records (MTAF)
|
9/2000
|
|
JU-10.0110
|
Order
Regarding Inspection of Records (ORAR)
|
9/2000
|
|
JU-10.0200
|
Motion
and Declaration for Order to Correct or Destroy Improperly Retained Records
(MTAF)
|
9/2000
|
|
JU-10.0210
|
Order
Regarding Correction or Destruction of Improperly Retained Records (ORIRR)
|
9/2000
|
|
JU-10.0300
|
Motion
and Declaration to Seal Records of Juvenile Offender Pursuant to RCW
13.50.050(11) (MTAF)
|
6/2004
|
|
JU-10.0315
|
Notice
of Respondent’s Motion to Seal Records of Juvenile Offender Pursuant to RCW
13.50.050(11) (NT)
|
9/2000
|
|
JU-10.0320
|
Order
of Motion to Seal Records of Juvenile Offender Pursuant to RCW 13.50.050(11)
(ORSF)
|
9/2000
|
11. MISCELLANEOUS - JU-11
|
JU-11.0100
|
Notice
of Hearing (NTHG)
|
9/2000
|
|
JU-11.0200
|
Declaration
(DCLR)
|
9/2000
|
|
JU-11.0300
|
Subpoena
(SB)
|
9/2000
|
|
JU-11.0310
|
Subpoena
Duces Tecum (SBDT)
|
9/2000
|
|
JU-11.0320
|
Return
of Subpoena (RTSB)
|
9/2000
|
|
JU-11.0400
|
Motion
and Declaration for Change of Judge (MTAF)
|
9/2000
|
|
JU-11.0410
|
Order
for Change of Judge q
Granting Motion q
Denying Motion (ORCJ)(ORDYMT)
|
9/2000
|
12. PETITION
FOR Review of Out-of-Home Placement – JU–12
|
JU-12.0100
|
Petition
for Review of Out-Of-Home Placement (PTDDP)
|
9/2001
|
|
JU-12.0400
|
Order
on Review of Out-Of-Home Placement (OROHC)
|
6/2004
|
|
JU-12.0500
|
Review
Hearing Order/Permanency Planning Hearing (DDPRHO)
|
6/2004
|
13. TRUANCY PROCEEDINGS -
JU-13
|
JU-13.0100
|
Petition
Regarding Truancy (PTTRU)
|
9/2001
|
|
JU-13.0200
|
Notice
and Summons/Order to Appear (NTSM)
|
9/2000
|
|
JU-13.0210
|
Return
of Service (RTS)
|
9/2000
|
|
JU-13.0215
|
Acceptance
of Service (ACSR)
|
9/2000
|
|
JU-13.0300
|
Motion
and Order to Stay Truancy Proceedings Pending Intervention (MT, ORSP)
|
9/2000
|
|
JU-13.0350
|
Progress
Report and Follow-up (RPT)
|
9/2000
|
|
JU-13.0400
|
Findings
and Order on Truancy Petition q Findings of Truancy q Dismissal of Petition (ORFCT)(ORDSM)
|
6/2002
|
|
JU-13.0600
|
Request
of Community Truancy Board for Further Action (RQTB)
|
9/2000
|
|
JU-13.0610
|
Order
on Request of Community Truancy Board for Further Action (ORRQTB)
|
9/2000
|
|
JU-13.0700
|
Motion
to Set Show Cause Hearing - Contempt (MTSC)
|
6/2002
|
|
JU-13.0710
|
Order
to Set Show Cause Hearing - Contempt (ORTSC)
|
9/2000
|
|
JU-13.0720
|
Order
on Hearing Re Contempt q
Review Hearing (ORRVH)
|
6/2002
|
|
JU-13.0800
|
Motion
to Assume Jurisdiction and Order Assuming Jurisdiction (MT and ORAJ)
|
9/2000
|
EM-1. EMANCIPATION OF MINORS -
EM-1
|
EM-01.0100
|
Petition
for Emancipation (PTE)
|
9/2000
|
|
EM-01.0200
|
Notice
of Hearing (NTHG)
|
9/2000
|
|
EM-01.0300
|
Order
Appointing Guardian Ad Litem (ORAPGL)
|
9/2000
|
|
EM-01.0400
|
Decree
of Emancipation (DCE)
|
9/2001
|
|
EM-01.0500
|
Order
Denying Petition for Emancipation (ORDYMT)
|
9/2001
|
