State of Alabama Unified Judicial System Form JU- 4 (front) INFORMAL ADJUSTMENT Case Number Rev. 1/09 IN THE JUVENILE COURT OF _________________________________________________ COUNTY, ALABAMA (Name of County) In the Matter of _________________________________________________________________, a child A complaint concerning the above–named child has been filed and an informal adjustment of this matter is hereby agreed to, subject to the following terms, conditions, and understandings: ** 1. 2. That this court has jurisdiction to consider this matter, and That the child and his/her parents or custodian have been advised of their rights This Agreement will be in force for six (6) months unless sooner terminated. It is further understood that the parents or custodian and the child will be notified upon termination or dismissal of this Agreement. I acknowledge that I have read, or have had read to me, the information which is printed on the reverse side of this form and it has been explained to me. Agreed : _____________________________________ Child ________________________________________________________ Parent / Custodian Recommended and Agreed : ______________________________________ Date _____________________________________________________ Intake Officer** ** Note to Intake Officer: In using this Agreement, you must explain Rule 15 of the Alabama Rules of Juvenile Procedure IN FULL and satisfy yourself that all conditions of this Rule are understood by all parties. (Rule 15 printed on the back of this form.) Rule 15, Ala.R.Juv.P; Ala. Code 1975, §12-15-119 INTAKE OFFICE : (Original) PARENT/LEGAL GUARDIAN/CUSTODIAN: (Copy) CHILD: (Copy) American LegalNet, Inc. www.FormsWorkFlow.com Form JU–4 (back) Rev. 1/09 RULE 15. INFORMAL ADJUSTMENT ALABAMA RULES OF JUVENILE PROCEDURE “ (A) If there is sufficient evidence to bring the child within the jurisdiction of the court, and following advisement of rights to the child and his parents or custodian, including the right to counsel at this and all other stages of the proceeding, upon recommendation of the intake office the matter may be held open and the intake office may attempt, with the consent of the child and his patents or custodian, to make satisfactory informal adjustment. (B) Informal adjustment shall include counseling and advising the child and his parents or custodian by the intake officer and other appropriate persons, which persons may also include the judge of the juvenile court, and informal adjustment may also include, with the consent of the juvenile and with the consent of his parents or custodian, supervision by the juvenile officer and the temporary placement of the juvenile with persons other than his parents or custodian. Referrals may be made to public and private agencies which may provide assistance or services to the juvenile and his parents or custodian. (C) The intake officer may either terminate the informal adjustment process and dismiss the child without further proceedings or terminate the informal adjustment process and file a petition in the court if at any time : (1) It appears that the child and his parents or custodian have received the maximum benefit from the informal adjustment process; (2) The child or his parents or custodian declines to participate further in the informal adjustment process; (3) The child or his parents or custodian denies the jurisdiction of the court; (4) The child or his parents or custodian expresses a desire that the facts be determined by the court; (5) The child fails without reasonable excuse to attend scheduled conferences; (6) The child appears unable or unwilling to benefit from the informal adjustment process; (7) The intake officer becomes apprised of new or additional information which makes it appear that further efforts at informal adjustment would not be in the best interests of the juvenile or of society; or (8) Other sufficient reasons exist for terminating the informal adjustment process. (D) The informal adjustment process shall not continue beyond a period of six months from its commencement. (E) Upon termination of the informal adjustment process and dismissal of the child without further proceedings, the intake officer shall notify the child and his parents and custodian thereof and report such action to the court.” American LegalNet, Inc. www.FormsWorkFlow.com