Order To Transport (Mentally Disordered Person)
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Order To Transport (Mentally Disordered Person) Form. This is a Missouri form and can be use in 7th Circuit (Clay County) Local Circuit Courts.
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Tags: Order To Transport (Mentally Disordered Person), 378-A, Missouri Local Circuit Courts, 7th Circuit (Clay County)
COURT
COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
......... ..
:
:
Index No.
Calendar No.
CIRCUIT COURT OF CLAY COUNTY, MISSOURI
:
JUDICIAL SUBPOENA
Plaintiff(s)
PROBATE DIVISION
-against:
No.
:
:
Matter of
Defendant(s)
:
......................................................
, an incapacitated person.
ORDER TO TRANSPORT
On this _____ day of ___________________________________, 20____, the Court
THE PEOPLE OF THE STATE OF NEW YORK
TO
considers the application of the Guardian herein requesting the transportation of
, to a mental health facility.
GREETINGS:
The Court finds that there is reasonable cause to believe that the Ward is mentally
disordered, and presents a business and serious physical aside, you and each of you attend before
WE COMMAND YOU, that alllikelihood ofexcuses being laid harm to *her___ / *him___self or to
,
the Honorable
at the
Court
others and should be transported to a mental health facility by the sheriff.
located at
County of
in room
, on the
day of
, 20
, at
o'clock in the
noon, and at any recessed
or adjourned date, to testify and give evidence as a witness in this action on the part of the
WHEREFORE, IT IS HEREBY ORDERED THAT the Sheriff of Clay County,
Missouri, take said
into custody and transport
Your failure to comply to this subpoena is punishable as a contempt of court and will make mental health
*her___/*him___ with
, an appropriate you liable to
the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a
facility, where the
result of your failure to comply. Guardian will make application for *her___ / *his___ admission.
Witness, Honorable
Court in
County,
, one of the Justices of the
day of
, 20
JUDGE
(Attorney must sign above and type name below)
Executed this order on
, 20_______.
Attorney(s) for
Sheriff’s Fees $_______.____
Mileage
$_______.____
Total
$_______.____
Sheriff____________________________________
BY:____________________________________
Office and P.O. Address Clay County, Missouri
Deputy Sheriff,
*Strike if inapplicable
Form 378-A
Revised 3/14/2003
Telephone No.:
Facsimile No.:
E-Mail Address:
Mobile Tel. No.:
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