IW-1716, 11/18 Notice of Rights and Obligations Indian Child Welfare Act 24724748.028, 48.21(3m), 48.21(3)(d), 48.24(1m), 48.243, 938.21(3)(d),and 938.243, Wisconsin Statutes This forms shall not be modified. It may be supplemented with additional material. STATE OF WISCONSIN, CIRCUIT COURT, COUNTY IN THE INTEREST OF Name Date of Birth Notice of Rights and Obligations Indian Child Welfare Act Case No. This proceeding is subject to the Indian Child Welfare Act. If a petition has not yet been filed, a referral may result in a petition to the court. The child/juvenile is alleged to be in need of protection or services: You have the right to: request counseling. know the nature and possible consequences of the proceedings: custody hearing: to determine whether the child/juvenile should be placed or remain in custody; future hearings: to determine if the allegations are true and whether any disposition should be imposed. remain silent: The silence of any party in a non-delinquency proceeding may be relevant and considered by the court. confront and cross-examine witnesses. present and subpoena witnesses. an attorney: If the child/juvenile desires to be represented by an attorney, the public defender shall appoint an attorney. Parents may be required to reimburse the state or county for the attorney and to contribute toward the expenses of post-adjudication services to the child/juvenile, including alcohol or drug treatment or education. If the parent or Indian custodian desires to be represented by an attorney and is determined to be indigent, the public defender shall appoint an attorney. intervene at any point in the proceeding, if a parent or Indian custodian is not already a party. request up to 20 additional days to prepare for the initial proceeding. request transfer to tribal court. have the allegations proven by clear and convincing evidence. a trial: In juvenile in need of protection or services proceedings: to the court In child in need of protection or services proceedings: to the court or a jury. a substitution of judge if the request is made before the end of the plea hearing and the law does not otherwise prohibit a substitution. Potential consequences of this proceeding may include: removal of child/juvenile from the home of the parent(s), guardian, or Indian custodian. placement outside the home, including a relative home, foster home, group home, or residential care center. a finding that the child/juvenile is in need of protection or services. a dispositional order entered containing specific conditions of supervision and/or return. transfer of legal custody. potential grounds for future termination of parental rights. I have received a written copy of the above rights and obligations. Signature Print or Type Name Date Signature Print or Type Name Date Signature Print or Type Name Date American LegalNet, Inc. www.FormsWorkFlow.com