JC-1623, 05/00 Order on Waiver of Parental Consent for Abortion 24748.375(7), Wisconsin Statutes This form shall not be modified. It may be supplemented with additional material. STATE OF WISCONSIN, CIRCUIT COURT, COUNTY IN THE INTEREST OF Jane Doe, Date of Birth ( a person under the age of 18 ) Order on Waiver of Parental Consent for Abortion Case No. THE COURT FINDS AND CONCLUDES: 1. A Petition has been filed to waive parental consent for an abortion. 2. A clergyperson has filed with the Petition an Affidavit under 24748.375(7)(bm), Wis. Stats. 3. A hearing was held on the Petition at which time evidence was heard relating to the emotional development, maturity, intellect and understanding of the minor; the understanding of the minor about the nature of, possible consequences of, and alternatives to the intended abortion procedure; and other evidence the court found useful in making the determination about waiver of parental consent, including the report of the guardian-ad-litem, if one was appointed. 4a. The minor is mature and well-informed enough to make the abortion decision on her own. 4b. The minor is not mature and well-informed enough to make the abortion decision on her own, in which case I further find: The performance or inducement of the abortion is in the minor's best interest. The performance or inducement of the abortion is not in the minor's best interest. 5. Other findings or conclusions relevant to the Order: THE COURT ORDERS: 1a. The Petition is granted. An abortion may be performed without parental consent. A certified copy of this decision shall be personally served on the minor or her attorney, or the member of the clergy who filed the petition on her behalf. 1b. The Petition is denied. An abortion may not be performed except as otherwise provided by law. A copy of this decision shall be personally served on the minor or her attorney, or the member of the clergy who filed the petition on her behalf. The minor is also notified that she has an immediate right to appeal this decision under 247809.105, Wis. Stats. American LegalNet, Inc. www.FormsWorkFlow.com