INTERSTATE COMPACT ON JUVENILES REQUISITION FOR ESCAPEE OR ABSCONDER REQUISITION FOR JUVENILE CHARGED WITH BEING DELINQUENT (RENDITION AMENDMENT) FORM II FORM II TO: DATE: (Appropriate Court or Executive Authority) FROM: (Name of Court or Agency) I, requisition the return of born on in accordance with the Interstate Compact on Juveniles, Article V and the Rendition Amendment, Return of an Escapee, Absconder, or Juvenile Charged with being Delinquent. Said juvenile (check appropriate item): was paroled to the custody of was placed on probation subject to the supervision of was committed to (institution or agency) OR has fled to avoid prosecution (Rendition Amendment) and, despite applicable provisions of law, has: escaped absconded fled (Rendition Amendment) and is now believed to be in your jurisdiction at . Juvenile’s physical description: Ht: Wt: Eyes: Hair: Race/Sex: Identifying marks or scars: Attached are two certified true copies of the judgment, formal adjudication, order of commitment, or petition alleging delinquency, verifying juvenile’s legal status. 1. Particulars of adjudication or allegations of delinquency: 2. Circumstances of breach of terms of probation, parole, escape from institution or fleeing to avoid prosecution: Accordingly, the undersigned hereby prays for the return of said juvenile as authorized by the Interstate Compact on Juveniles. If Requisition is honored, please notify: (Name, title, address, telephone no.) Signed: (Judge or Compact Official) (Date) (Requisition must be verified by affidavit, signed by requisitioner, and notarized.) AFFIDAVIT OF VERIFICATION ______________________________________________________ (Signature of Requisitioner) On this day of , , personally appeared before me , proved to me on the basis of satisfactory evidence to be the person whose name is subscribed to this instrument and acknowledged that he she executed the same. Subscribed and sworn to before me on this day of , . ________________________________________________________________ NOTARY PUBLIC Residing at: My Commission expires: This is the official ICJ Form II as approved by AJCA in August 2000. No state or other governmental entity party to the Interstate Compact on Juveniles may change, alter or otherwise modify any form that has been approved and adopted for use by the Association of Juvenile Compact Administrators. No other form may be substituted. (See Rule 3-103: Revision/Modification of Forms) ICJ FORM II AJCA Policy and Procedure Manual REVISED JANUARY 2007 3.71 January 2007 American LegalNet, Inc. www.FormsWorkFlow.com