State of Alabama Unified Judicial System JU-25 Sample ORDER OF ADJUDICATION OF DEPENDENCY/DISPOSITION/MODIFICATION Case Number 05/10 IN THE JUVENILE COURT OF___________________ COUNTY, ALABAMA (Name of County) In the Matter of _______________________________________, a child Date of adjudicatory hearing: ____________________ Note: Check which parties and attorneys or others were present at the hearing, place names in the blanks, and check whether or not the attorneys appointed retained. Child's Attorney__________________ Appt. Rtnd. Child _________________________ DHR worker ___________________ Mother ________________________ Father _________________________ Custodian ______________________ Other _________________________ Foster Parents __________________ GAL ___________________________ Attorney ________________________ Atty/GAL _______________________ Atty/GAL _______________________ Attorney ________________________ Attorney ________________________ Attorney ________________________ The Court having considered the agreement stipulation of facts [CHECK WHICH BOXES ARE APPLICABLE]: 1. Appt. Appt. Appt. Appt. Appt. Appt. Appt. Rtnd. Rtnd. Rtnd. Rtnd. Rtnd. Rtnd. Rtnd. evidence presented, the Court finds as follows That continuation of the residence of the child in his or her home would be contrary to the welfare of the child because: After reviewing the attached Department’s written court report dated ________, p. ____, and based on the testimony of the parties, I incorporate into this Order the findings in the court report; After reviewing the attached Department’s written court report dated ________, p. ____, and based on the testimony of the parties, I modify the findings in the court report as follows: 2. That based on clear and convincing evidence, competent, material, and relevant in nature, the above-named child is dependent pursuant to Ala. Code 1975, §12-15-102(8), based on the following facts: (a) That the efforts made by the Department to prevent the removal of the child from his or her home were were not reasonable. The Department’s efforts consisted of the following: After reviewing the attached Department’s written court report dated ________, p. ____, and based on the testimony of the parties, I incorporate into this Order the findings in the court report; After reviewing the attached Department’s written court report dated ________, p. ____, and based on the testimony of the parties, I modify the findings in the court report as follows: (b) That an emergency situation exists which requires the immediate temporary removal of the child from his or her home and that under the conditions described in the Department’s attached written court report dated _______, p.______, reasonable efforts were not required/appropriate because of the emergency situation as follows: After reviewing the attached Department’s written court report dated ________, p. ____, and based on the testimony of the parties, I incorporate into this Order the findings in the court report; After reviewing the attached Department’s written court report dated ________, p. ____, and based on the testimony of the parties, I modify the findings in the court report as follows: American LegalNet, Inc. www.FormsWorkFlow.com JU-25 Sample (Back) 05/10 ORDER OF ADJUDICATION OF DEPENDENCY/DISPOSITION/MODIFICATION Case Number [Note: The following items need to be completed only if these situations apply]: That reasonable efforts ARE NOT REQUIRED to be made because: the parental rights of the mother the father to a sibling have been involuntary terminated: ______________. this court has determined that the mother the father has subjected the child or a sibling of the child to an aggravated circumstance, specifically __________________________________________________________________, and the risk of child abuse or neglect is too high for the child to remain at home safely or to be returned home. this court has determined that the mother the father committed murder pursuant to Ala. Code 1975, {13A-6-2, or manslaughter pursuant to Ala. Code 1975, {13A-6-3, of ________________________________ another child of the parent or the other parent of the child, as shown in Case No. _________________________________; this court has determined that the mother the father aided or abetted, attempted, conspired, or solicited to commit murder or manslaughter pursuant to Ala. Code 1975, {13A-4-_____, of ________________________ another child of the parent or the other parent of the child, as shown in Case No. ___________________________________; this court has determined that the mother the father committed Assault 1st pursuant to Ala. Code 1975, {13A-6-22, nd Assault 2 pursuant to Ala. Code 1975, {13A-6-23, which resulted in the serious bodily injury to the child or ______________________________________, another child of the parent, or the other parent of the child. (c) A permanency hearing is scheduled to take place at _____________________________, which is within 30 days from today’s date. It is hereby ORDERED, ADJUDGED, and DECREED as follows [CHECK WHICH BOXES ARE APPLICABLE]: Dismissed on Motion of Petition for Lack of Prosecution on Failure of proof Petition sustained Adjudicated Dependent. Custody transferred to _____________________________ County Department of Human Resources ___________________ Discretion in planning and placement Placement with __________________________________________________________ DHR to supervise for ______________________________ Other _________________________________________________ _______________________________________________________________________________________________________ Case to be set: Review _____________________________ Permanency Hearing ___________________________________ To Terminate On _________________________ Motion Terminated Court Costs: Waived Attorney Fees ___________ ___________ ___________ Taxed to __________________________ Amount _________ taxed to ______________________ _________ taxed to ______________________ _________ taxed to ______________________ Prepaid Let execution Recoupment by _______________ Recoupment by _______________ Recoupment by _______________ Waived Waived Waived Relieved Relieved Relieved The parties are hereby notified of their right to file a written notice of appeal within fourteen (14) days of this Order being entered into the State Judicial Information System (SJIS). See page 2 for additional terms, conditions, and/or findings. DONE and ORDERED __________________________ (date) ______________________________________________ JUDGE Ala. Code 1975, §§ 12-15-310, 12-15-311, 12-15-312, 12-15-314 American LegalNet, Inc. www.FormsWorkFlow.com