State of Alabama Unified Judicial System Form JU-40 Dev 10/2011 REQUEST TO APPOINT A JUVENILE COURT MAGISTRATE I. County of ____________________________________ (City or Town) of _______________________________________ II. Please APPOINT the following as a Juvenile Court Magistrate RESCIND appointment for the following: Mr. Ms. Name ________________________________________ Social Security Number _________________________ Home Address_______________________________________________________________________________ Street City State Zip Code Present Employer ____________________________________________________________________________ Employer’s Address __________________________________________________________________________ Mailing City State Zip Code Employer’s Telephone Number __________________________________________________________________ Work Email Address____________________________________________________________________ Present Job Title and Duties ____________________________________________________________________ Check only one: The above-named person is a Unified Judicial System (UJS( Employee or; working in the juvenile court and paid by _______________________ I certify that I meet all of the following requirements established by law for public officers, designated in numbers (1) through (7) below, and that I am neutral and detached from law enforcement as mandated by decisions of the U. S. Supreme Court designated in numbers (8) through (11) below: (1) Is a resident of the State of Alabama, (2) Is a qualified elector (must be 18 years of age) of the State of Alabama, (3) Has never been convicted of treason, embezzlement of public funds, malfeasance in office, larceny, bribery, perjury or any other crime punishable by imprisonment in the state or federal penitentiary, or, if the person has been convicted of of one of the above offenses he/she has had his civil and political rights restored by pardon; (4) Has never been adjudicated to be an idiot or insane; (5) Does not have any unpaid judgment against him/her for any moneys received by him/her in any official capacity due to the United States, this State, or any County or Municipality thereof: (6) Is not a soldier, seaman, or marine in the regular army or navy of the United States; and (7) Does not hold an office of profit under the United States or under this state; NEUTRAL AND DETACHED REQUIREMENT: (8) Is not affiliated with prosecution and police in any manner; (9) Is not in any way assigned to police and subject to the supervision of the chief of police, prosecutor, etc.; and (10) Is not connected with law enforcement activities in any way. (11) Is neutral and detached from the executive and legislative branches of government and does not hold any elective or appointive offices or positions of trust unless expressly authorized by law. ________________________________________________ ________________________________________________ Print or Type Name of Potential Appointee Signature of Potential Appointee IMPORTANT NOTE: If the person being recommended for appointment as a juvenile court magistrate intends to serve as both a juvenile court magistrate and a municipal court magistrate, the person, if appointed can be paid for only one position; otherwise, the appointee will be considered as holding two offices of profit in violation of Article XVII, § 280, Constitution of Alabama of 1901. III. I do attest to the fact that the heretofore requested appointee meets all of the above requirements established by law for public officers, designated in numbers (1) through (7) above, and is neutral and detached from law enforcement as mandated by decisions of the U. S. Supreme Court designated in numbers (8) through (11) above. Presiding Juvenile Court Judge ___________________________ Signature _______________________________ Circuit Clerk ___________________________________________ Signature _______________________________ Court Address (city, state, and zip code) _____________________________________________________________ Court Telephone Number __________________________________________________________________________ Please Mail Form To: Administrative Office of Courts, Magistrate Appointments, 300 Dexter Avenue, Montgomery, AL 36104-3741 or Fax to Joy Evans 334.954.3142 or Email to joy.evans@alacourt.gov American LegalNet, Inc. www.FormsWorkFlow.com