COVER SHEET STATE OF ARKANSAS CIRCUIT COURT: JUVENILE DELINQUENCY/EJJ 1 //2017 This delinquency/EJJ cover sheet is required by Supreme Court Administrative Order 8 to be completed and filed for every juvenile. The data contained herein shall not be admissible as evidence in any court proceeding or replace or supplement the filing and service of pleadings, orders, or other papers as required by law or Supreme Court rule. Instructions are located at www..gov. County: District: Filing Date: Judge: Division: Case ID: Case Type (select one): (JD) Delinquency (EJ) Extended Juvenile Jurisdiction Is this an amendment? Yes No If yes, reason: Does this juvenile have other active cases? Yes No Case IDs: Juvenile information Last Name Alias Suffix Address First Name Middle Name City Contexte ID State DLN/State ID ZIP SSN Custody date Date of Birth Arrest date Sex Male Female ATN Ethnicity Hispanic Non - Hispanic Was this a school - related arrest? Yes No Race Ch one School Status Ch one Educational Accommodation IEP 504 N/A Interpreter needed? Language Other: Parent /Guardian 1 Parent /Guardian 2 Relationship Relationship Last Name Last Name Suffix Suffix First Name First Name Middle Name Middle Name DL N /State ID DL N /State ID SSN SSN Date of Birth Date of birth Address Address City, State ZIP City, State ZIP Email Email Interpreter needed? Interpreter needed? American LegalNet, Inc. www.FormsWorkFlow.com COVER SHEET STATE OF ARKANSAS CIRCUIT COURT: JUVENILE DELINQUENCY/EJJ 2 //2017 Code # Offense name/DescriptionA/S/C Offense Date Counts F/M Class Other Juveniles/Defendants: Related Case IDs: Attorney Providing Information: Bar #: Email Address: Phone: Manner of filing (choose one): Date of transfer hearing: Was juvenile222s attorney present? Yes No If a detention hearing related to this petition has already occurred, Date of detention hearing (HD60): Detention hearing outcome: Continue detention Release on personal recognizance Release to parent/guardian/custodian Release to qualified person/agency Reasonable restrictions Release upon order to appear Release upon bond Was juvenile222s attorney present? Yes No American LegalNet, Inc. www.FormsWorkFlow.com