JDF 54 2 D & N Motion for Special Action R 7 - 12 District Court Denver Juvenile Court County, Colorado Court Address: THE PEOPLE OF THE STATE OF COLORADO In the interest of: Child(ren) and Concerning Respondent(s) COURT USE ONLY Attorney /CASA/GAL or Party Without Attorney (Name and Address): Phone Number: E - mail: FAX Number: Atty. Reg. #: Ca se Number: EP DN Division Courtroom D & N MOTION FOR SPECIAL ACTION Motion is hereby made for authorization of placement as follows: Placement change Out of state travel Bench warrant . Child(ren) name(s ): Is the Child(ren)(s) in a permanent home? Y es No If yes when was it ordered? Prior placement: Current placement: Date of placement change: Reason for change in placement: Legal custody of the child(ren) is with: Next hearing is scheduled for: By: Casew orker/ Supervisor Attorney for GAL CASA Parties notified: Caseworker/ Supervisor Attorney for GAL CASA Respondent Parent American LegalNet, Inc. www.FormsWorkFlow.com