Form 246 Rev 7/18 The Family Court of the State of Delaware In and For New Castle County Kent County Sussex County PETITION FOR EXTENDED JURISDICTION Petitioner v. Respondent COMES NOW , on this date , petitioner , hereby requests that this Court enter an Order extending jurisdiction over the above named petitioner beyond his/her eighteenth (18 th ) birthday pursuant to 247929 of Title 10 of the Delaware Code to oversee the provision of Independent Living (IL) services to which he/she is entitled, and appoint a n attorney to assist/represent petitioner if the petitioner is currently represented by a Child Attorney . In support of this petition, the following is alleged: Petitioner entered the custody of DSCYF/DFS on and will be in custody of DSCYF/DFS at the time he/she attains (18) years of age on a nd will exit foster care after his/her eighteenth birthday. As such, petitioner meets the DSCYF/DFS criteria for eligibility for the provis ions of IL servi ces under its IL Preparation policy. DSCYF/ DFS has implemented an IL Preparation policy which states, in relevant part: The Division will provide independent living (223IL224) services to assist youth205 who have exited foster care after their eighteenth birthday but have not reached age twenty-one. Eligible youth and 205 adults shall receive developmentally appropriate services to prepare them for independent living. DSCYF/ DFS is currently providing IL Services or actively working to formulate a sustainable IL plan for petitioner. Additional d etails regarding IL plan/provider : Petitioner222s representative (Child Attorney) supports this petition for extended jurisdiction. Please print the name of the representative: If applicable, Petitioner222s CASA supports this petition for extended jurisdiction. Please print the name of the CASA: DSCYF/DFS supports this petition for extended jurisdiction. Name D.O.B. DSCYF/DFS File Number I ndependent Living Program Street Address (Inc. Apt) 1825 Faulkland Road Wilmington, DE 19805 P.O. Box Number Petition Number Counsel for DSCYF/DFS : C ity/State/Zip Code Delaware Department of Justice Child Protection Unit Representative / Child Attorney 820 N. French Street, 5th Floor Wilmington, DE 19801 American LegalNet, Inc. www.FormsWorkFlow.com Form 246 Rev 7/18 Petitioner consents to Extended Jurisdiction pursuant to 10 Del.C. 247 929. By such consent, the petition understands that he/she is: 1. Eligible for referral to needed services, legal or otherwise, if available; 2. Eligible to receive education assistance, if available; 3. Eligible to receive employment related services, if available; 4. Eligible to receive housing assistance, if available; 5. Eligible to receive transition services, if available; 6. Eligible to receive services which are in existence and have been funded; 7. Eligible to receive independent living services, if available. The Petitioner understands that by such consent he/she is: 1. Not eligible to receive unfunded services; 2. Not eligible to have new entitlements created. Petitioner further understands that Extended Jurisdiction will terminated on his/her 21st birthday, or if he/she: 1. No longer consents to the Court222s extended jurisdiction; 2. No longer consents to the continued assistance of DSCYF (i.e. independent living services); 3. Fails to cooperate with DSCYF (i.e. independent living services); or 4. For other good cause shown (i.e. youth resides out of state or is incarcerated). WHEREFORE, the petitioner (and counsel) respectfully requests that this Court issue order for extended jurisdiction and continuing appointment of named representative. Petitioner Child Attorney American LegalNet, Inc. www.FormsWorkFlow.com