IN THE CIRCUIT COURT OF THE ___________ JUDICIAL CIRCUIT IN AND FOR ___________________ COUNTY, FLORIDA JUVENILE DIVISION In the Interest of ) ) ) ) ) Case No. a child children ORDER TO TAKE INTO CUSTODY TO: A(n) verified petition affidavit having been filed in this case, alleging facts which under existing law are determined to be sufficient to authorize taking into custody the below- named/ identified child children, believed to be of an age subject to the juvenile jurisdiction of the circuit court; therefore You are commanded to take the following Name Age Sex Date of birth Race Address ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ child / children into custody: ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ____________________ ____________________ ____________________ ____________________ ____________________ ____________________ ____________________ ____________________ ____________________ ____________________ ____________________ ____________________ ____________________ ____________________ ____________________ ____________________ ____________________ ____________________ ____________________ Identifying description Parent/ Custodian Address For the following reasons: ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ ___________________ Upon taking the child children into custody, you will deliver him/her/them to: to be held pending a detention hearing or upon further order of this court. Affidavit For Order To Take Into Custody {8.904} Page 1 of 2 American LegalNet, Inc. www.USCourtForms.com ORDERED in the circuit court in and for County, Florida, on , 20 . __________________________________ Circuit Judge RETURN This order to take into custody was executed at m. on , 20 by the undersigned. __________________________________ (Title) Affidavit For Order To Take Into Custody {8.904} Page 2 of 2 American LegalNet, Inc. www.USCourtForms.com