1. � In the matter of � en-USname(s), alias(es) 2. � Date of hearing: en-US � Judge/Referee: en-USBar no. 3. � Notice of hearing for the disposition was given as required by law. 4. � The juvenile has appeared in court in person with parent(s), guardian, legal custodian, guardian ad litem, and � was represented by an attorney. � en-US waived representation by an attorney. � � � � � � � � � � � � � � � � � � � � en-USCounten-USADJUDICATED BYen-USDISMISSEDen-USALLEGATIONSen-USCHARGE CODE(S)en-USPlea*en-USCourten-USJuryen-USBy*en-USMCL Citation/PACC Code � � � � � � � � � � � � � � � � � � � � � � � � en-US6 � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � 9. � The juvenile222s biometric data has been collected in accordance with MCL 28.243. � � � � � � � � � � � � � � � � MCL 324.80131, MCL � 324.81134(12), MCL 324.81135(7), MCL 324.82157, or MCL 333.7408a(12). � � The juvenile's driver's license number is en-US en-US .en-US American LegalNet, Inc. www.FormsWorkFlow.com Order of Disposition, Out-of-Home � (12/18) � Page of Case No. Petition No. � 11. � The licensing sanction is reportable to the Michigan State Police under MCL 333.7408a(12) or MCL 257.625(21)(b). � Revoked. � en-US Suspended en-US days. � en-US Restricted en-US en-US days. 12. � Return of the juvenile to his or her parent would cause a substantial risk of harm to the juvenile or society. � 13. � The juvenile must be placed in an institution outside Michigan because � � a. institutional care is in the best interests of the juvenile, � � b. equivalent facilities to meet the juvenile222s needs are not available within Michigan, and � c. the placement will not cause undue hardship. � � 14. � It is contrary to the welfare of the juvenile to remain in the home because: � 15. � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � en-US(Specify.) � 16. � � � � � � � � � � � � � � � � � � � � � � return home. � � � � � � � � � � � � � � � � � � � � juvenile's health and safety. � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � en-US(Specify � � � � � � � � en-US*Note: � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � en-USreturned home, at any subsequent removal. American LegalNet, Inc. www.FormsWorkFlow.com Order of Disposition, Out-of-Home � (12/18) � Page of Case No. Petition No. en-USIT IS ORDERED: 17. � The juvenile is placed in the temporary custody of this court. 18. � � a. � The juvenile is placed with � � � � � � � en-US . � � � b. � The juvenile is referred to the department for placement and care under MCL 400.55(h). � � � c. � The juvenile is placed in and shall satisfactorily complete the juvenile boot camp program established by the � department. After satisfactorily completing the program, the juvenile shall be placed in the home of � en-US en-US � and shall complete a minimum of 120 to a maximum of 180 days of intensive supervised probation in the community. � � d. � The juvenile is committed to the department under MCL 803.301 (Y.R.A.). The director of the department is appointed � � � � � � � � � � � � � � � � � � � � � � States. Pending transfer to the department, temporary placement is as follows: � 19. � The juvenile is placed on probation. Probation terms are � attached. � � � � � � � � � 20. � Other: en-US(Include reimbursement as required by MCL 712A.18[2] or as permitted by MCL 769.1f.) 21. � Restitution as follows: 22. � The juvenile shall pay � $25.00 for Crime Victim222s Rights Fund. � en-US State minimum costs en-USSpecify for each counten-US . � � $ en-US en-US DNA assessment (not required if item 8 is checked). � � 23. � The review hearing is en-USDate and timeen-US .en-USRecommended by: Referee signature � Date en-USDate � en-USJudge American LegalNet, Inc. www.FormsWorkFlow.com