IN THE DISTRICT COURT OF ____________________________________ COUNTY STATE OF OKLAHOMA JUVENILE DIVISION IN THE MATTER OF: DOB: _______________ DOB: _______________ DOB: _______________ DOB: _______________ DOB: _______________ DOB: _______________ ) ) JD- _______________________________________ ) ) Date: ____________________________________ ) Judge: ___________________________________ ) ) Alleged Deprived Child(ren). DISPOSITION ORDER NOW on this _____ day of __________________________, 20_____, the following appearances were made and proceedings held: APPEARANCES: State Mother Mother Father Father Father Father Legal Guardian Child Child Child Child Child Child Tribal Representative GAL/CASA Foster Parent or Placement Interpreter for Mother Father Other Court Reporter Other DHS Attorney Attorney Attorney Attorney Attorney Attorney Attorney Attorney Attorney Attorney Attorney Attorney Attorney Attorney Other Attorney Interpreter for Mother Father Other Other Other Minor child(ren) was/were placed out of home on the ______day of _____________________, 20____. Order of Disposition OK-J-UO-0004 Version 1.1.16.2 Page 1 of 6 OCIS Docket Code: ODISP or DOISP American LegalNet, Inc. www.FormsWorkFlow.com FINDINGS AND ORDERS OF THE COURT The Court has reviewed and considered the evidence, oral and written, submitted by the parties on this date including the testimony of witnesses, exhibits admitted into evidence, statements and arguments of counsel, reports and/or treatment plans of DHS, reports of service providers, reports of CASA or GAL, if appointed, and any previous orders of this Court and HEREBY FINDS, ORDERS AND DECREES: I. PRELIMINARY MATTERS A. REASONABLE EFFORTS A1. The continuation of all named child(ren)/or these specified child(ren) ________________________________________________ in the(ir) home is is not contrary to the welfare of the child(ren), to wit: ____________________________________________________________. AND Reasonable efforts have or have not been made to prevent the need for removal all named child(ren)/or these specified child(ren) _______________________________, of to wit: ______________________________________________________________________________________________. A2. Reasonable efforts have or have not been made to finalize the permanency plan all named child(ren)/or these specified child(ren) and to place the ______________________________________________ in a timely manner in accordance with the plan to wit: ______________________________________________________________________________________________. OR Reasonable efforts to reunite the child(ren) with the child(ren)'s family are not required pursuant to Title 10A O.S. �1-4-809 and a permanency hearing is set for ___________________, if applicable. B. All named child(ren)/or these specified child(ren) ___________________________________ is/are age fourteen (14) or older and services are are not being provided to facilitate transition into successful adulthood, to wit:_________________________________________. have have not been made to place the siblings together in the same placement, to wit: ____________________________________; C1. If siblings have been removed, reasonable efforts AND C2. If siblings are separated, reasonable efforts have have not been made to provide for frequent visitation or other on-going interactions; have not been made, as it is contrary to the safety or well-being of the child(ren) or sibling because _____________________________________________________________________________________________. D. INDIAN CHILD WELFARE ACT and ACTIVE EFFORTS D1. The Indian Child Welfare Act does does not apply The name of the Tribe is: ______________________________________________. The Tribe and BIA, if tribe unknown, has been notified has not been notified. Other _____________________________________________________________________________________________. Order of Disposition OK-J-UO-0004 Version 1.1.16.2 Page 2 of 6 OCIS Docket Code: ODISP or DOISP American LegalNet, Inc. www.FormsWorkFlow.com D2. If ICWA applies, active efforts to provide remedial services and rehabilitative programs to prevent the breakup of the Indian Family have have not been made have proven unsuccessful, to wit:___________________________________________________________________. AND D3. Placement has has not been made in accordance with the placement preferences set forth in 25 U.S.C. 1915. OR If applicable, good cause exists to deviate from the placement preferences, to wit: _____________________________________________________________________________________________________ No ICWA compliant placement exists. INDIVIDUAL SERVICE PLAN (ISP) MOTHER FATHER FATHER LEGAL GUARDIAN II. A. An ISP was adopted on ____________________________________. B. The ISP C. was was not developed with the participation of the parent. The proposed ISP was reviewed in open court with the parent(s) or legal custodian who acknowledged that he/she understood the conditions to be corrected, the plan requirements and that failure to correct the conditions that led to the deprived adjudication and/or failure to follow the orders of the court and/or failure to appear in court could result in the termination of their parental rights to the child(ren). ISP is agreed to by the all the parties. Object _________________________________________. D. E. OR ISP is modified in the following manner _____________________________________________________, by interlineations. The ISP is incorporated herein and made a part of the dispositional order of the court and all parties are hereby ordered to fully comply with its provisions. III. PERMANENCY PLAN The Court approves the permanency plan for all named child(ren) /or these specified child(ren) __________________________________________________________________________________ : A. Reunification B. Adoption C. Guardianship D. Planned permanent living arrangement E. Out of home placement (check all applicable). IV. TEMPORARY CUSTODY The temporary custody of the child(ren) is granted as follows: A. All named child(ren)/or these specified child(ren) __________________________________ is/are released to custody of ___________________________________ (the parent, legal guardian or custodian) from whom the child was removed under the following conditions: __________________________________________________________________________________________________________ with without DHS supervision; Page 3 of 6 OCIS D