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SUPERIOR COURT Unit In Re: STATE OF VERMONT FAMILY DIVISION Docket No. DOB MERITS STIPULATION The undersigned parties agree that the above named child is a Child in Need of Care or Supervision pursuant to 33 V.S.A. § 5102(3) committed the following delinquent act: ______________________________________________________________________________ ______________________________________________________________________________ based on the following facts: (check all applicable boxes.) all facts set forth in the affidavit the following paragraphs in the affidavit: the following facts not included in, or different from the affidavit: _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ The parties agree that the following issues may also be addressed at disposition: _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ The parties agree to waive the disposition case plan. The school where the child is currently enrolled (if stipulation is to a ''listed'' delinquent act, 33 V.S.A. § 5118): __________________________________ Dated: _____________________________ ___________________________________ Attorney for Parent ___________________________________ Attorney for Parent ___________________________________ Attorney for Child ___________________________________ Deputy State's Attorney ___________________________________ DCF (if in custody) 400-00108S - Merits Stipulation (7/2016) ___________________________________ Parent ___________________________________ Parent ___________________________________ Child (if applicable) ___________________________________ Guardian ad Litem ___________________________________ Other American LegalNet, Inc. www.FormsWorkFlow.com Page 1 of 1