Form 109 STATE OF VERMONT SUPERIOR COURT ______________ Unit FAMILY DIVISION Docket No.______________ DOB In Re: / / NOTICE OF INTENT NOT TO FILE JUVENILE PETITION SA Incident # ______________ NOW COMES the State of Vermont, _____________ County State's Attorney, by and through the undersigned counsel, to inform the court of its intent not to pursue a petition after an Emergency Care Order was issued in the above captioned matter. DATED at __________________, Vermont, this ________ day of ______, 20___. ___________________________ Deputy / State's Attorney cc: Department for Children and Families 7/10 SML American LegalNet, Inc. www.FormsWorkFlow.com