SUPERIOR COURT OF WASHINGTON COUNTY OF _______________________ JUVENILE COURT STATE OF WASHINGTON v. NO: ORDER ON DECLINATION HEARING (ORDJ) Respondent(s). D.O.B.: I. BASIS The court has held a hearing and has entered written findings of fact and conclusions of law. The parties and the court have agreed to waive the hearing and: retain jurisdiction in Juvenile Court. decline jurisdiction in Juvenile Court and transfer to Superior Court where the respondent shall be treated as an adult. II. ORDER IT IS ORDERED that: 2.1 JURISDICTION IS: retained. permanently declined and the respondent is transferred for adult criminal prosecution and/or disposition in this and any future proceeding(s). 2.2 INCARCERATION: The respondent may be placed in any lawful place of incarceration as directed by law enforcement authorities. The sheriff shall: ________________________________________________________________ _______ ORDER ON DECLINATION HEARING (ORDJ) - Page 1 of 2 WPF JU 08.0120 (6/2005) - RCW 13.04.030(1)(e)(v), 13.40.110 American LegalNet, Inc. www.FormsWorkflow.com ________________________________________________________________ _______ ________________________________________________________________ 2.4 _______ OTHER: _____________________________________________________________________________ _ _____________________________________________________________________________ _ ______________________________________________________________________________ . Dated: _________________________ _____________________________________________ JUDGE/COMMISSIONER CERTIFICATE: I, _______________________________, Clerk of this Court, certify that the above is a true copy of the Order of Disposition in this action on record in my office. FINGERPRINTS (If required by RCW 10.64.110) I further attest that the fingerprint(s) appearing on this Order are those of __________________________________________________, the subject of this Order. Dated:______________________ Clerk________________________________________ By: _______________________________Deputy Clerk Presented by: ________________________________________ Signature ORDER ON DECLINATION HEARING (ORDJ) - Page 2 of 2 WPF JU 08.0120 (6/2005) - RCW 13.04.030(1)(e)(v), 13.40.110 American LegalNet, Inc. www.FormsWorkflow.com ________________________________________ Type or Print Name/Title Copy Received; Approved for Entry; Notice of Presentation Waived: _________________________________ Deputy Prosecuting Attorney/WSBA No. _____________________________________________ Attorney for Respondent/WSBA No. _________________________________ Probation Counselor _____________________________________________ Respondent ORDER ON DECLINATION HEARING (ORDJ) - Page 3 of 2 WPF JU 08.0120 (6/2005) - RCW 13.04.030(1)(e)(v), 13.40.110 American LegalNet, Inc. www.FormsWorkflow.com