Findings and Order Regarding Eligibility (FOSIJS) Page 1 of 2 for Special Immigrant Juvenile Status JU 11.0500 (06/2018) Superior Court of Washington County of Juvenile Court In re: NO: Findings and Order Regarding Eligibility for Special Immigrant Juvenile Status (FOSIJS) The Court, having reviewed the supporting material on file, including motion papers and supporting affidavits, all the pleadings and prior proceedings in this matter, and/or hearing testimony and argument, if any, enters the following: I. Findings: 1.1 This court has jurisdiction under State law to make judicial determinations about the custody and care of (child222s name) who was found to be within the jurisdiction of this court and remains under this court222s jurisdiction. 1.2 This child is under 21 years of age. 1.3 This child is unmarried. 1.4 This child was: declared dependent by a juvenile court on (date); or legally committed to or placed in the custody of a state agency or department, on (date); or placed under the custody of an individual or entity (name of individual or entity), appointed by a state or juvenile court, on (date). 1.5 Reunification of the child with one or both of his or her parent/s (name of parent/s who child cannot reunify with) was found not to be viable on (date). This finding was based on a American LegalNet, Inc. www.FormsWorkFlow.com Findings and Order Regarding Eligibility (FOSIJS) Page 2 of 2 for Special Immigrant Juvenile Status JU 11.0500 (06/2018) finding of abuse, neglect, or abandonment, or a similar basis under Washington State Law (RCW or case cite) in that: (Provide brief description of supporting facts:) . 1.6 It is not in this child222s best interest to return to his or her previous country of nationality or country of last habitual residence, (name of country or countries) or to the country or countries of his or her parent(s) (name of country or countries). It is in the child222s best interest to remain in the United States in that (Provide brief description of supporting facts:) . II. Order One certified copy of this order will be provided to the child or his/her attorney at public expense. Dated: Judge/Commissioner Presented by: Signature Print Name/Title WSBA No Attorney for American LegalNet, Inc. www.FormsWorkFlow.com