Order For Adoptive Placement
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Order For Adoptive Placement Form. This is a Wisconsin form and can be use in Circuit Court Statewide.
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Tags: Order For Adoptive Placement, JC-1642, Wisconsin Statewide, Circuit Court
COUNTY
STATE OF WISCONSIN, CIRCUIT COURT,
IN THE INTEREST OF
For Official Use
Order for
Adoptive Placement
Name
Case No.
Date of Birth
THE COURT FINDS AND CONCLUDES:
1. The child was born on (date)
.
2. The recommendation and report of (agency)
has been filed.
3. Adoptive placement is in the best interests of the child.
4. The adoptive placement is in a licensed foster home.
5. A Petition for Termination of Parental Rights was filed and granted.
6.
The child is subject to the Indian Child Welfare Act and:
a. Placement has been made in accordance with the order of preference set forth in the Indian Child
Welfare Act.
OR
b. There is good cause to depart from the order of placement preference in the Indian Child Welfare Act:
THE COURT ORDERS:
1. This child is placed with the proposed adoptive parent(s):
Name(s)
2. The appointed guardian is
THIS IS A FINAL ORDER FOR PURPOSES OF APPEAL.
BY THE COURT:
Distribution:
1. Court - Original
2. Agency
3. Adoptive Placement
4. Tribe (if any)
5. Other:
_____________________________________
Circuit Court Judge
Name Printed or Typed
Date
JC-1642, 04/09 Order for Adoptive Placement
§48.837, Wisconsin Statutes; 25 U.S.C. §1915.
This form shall not be modified. It may be supplemented with additional material.
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