IW-1746, 11/15 Dispositional Order Protection or Services (Chapter 938) Indian Child Welfare 247247938.34, 938.345, 938.396(7)(a), 938.355, 938.78(2)(ag) and (aj), Wisconsin Statutes; and 25 U.S.C. 2472471912, 1915. This form shall not be modified. It may be supplemented with additional material. Page 1 of 4 STATE OF WISCONSIN, CIRCUIT COURT, COUNTY IN THE INTEREST OF Name Date of Birth Dispositional Order - Protection or Services (Chapter 938) Indian Child Welfare Act Case No. A P etition was filed with the court. This dispositional hearing was held on [Date] , which is the effective date of this O rder. THE COURT FINDS: 1. The juvenile is in need of protection or services b ecause the juvenile is uncontrollable. habitually truant from home. habitually truant from school. a school dropout. This is a result of the person . 2. The juvenile is subject to the Indian Child Welfare Act. (If the juve nile is placed in the home and therefore not subject to the Indian Child Welfare Act, use form JD - 1746 instead of this order.) 3. The juvenile is placed out of the home. A. Continued custody of the juvenile by the parent or Indian custodian is is not likely to result in serious emotional or physical damage to the juvenile, based on the testimony of one or more qualified expert witnesses. ( This finding is not required if made at a previous hea ring in the case .) B . Active efforts were were not made to provide remedial services and rehabilitation programs designed to prevent the breakup of the Indian family. ( This finding is not required if made at a previous hearing in the case .) See attached Statement of Active Efforts (IW - 1609) C. Placement has been made in accordance with the order of preference set forth in the Indian Child Welfare Act. OR There is good cause to depart from the order of placement preference in the Indian Child Welfare Act. D. Placement in the home at this time is is not contrary to the welfare of the juvenile and the community. American LegalNet, Inc. www.FormsWorkFlow.com IW-1746, 11/15 Dispositional Order Protection or Services (Chapter 938) - Indian Child Welfare Act 247247938.34, 938.345, 938.396(7)(a), 938.355, 938.78(2)(ag) and (aj), Wisconsin Statutes; and 25 U.S.C. 2472471912, 1915. This form shall not be modified. It may be supplemented with additional material. Page 2 of 4 E. Reasonable efforts to prevent removal were [ Complete one of the following ] made by the department or agency responsible for providing services as follows: made by the department or agency responsible for providing services, although an emergency situation resulted in immediate removal of the juvenile from the home as follows: required, but the department or agency responsible for providing services failed to make reasonable efforts. F. Reasonable efforts to place the juvenile in a placement that enables the siblin g group to remain together were made. not required because the juvenile does not have siblings in out - of - home care. not required because it would be c ontrary to the safety or well being of the juvenile or any of the siblings. G. Permanency plan was not filed. filed and reasonable efforts to achieve the permanency goal of the permanency plan, including through an out - of - state placement if appropriate, were [ Complete one of the following only if a permanency plan has been filed] made by the department or agency responsible for providing services as follows: not made by the department or agency responsible for providing services as follows: H . The mother father was present and was asked to provide the names and other identifying information of three adult relat ives of the juvenile or other adult individuals whose home the parent requests the court to consider as placements for the juvenile, unless that information was previously provided. 4. As to t he depa rtment or agency recommendation: A . The placement location recommended by the department or agency is adopted. OR B . After giving bona fide consideration to the recommendations of the department or agency and all parties, the placement location recommended is not adopted. 5. P articipation in the Teen Court program will likely benefit the juvenile and the community and the juvenile has not successfully completed a Teen Court program in the two years before the date of the viol ation. 6 . The rehabilitation and treatment/care of the juvenile cannot be accomplished by means of voluntary consent of the parent/guardian, and the transfer of legal custody is necessary. 7 . Restitution. A . The juvenile alone is financially able to pay restitution of $ and/or a forfeiture of $ . B . The juvenile is physically able to perform services for the victim [ under age 14, 40 hour limit ] and the victim agrees to accept such services. C . The custodial parent is financially able to pay reasonable restitution of $ and/or a forfeiture of $ . 8 . The Statement of Guardian ad Litem was filed. 9 . Other: American LegalNet, Inc. www.FormsWorkFlow.com IW-1746, 11/15 Dispositional Order Protection or Services (Chapter 938) - Indian Child Welfare Act 247247938.34, 938.345, 938.396(7)(a), 938.355, 938.78(2)(ag) and (aj), Wisconsin Statutes; and 25 U.S.C. 2472471912, 1915. This form shall not be modified. It may be supplemented with additional material. Page 3 of 4 THE COURT ORDERS: 1. The juvenile is placed under court jurisdiction. 2. Placement out - of - home at and into the placement and care responsibility of the department in the county where this order is issued, which has primary responsibility for providing services. Unless otherwise specified, the expiration date of this order shall be the later of the following: One year from the date of this order; The date the juvenile reaches his or her 18 th birthday; The date the juvenile is granted a high school or high school equivalency diploma or the date the juvenile reaches his or her 19 th birthday, whichever occurs first, if the juvenile is enrolled fulltime in a secondary school or vocational or technical equivalent and reasonably expected to complete the prog ram prior to age 19; The date the juvenile is granted a high school or high school equivalency diploma or the date the juvenile reaches his or her 21 st birthday, whichever occurs first, if ALL of the following apply: The juvenile is a fulltime student in secondary school or voca tional or technical equivalent. An individualized education program is in effect for the juvenile. The juvenile or guardian, on behalf of the juvenile, agrees to this O rder. The juvenile is 17 years of age or older when this order is entered . OR Expiration date of this O rder : . 3 . The juvenile has one or more siblings in out - of - home care and the juvenile is not placed with all those siblings. The department or agency shall make reasonable efforts to provide frequent visitation or other ongoing interaction between the juvenile and any siblings. is not required to provide for frequent visitation or other ongoing interaction because it would be contrary to the safety or well being of the juvenile or any siblings. 4. The department or agency shall conduct a diligent search in order to locate and provide notice as required by 247938.355(2)(cm) , Wis. Stats., to all adult relatives of the juvenile , including the three adult relatives provided by the parents under 247938.335(6), Wis. Stats., no later than 30 days from the date of the j removal from the home, unless the search was previously conducted and notice provided. 5. If a permanency plan has been prepared, filed and is consistent with this order, this order contains the plan. Otherwise, a permanency plan consistent 6. Total r estitution is $ . $ [under age 14, $250 limit] to be paid See restitution supplement Make repairs or provide services agreeable to the victim [under age 14, 40 hour limit] The juvenile is in an out - of - home placement and receiving income; the juvenile shall pay % of that income for restitution. 7 . Costs of $ [age 14 and over] , to be paid . 8 . Legal custody transferred to County Department of Human/Social Services . Other: 9. Conditio ns of supervision and/or return. See attached 10 . The parent(s) shall provide