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Notice Of Intake Inquiry Form. This is a Wisconsin form and can be use in Circuit Court Statewide.
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Tags: Notice Of Intake Inquiry, JD-1705, Wisconsin Statewide, Circuit Court
Name of Form:
FORM SUMMARY
Notice of Intake Inquiry
Form Number:
JD-1705
Benchbook Reference:
JV 2-5
Statutory Reference:
§§48.24(2) and 938.24(2)
Purpose of Form:
To provide written notification to juvenile and parent(s) that a
referral has been made to intake, and to request their presence at
intake inquiry.
Who Completes It:
Intake worker
Distribution of Form:
Original to custodial parent/child. Copy to intake file.
Accompanying Forms:
To be determined by county policies.
New Form/Modification:
Modification, last update 05/00.
Modifications:
Added Indian Child Welfare Act (ICWA) language and references.
Comments:
None.
About this Form:
This form was developed by the Wisconsin Juvenile Court
Intake Forms Committee. It has been approved by the
Wisconsin Records Management Committee, a committee of
the Director of State Courts Office and a mandate of the
Wisconsin Judicial Conference.
If you have additional information that does not change the
meaning of the form, attach it on a separate page. The form
itself shall not be altered.
Date: 04/24/2008
Page 1
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1. Intake Case Number
State of Wisconsin
Circuit Court
2. County
3. Case Type
Delinquency
In Need of Protection/Services under ch. 48
In Need of Protection/Services under ch. 938
Ordinance/Civil Law
Notice of Intake Inquiry
4. Child’s/Juvenile’s Last Name
First
7. Child’s/Juvenile’s Street Address
City
9. Legal Father’s Name
Address
11. Legal Mother’s Name
Address
13. Guardian/Legal Custodian/Indian Custodian
Middle
5. Date of Birth
Address
6. Sex
Female
Male
State
Zip Code
8. Telephone Number
(
)
10. Telephone Number
(
)
12. Telephone Number
(
)
14. Telephone Number
(
)
15. The Juvenile Court Intake Office has received a referral from
regarding the following allegations:
A referral to court is a serious matter.
An intake inquiry will be conducted on behalf of the court regarding this matter to determine whether the available
facts are sufficient to establish jurisdiction and to determine the best interests of your child and of the public with
regard to any action to be taken.
You and your child are requested to be present at an intake conference scheduled below.
16. Date
Time
17. Location
No child/juvenile or other person may be compelled by an intake worker to appear at any conference, produce any
papers, or visit any place. Failure to attend this conference may result in referral to court.
18. Intake Agency’s Name
Address
Telephone Number
19. Name of Intake Worker
Signature
Date
JD-1705, 04/08 Notice of Intake Inquiry
§§48.24(2) and 938.24(2), Wisconsin Statutes.
This form shall not be modified. It may be supplemented with additional material.
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