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ME-907, 12/02 Statement of Emergency Detention by District Attorney or Corporation Counsel 24724751.15 and 971.14(6)(b), Wisconsin Statutes This form shall not be modified. It may be supplemented with additional material. STATE OF WISCONSIN, CIRCUIT COURT, COUNTY IN THE MATTER OF THE CONDITION OF Name of Subject Date of Birth Statement of Emergency Detention by District Attorney or Corporation Counsel Case No. File this statement with the detention facility and court immediately. A probable cause hearing must be held within 72 hours of detention. Please print or type all information below. All blanks must be filled in. I am the District Attorney/Corporation Counsel for County and state that: disabled. as set forth in 24751.15, Wis. Stats. (copy attached), pursuant to 247971.14(6)(b), Wis. Stats. My belief is based on specific and recent dangerous acts, attempts, threats or omissions by the subject reliably reported to me as stated below: Dangerous Behavior: When: Where: Describe Behavior (summarize below and attach a copy of the Criminal Complaint): See attached page Witnesses to the dangerous behavior: Name of Witness Telephone Address Relationship The subject was detained at [Name of Mental Health Facility and Unit] on [Date] , at [Time] a.m. p.m. City County State DISTRIBUTION: 1. Court 2. Mental Health Detention Facility 3. Subject with Notice of Rights Signature Title Name Printed or Typed Telephone American LegalNet, Inc. www.FormsWorkFlow.com