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Order Concerning Termination Of Parental Rights (Voluntary) Form. This is a Wisconsin form and can be use in Circuit Court Statewide.
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Tags: Order Concerning Termination Of Parental Rights (Voluntary), JC-1638, Wisconsin Statewide, Circuit Court
FORM SUMMARY
Name of Form:
Order Concerning Termination of Parental Rights (Voluntary)
Form Number:
JC-1638
Statutory Reference:
§§48.427 and 48.43, Wisconsin Statutes
Benchbook Reference:
Purpose of Form:
Order formally indicating the court's decision on a petition to
voluntarily terminate the parental rights of a parent.
Who Completes It:
The court, attorney, corporation counsel, district attorney.
Distribution of Form:
Original to court file, copies to be served on party whose rights are
being terminated.
Accompanying Forms:
Generally none.
New Form/Modification:
Modification, last update 10/07.
Modifications:
Added Indian Child Welfare Act (ICWA) language and references.
New ICWA version created – IC-1638.
Comments:
RMC recommends that the court not rely upon attachments alone as
the basis for its findings. Where attachments are used, specific
reference to the document title, page and paragraph should be made.
About this form:
This form is the product of the Wisconsin Records Management
Committee, a committee of the Director of State Court's 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
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COUNTY
STATE OF WISCONSIN, CIRCUIT COURT,
IN THE INTEREST OF
For Official Use
Order Concerning
Termination
of Parental Rights
(Voluntary)
Name
Case No.
Date of Birth
THE COURT FINDS:
1. Notice has been given to all those entitled to notice.
2. The provisions of the Indian Child Welfare Act do not apply.
(For an Indian child, use the Indian Child Welfare Act version (IW-1638) of this order.)
3. The parent(s) are:
a. Mother’s name:
Date of birth:
b. Father’s name:
Date of birth:
c. Other possible father(s):
Name:
Name:
Name:
Date of birth:
Date of birth:
Date of birth:
4. There has been no declaration of paternal interest.
5. Testimony supporting the allegations in the petition has been presented to the court and the allegations are
true. Findings made on the record are incorporated.
father(s) is not contested,
mother
6. The petition to terminate the parental rights of the
and the terminating parent(s) have freely, voluntarily and knowingly consented to a termination of their rights.
7. It is in the best interest of the child that the parental rights of the
after considering the following factors:
mother
father(s)
be terminated
• The likelihood of the child’s adoption after termination.
• The age and health of the child, both at the time of the disposition and, if applicable, at the time the
child was removed from the home.
• Whether the child has substantial relationships with the parent or other family members, and whether
it would be harmful to the child to sever these relationships.
• The wishes of the child.
• The duration of the separation of the parent from the child.
• Whether the child will be able to enter into a more stable and permanent family relationship as a result
of the termination, taking into account the conditions of the child’s current placement, the likelihood of
future placements and the results of prior placements.
8. The child is placed in sustaining care because:
the child is not likely to be adopted.
adoption is not in the best interest of the child.
JC-1638, 04/08 Order Concerning Termination of Parental Rights (Voluntary)
§§48.427 and 48.43, Wisconsin Statutes
This form shall not be modified. It may be supplemented with additional material.
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Order Concerning Termination of Parental Rights (Voluntary)
Page 2 of 2
Case No.
9. (Complete one of the following only if there is a permanency plan.)
Reasonable efforts to achieve the goal(s) of the permanency plan were:
made by the department or agency responsible for providing services.
not made by the department or agency responsible for providing services.
10. Any parent who has appeared has been informed of the provisions of §§48.432, 48.433 and 48.434,
Wisconsin Statutes.
11. Other:
THE COURT ORDERS:
is/are terminated.
1a. The parental rights of
Name of Parent(s)
Guardianship, placement and care responsibility, and custody of the child:
remain with the parent whose rights have not been terminated.
are transferred pending adoption to:
Other:
If guardianship or custody is transferred to an agency, that agency shall be responsible for securing
the adoption of the child or establishing the child in a permanent family setting. The child’s permanency
will be filed within 60 days.
is attached.
has been filed.
plan:
The provisions of §§48.432, 48.433 and 48.434, Wisconsin Statutes are attached.
1b. The petition to terminate parental rights of (name)
is dismissed.
2. Other:
THIS IS A FINAL JUDGMENT/ORDER FOR PURPOSES OF APPEAL.
BY THE COURT:
Circuit Court Judge
Name Printed or Typed
Date
JC-1638, 04/08 Order Concerning Termination of Parental Rights (Voluntary)
§§48.427 and 48.43, Wisconsin Statutes
This form shall not be modified. It may be supplemented with additional material.
Page 2 of 2
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