WPCU9  
           l0
:-N"х,;zv_͆ WrVOz7!Us58k;ڋJoɄ#{A)F(NaE"*3NPo@r]1X{_n$ޝtbhcQ-j+#O. rztrXm-	4UjiƤ?C>HmP:e3QGr9xt. wBl(!i&BHC#gnu"҃o(~cRazJhèi,j=22 R}eݡQ;6YaOa۝#겔уo4	Fc`&:jW^]0s'Y%6"=~\/#
NoQ+s:s Ĕrʯ.AHH:Fkx;H?0Eh u           #     f   U   N   /  	%      }  0   :     0   U     0        0        0        0      y  0      2  0        0        0      9  0        0        0      p  0      #  0        0      w  0        0        0      H  0        0        0      e  0        0        0      c  0        0        0      +  0        0      g  0      %  0   >     0      !   0      !  0      !  0      "  0      #  0      $  0      %  0      =&  0   2   '  0      A'  0   :   =(  0   Y   w(  0   _   (  0   
  /)  0     9*  0     +  	B   *   -  	D   /   -  	D   +   .  0     E.   U   6   K0  	D   /   0  0      0  0   6   ~1  0     1  0   :   2  0   ^   2  0   <   T3  	1   e   3   U   >   3   U   *   34  N      ]4  	1   u   _4  0   N   4  	7   2   "5  ^      T5  w      `5  4      d5        x5        5  	m      5   U3   >   5  0   U   5   b      36  0L      ;6   	      6        6        7            7            7     Z   7            7            7            7            7   	      8   	      8            8            8   	      -8            -8            -8            -8            -8            -8            -8            -8   	      A8   	      U8   	      i8   	      }8   	      8   	      8   	      8   	      8   	      8   	      8   	      9   	      9   	      /9   	      C9   \ \ K J C D C 0 1 \ S A V I N   9 0 6 0                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      0                                                                                                                                                                 ( 9  	   Z  6 T i m e s   N e w   R o m a n   R e g u l a r           X    (                  $          USUS. ,      *       +           ( _ 2 6     2      3
   
       . .        *   G   +       G   ( _ 2 5             /  % `	 `	   h   p    x  / 2     3
   
       . .    /  % `	 `	   h   p    x  /             *   8   +       8   ( _ 2 4         ,  " 
   h   p    x  , 2     3
   
       . .    ,  " 
   h   p    x  ,         *   5   +       5   ( _ 2 3        `	 )   	  h   p    x  ) 2     3
   
       . .    )   	  h   p    x  )    `	     *   2   +       2   ( _ 2 2         &   h h   p    x  & 2     3
   
       . .    &   h h   p    x  &         *   /   +       /   ( _ 2 1         #      p    x  # 2     3
   
       . .    #      p    x  #         *   ,   +       ,   ( _ 2 0        h       p    x    2     3
   
       . .          p    x       h     *   )   +       )   ( _ 1 9            p p    x   2     3
   
       . .       p p    x           *   &   +       &   ( _ 1 8                x   2     3
   
       . .           x           *   A          A   ( _ 1 7           5  +    `	   h   p    x  5 2      3
   
 Ԁ5  +    `	   h   p    x  5           *   G          G   ( _ 1 6             /  % `	 `	   h   p    x  / 2     3
   
 Ԁ/  % `	 `	   h   p    x  /             *   8          8   ( _ 1 5         ,  " 
   h   p    x  , 2     3
   
 Ԁ,  " 
   h   p    x  ,         *   5          5   ( _ 1 4        `	 )   	  h   p    x  ) 2     3
   
 Ԁ)   	  h   p    x  )    `	     *   2          2   ( _ 1 3         &   h h   p    x  & 2     3
   
 Ԁ&   h h   p    x  &         *   /          /   ( _ 1 2         #      p    x  # 2     3
   
 Ԁ#      p    x  #         *   ,          ,   ( _ 1 1        h       p    x    2     3
   
 Ԁ      p    x       h     *   )          )   ( _ 1 0            p p    x   2     3
   
 Ԁ   p p    x           (   &          &   & _ 9                x   2     3
   
 Ԁ       x           (   A          A   & _ 8           5  +    `	   h   p    x  5 2      3
   
 5  +    `	   h   p    x  5           (   G          G   & _ 7             /  % `	 `	   h   p    x  / 2     3
   
 /  % `	 `	   h   p    x  /             (   8          8   & _ 6         ,  " 
   h   p    x  , 2     3
   
 ,  " 
   h   p    x  ,         (   5          5   & _ 5        `	 )   	  h   p    x  ) 2     3
   
 )   	  h   p    x  )    `	     (   2          2   & _ 4         &   h h   p    x  & 2     3
   
 &   h h   p    x  &         (   /          /   & _ 3         #      p    x  # 2     3
   
 #      p    x  #         (   ,          ,   & _ 2        h       p    x    2     3
   
       p    x       h     (   )          )   & _ 1            p p    x   2     3
   
    p p    x           &   &          &   $ _                x   2     3
   
        x           0   A           A   . N o r m a l           5  +    `	   h   p    x  5 5  +    `	   h   p    x  5           <   A           A   : D e f i n i t i o n   T           5  +    `	   h   p    x  5 5  +    `	   h   p    x  5           <   A           A   : D e f i n i t i o n   L        , 5  +    `	   h   p    x  5       5  +    `	   h   p    x  5     8                  6 D e f i n i t i o n         (   h           h   & H 1           5  +    `	   h   p    x  5                                5  +    `	   h   p    x  5           (   ]           ]   & H 2           5  +    `	   h   p    x  5                       5  +    `	   h   p    x  5           (   ]           ]   & H 3           5  +    `	   h   p    x  5                       5  +    `	   h   p    x  5           (   ]           ]   & H 4           5  +    `	   h   p    x  5     X      XX            5  +    `	   h   p    x  5           (   ]           ]   & H 5           5  +    `	   h   p    x  5            5  +    `	   h   p    x  5                      (   ]           ]   & H 6           5  +    `	   h   p    x  5                       5  +    `	   h   p    x  5           2   D           D   0 A d d r e s s           5  +    `	   h   p    x  5 5  +    `	   h   p    x  5           8   M           M   6 B l o c k q u o t e        ,    , 5  +    `	   h   p    x  5             5  +    `	   h   p    x  5     ,                  * C I T E         ,       d       l    * C O D E                K 8          < 6X  9   ` (  C o u r i e r   N e w         K            S A           \	  	   `  & T i m e s   N e w   R o m a n         S     4                  2 E m p h a s i s         6                  4 H y p e r l i n k                    <                  : F o l l o w e d H y p e                   4       g       o    2 K e y b o a r d                K 8          < 6X  9   ` (  C o u r i e r   N e w         K            S A           \	  	   `  & T i m e s   N e w   R o m a n         S     <                 : P r e f o r m a t t e d           /  %    
  , K k     %#/            K 8          < 6X  9   ` (  C o u r i e r   N e w         K            S A           \	  	   `  & T i m e s   N e w   R o m a n         S /  %    
  , K k     %#/           <                 : z  B o t t o m   o f       7 5   (                   X                 7           5  +    `	   h   p    x  5            ? B          % 2  A   `   A r i a l         ?                 S A           \	  	   `  & T i m e s   N e w   R o m a n         S 7 6   (                   X                 7 5  +    `	   h   p    x  5         &              d          d   4 )     1                        d x    d  '                              d x    d    <                 : z  T o p   o f   F o r     7 9   (                   X                 7           5  +    `	   h   p    x  5            ? B          % 2  A   `   A r i a l         ?                 S A           \	  	   `  & T i m e s   N e w   R o m a n         S 7 6   (                   X                 7 5  +    `	   h   p    x  5       < 6X  9   ` (  C o u r i e r   N e w          4 )     2                        d x    d    0       K       S    . S a m p l e     K 8          < 6X  9   ` (  C o u r i e r   N e w         K S A           \	  	   `  & T i m e s   N e w   R o m a n         S     0                  . S t r o n g         8       d       l    6 T y p e w r i t e r                K 8          < 6X  9   ` (  C o u r i e r   N e w         K            S A           \	  	   `  & T i m e s   N e w   R o m a n         S     4                  2 V a r i a b l e         :                  8 H T M L   M a r k u p     B
   
                2       
            0 C o m m e n t     B
   
                   3 5 ; A G M S Y _ 1     1 .   1 .   1 .   1 .   1 .   1 .   1 .   1 .    \	  	   `  & T i m e s   N e w   R o m a n         % 2  A   `   A r i a l                           3#   3 7 = C I Q Y a g       1 .   a .   i .   ( 1 )   ( a )   ( i )   1 )   a )               (                 O$                          D    i )                                       :~v=e         }i=    :i +003| x                    U    \	  	   `   & T i m e s   N e w   R o m a n             (   -               2$       
   !    USUS. ,      -  -       H   2           2   4 B o d y   T e x t   B o d y   T e x t       X      XX                                    C h e c k 2 0    
      
 N  '    USUS. ,      _           "   X     A " _        11/23/10_         
          8         D o c u m e n t M a n a g e m e n t : : M o d i f i e d B o o l e a n T R U E  T e x t 2 7    C h e c k 2 1    C h e c k 2 2    C h e c k 4 3    C h e c k 4 4    C h e c k 4 5    C h e c k 4 6    C h e c k 4 7    T e x t 3 3    C h e c k 2 3    C h e c k 2 7    C h e c k 2 8    C h e c k 2 9    C h e c k 3 0    C h e c k 3 1    C h e c k 3 2    T e x t 3 9   
   !    USUS. ,      _        _               S  N  @    $$(  140b   	        
@           (         0                               3                            D                    ?  +    `	   h   p    x     X?  O      8   T X  X       d                  d  8 =    T  X   X       d                 d= _        R        _       A  XT  X  X X   @    @@  INTHEDISTRICTCOURTOF__________________COUNTY,KANSAS   	           INTHEINTERESTOF   	 f         Name_____________________________              p      CaseNo._____________   	 >	   DOB#   XT  X  XA XT  #  M  XT  X  X XT xx#   XT  X  XM XT~  #  A  XT  X  X XT /#   XT  X  XA XT  #  M  XT  X  X XT xx#   XT  X  XM XT  #  A  XT  X  X XT /____A&#   XT  X  XA XTK  #  A  XT  X  X XT Ԁmale&#   XT  X  XA XT  #  A  XT  X  X XT Ԁfemale   	 *
   Name_____________________________              p      CaseNo._____________   	 `   DOB#   XT  X  XA XT  #  M  XT  X  X XT xx#   XT  X  XM XT  #  A  XT  X  X XT /#   XT  X  XA XT  #  M  XT  X  X XT xx#   XT  X  XM XTO  #  A  XT  X  X XT /____A&#   XT  X  XA XT  #  A  XT  X  X XT Ԁmale&#   XT  X  XA XT  #  A  XT  X  X XT Ԁfemale   	 L	   #   XT  X  XA XT0  #  A  XT  X  X XT Name_____________________________              p      CaseNo._____________   	 $
   DOB#   XT  X  XA XT  #  M  XT  X  X XT xx#   XT  X  XM XTR  #  A  XT  X  X XT /#   XT  X  XA XT  #  M  XT  X  X XT xx#   XT  X  XM XT  #  A  XT  X  X XT /____A&#   XT  X  XA XT	  #  A  XT  X  X XT Ԁmale&#   XT  X  XA XTn	  #  A  XT  X  X XT Ԁfemale   	    #   XT  X  XA XT	  #  A  XT  X  X XT #   XT  X  XA XT
  # @          Yy   X XT *#   XT  X   Yyo
  # COMBINEDJOURNALENTRYANDORDEROF A  XT  X  X XT ADJUDICATION#   XT  X  XA XT
  #  A  XT  X  X XT    	 v   @    OO  PursuanttoK.S.A.382251#   XT  X  XA XT+  #  A  XT  X  X XT Ԁand42U.S.C.#   XT  X  XA XT  #  M  XT  X  X XT 671etseq.#   XT  X  XM XT  #  A  XT  X  X XT Ԉ   	         Nowonthis______dayof______________,___________,theabovecaptionedmatter   	    comesonforadjudicationbeforeJudge________________________#   XT  X  XA XT[  #  A  XT  X  X XT .   	         #   XT  X  XA XTd  # TheCourtfindsthat A  XT  X  X XT &theIndianChildWelfareAct(ICWA)isnotapplicable.   	 t   &#   XT  X  XA XT  #  A  XT  X  X XT ԀICWAisapplicable,thetribehasbeengivennotice,andanICWASupplementalOrder   	 d   (Form222)isattached.#   XT  X  XA XTx  # Ԁ A  XT  X  X XT (IfICWAisapplicableuseForm215binlieuofthisformorForm222   	 P   inconjunctionwiththisform.)#   XT  X  XA XTB  #    	 @    A  XT  X  X XT      TheCourtfindsthatjurisdictionandvenueareproper.Noticetoparties,interested   	 v   partiesandthoserequiredtoreceivenoticehasbeengivenasrequiredbylaw.   	 b   #   XT  X  XA XT  #  A  XT  X  X XT $    , `	X X$ &#   XT  X  XA XT;  #  A  XT  X  X XT 0     #   XT  X  XA XT  #  A  XT  X  X XT Thepetitionerappearsby__________________________&#   XT  X  XA XT  #  A  XT  X  X XT ԀCounty/DistrictAttorneyor   	 :   designee&#   XT  X  XA XTy  #  A  XT  X  X XT Ԁother____________________#   XT  X  XA XT  #  A  XT  X  X XT .    * (#(#  &#   XT  X  XA XT]  #  A  XT  X  X XT 0     #   XT  X  XA XT  #  A  XT  X  X XT Thechild(ren)appears&#   XT  X  XA XT  #  A  XT  X  X XT Ԁinpersonand&#   XT  X  XA XTp  #  A  XT  X  X XT Ԁnotinperson,butbythechild(_      ren_      s)guardian   	    adlitem,___________________________.     
 (#(#  #   XT  X  XA XT  #  A  XT  X  X XT &0     򀀀NameofMother,#   XT  X  XA XT  #  A  XT  X  X XT themother#   XT  X  XA XTN  #  A  XT  X  X XT &#   XT  X  XA XT  #  A  XT  X  X XT Ԁappearsinpersonprose&#   XT  X  XA XT  #  A  XT  X  X XT Ԁappearsin   	 !   person,andthroughherattorney,________________________&#   XT  X  XA XTK  #  A  XT  X  X XT Ԁappearsnotin   	 "    person,butbyandthroughherattorney___________________________&#   XT  X  XA XT  #  A  XT  X  X XT Ԁdoesnot   	 t#!   appear.    `$" (#(#  #   XT  X  XA XT  #  A  XT  X  X XT &#   XT  X  XA XT'  #  A  XT  X  X XT 0     򀀀NameofFather,#   XT  X  XA XTs  #  A  XT  X  X XT the&#   XT  X  XA XT  #  A  XT  X  X XT Ԁfather&#   XT  X  XA XTD  #  A  XT  X  X XT putativefatherof󀀀Nameofchild#   XT  X  XA XT  #  A  XT  X  X XT ,#   XT  X  XA XT  #  A  XT  X  X XT    	 P% #   &#   XT  X  XA XT^  #  A  XT  X  X XT Ԁappearsinpersonprose&#   XT  X  XA XT  #  A  XT  X  X XT Ԁappearsinperson,andthroughhisattorney,   	 @&!$   _____________________&#   XT  X  XA XT   #  A  XT  X  X XT Ԁappearsnotinperson,butbyandthroughhisattorney,   	 ,'"%   __________________________&#   XT  X  XA XT  #  A  XT  X  X XT Ԁdoesnotappear.    (v#& (#(#  #   XT  X  XA XTl  #  A  XT  X  X XT &#   XT  X  XA XT  #  A  XT  X  X XT 0     򀀀NameofFather,#   XT  X  XA XT'  #  A  XT  X  X XT the&#   XT  X  XA XT  #  A  XT  X  X XT Ԁfather&#   XT  X  XA XT  #  A  XT  X  X XT putativefatherof󀀀Nameofchild#   XT  X  XA XTH  #  A  XT  X  X XT ,#   XT  X  XA XT  #  A  XT  X  X XT    	 )b$'   &#   XT  X  XA XT   #  A  XT  X  X XT Ԁappearsinpe_      rson_      Ԁprose&#   XT  X  XA XTm   #  A  XT  X  X XT Ԁappearsinperson,andthroughhisattorney,   	 )R%(   _____________________&#   XT  X  XA XT   #  A  XT  X  X XT Ԁappearsnotinperson,butbyandthroughhisattorney,   	 *>&)   __________________________&#   XT  X  XA XT!  #  A  XT  X  X XT Ԁdoesnotappear.    +*'* (#(#  _      #   XT  X  XA XT@"  #  A  XT  X  X XT &#   XT  X  XA XT"  #  A  XT  X  X XT 0     򀀀NameofFather,#   XT  X  XA XT#  #  A  XT  X  X XT the&#   XT  X  XA XT#  #  A  XT  X  X XT Ԁfather&#   XT  X  XA XT#  #  A  XT  X  X XT putativefatherof󀀀Nameofchild#   XT  X  XA XT,$  #  A  XT  X  X XT ,#   XT  X  XA XT$  #  A  XT  X  X XT    	       &#   XT  X  XA XT$  #  A  XT  X  X XT Ԁappearsinpersonprose&#   XT  X  XA XTQ%  #  A  XT  X  X XT Ԁappearsinperson,andthroughhisattorney,   	     _____________________&#   XT  X  XA XT%  #  A  XT  X  X XT Ԁappearsnotinperson,butbyandthroughhisattorney,   	 ~   __________________________&#   XT  X  XA XTV&  #  A  XT  X  X XT Ԁdoesnotappear.    j (#(#  #   XT  X  XA XT'  #  A  XT  X  X XT &#   XT  X  XA XTv'  #  A  XT  X  X XT 0     #   XT  X  XA XT'  #  A  XT  X  X XT (Otherparentappearances)____________________________________________________   	 V   ___________________________________________________________________________   	 F	   ___________________________________________________________________________    2
 (#(#  &#   XT  X  XA XT(  #  A  XT  X  X XT 0     #   XT  X  XA XT)  #  A  XT  X  X XT Interestedpartiesappearingare:_________________________________________________    | (#(#  0     ___________________________________________________________________________    l (#(#  &#   XT  X  XA XT)  #  A  XT  X  X XT 0     TheSecretaryispresentthrough________________________________________________    X	 (#(#  0     ___________________________________________________________________________    H	
 (#(#  &#   XT  X  XA XT+  #  A  XT  X  X XT 0     Alsopresentis/are:___________________________________________________________    4
 (#(#  0     ___________________________________________________________________________    $ (#(#  Ѐ      #   XT  X  XA XTT,  #  A  XT  X  X XT Ԁ#   XT  X  XA XT-  #  A  XT  X  X XT    	    1.0     THECOURTF#   XT  X  XA XT-  #  A  XT  X  X XT UR#   XT  X  XA XTI.  # THERFINDSTHAT:     (#(#   A  XT  X  X XT &#   XT  X  XA XT.  #  A  XT  X  X XT 0     theguardianadlitemandparentsofthechild(ren)didsubmittotheCourtastipulationor   	 v   statementofnocontesttothepetitionpursuanttoK.S.A.382248,filedinthecaptioned   	 b   matter.UponinquirytheCourtfindsthat#   XT  X  XA XT/  #  A  XT  X  X XT itisknowinglyandvoluntarilyofferedandthat   	 N   thereisafactualbasisandacceptsit.#   XT  X  XA XTb0  #  A  XT  X  X XT    	 :   #   XT  X  XA XT1  #  A  XT  X  X XT @    ) (#(# or   	 &   &#   XT  X  XA XTi1  #  A  XT  X  X XT 0     TheCourtreceivedevidenceandconsideredstatementsfromtheparties.    p (#(#  2.0     WHEREUPON,THECOURTFINDS:#   XT  X  XA XT1  #  A  XT  X  X XT     H (#(#  #   XT  X  XA XT2  #  A  XT  X  X XT &#   XT  X  XA XT(3  #  A  XT  X  X XT theevidenceisclearandconvincingth#   XT  X  XA XTo3  #  A  XT  X  X XT atthechild(ren)(Showname(s)ofchild(ren)online):   	 4        &#   XT  X  XA XT3  #  A  XT  X  X XT 0     iswithoutadequateparentalcare,controlorsubsistenceandtheconditionisnotdue   	     solelytothelackoffinancialmeansofthechildsparentsorothercustodian;_________   	    _______________________________________________________________________     (#(#  0     &0    (#(# #   XT  X  XA XT}4  #  A  XT  X  X XT iswithoutthecareorcontrolnecessaryforthechildsphysical,mentaloremotional   	 r   health;_________________________________________________________________    ^  (#(#  0     &#   XT  X  XA XT@6  #  A  XT  X  X XT 0    (#(# hasbeenphysically,mentallyoremotionallyabusedorneglected,orsexuallyabused;   	 6"    _______________________________________________________________________    "#! (#(#   P    A  XT  X  XA XT                               P  8        0     &#   XT  X  XA XTu7  #  A  XT  X  X XT 0    (#(# hasbeenplacedforcareoradoptioninviolationoflaw;_________________________   	 $X #   __________________________________________________________________________ P  8  8   ݌    %D!$ (#(#  Ќ                A  XT  X  XA XT 	             8    P    A  XT  X  XA XT                      P  :         P  :  ;   ݌̌                A  XT  X  XA XT 	          -       P    A  XT  X  XA XT                             ;             P  ;        0     &#   XT  X  XA XTA9  #  A  XT  X  X XT 0    (#(# hasbeenabandonedordoesnothaveaknownlivingparent;_______________________   	 ($'   ________________________________________________________________________ P  ;  0<   ݌    )$( (#(#  Ќ                A  XT  X  XA XT 	             <    P    A  XT  X  XA XT                      P   >         P   >  X>   ݌   	 *%)   Ќ                A  XT  X  XA XT 	          11       P    A  XT  X  XA XT                             >                     X   '     X , `	X'  P  ?        0     &#   XT  X  XA XT<  #  A  XT  X  X XT 0    (#(# isnotattendingschoolasrequiredbyK.S.A.72977or721111,andamendmentsthereto;   	       _________________________________________________________________________ P  ?  ?   ݌      (#(#  Ќ                A  XT  X  XA XT 	             v?             P    A  XT  X  XA XT                             A             P  A         P  A  4B   ݌   	 z   Ќ                A  XT  X  XA XT 	      P    A  XT  X  XA XT                             "B             P  B        0     &#   XT  X  XA XT#@  #  A  XT  X  X XT 0    (#(# exceptinthecaseofaviolationofK.S.A.214204a,41727,subsection(j)ofK.S.A.74   	 f   8810orsubsection(m)or(n)ofK.S.A.793321,andamendmentsthereto,or,exceptas   	 R   providedinK.S.A.382202(d)(12),didanactwhich,whencommittedbyapersonunder   	 >	   18yearsofage,isprohibitedbystatelaw,cityordinanceorcountyresolutionbutwhichis   	 *
   notprohibitedwhendonebyanadult;__________________________________________   	 t   ________________________________________________________________________ P  B  NC   ݌    ` (#(#  Ќ                A  XT  X  XA XT 	             <C             P    A  XT  X  XA XT                             F             P  F         P  F  dG   ݌   	 L	   Ќ                A  XT  X  XA XT 	      P    A  XT  X  XA XT                             RG             P  G        0     &#   XT  X  XA XTC  #  A  XT  X  X XT      whilelessthan10yearsofage,committedanactwhichifdonebyanadultwould P  G  xH   ݌    8	
 (#(#  Ќ                A  XT  X  XA XT 	      P    A  XT  X  XA XT                             fH             P  I                  constitutethecommissionofafelonyormisdemeanorasdefinedbyK.S.A.213105, P  I  QJ   ݌   	 $
   Ќ                A  XT  X  XA XT 	      P    A  XT  X  XA XT                             ?J             P  OK                  andamendmentsthereto;___________________________________________________   	    ________________________________________________________________________ P  OK  K   ݌   	    Ќ                A  XT  X  XA XT 	             K             P    A  XT  X  XA XT                             9M             P  KM         P  KM  M   ݌   	    Ќ                A  XT  X  XA XT 	      P    A  XT  X  XA XT                             M             P  eN        0     &#   XT  X  XA XTH  #  A  XT  X  X XT      iswillfullyandvoluntarilyabsentfromthechildshomewithouttheconsentofthe P  eN  N   ݌    v (#(#  Ќ                A  XT  X  XA XT 	      P    A  XT  X  XA XT                             N             P  ?P                  childsparentorothercustodian;_____________________________________________   	 b   ________________________________________________________________________ P  ?P  P   ݌   	 N   Ќ                A  XT  X  XA XT 	             P             P    A  XT  X  XA XT                             1R             P  CR         P  CR  R   ݌   	 :   Ќ                A  XT  X  XA XT 	      P    A  XT  X  XA XT                             R             P  ]S        0     &#   XT  X  XA XT=O  #  A  XT  X  X XT      iswillfullyandvoluntarilyabsentatleastasecondtimefromacourtorderedor P  ]S  S   ݌    & (#(#  Ќ                A  XT  X  XA XT 	      P    A  XT  X  XA XT                             S             P  2U                  designatedplacement,oraplacementpursuanttocourtorder,iftheabsenceis P  2U  U   ݌   	 p   Ќ                A  XT  X  XA XT 	      P    A  XT  X  XA XT                             U             P  V                  withouttheconsentofthepersonwithwhomthechildisplacedor,ifthechildis P  V  -W   ݌   	 \   Ќ                A  XT  X  XA XT 	      P    A  XT  X  XA XT                             W             P  -X                  placedinafacility,withouttheconsentofthepersoninchargeofsuchfacilityor P  -X  X   ݌   	 H   Ќ                A  XT  X  XA XT 	      P    A  XT  X  XA XT                             X             P  Y                  suchpersonsdesignee;____________________________________________________   	 4   ________________________________________________________________________ P  Y  .Z   ݌   	     Ќ                A  XT  X  XA XT 	             Z             P    A  XT  X  XA XT                             [             P  [         P  [  .\   ݌   	    Ќ                A  XT  X  XA XT 	      P    A  XT  X  XA XT                             \             P  \             &#   XT  X  XA XT5T  #  A  XT  X  X XT 0     hasbeenresidinginthesameresidencewithasiblingoranotherpersonunder18yearsof   	    age,whohasbeenphysically,mentallyoremotionallyabusedorneglected,orsexually   	    abused;_________________________________________________________________   	 r   ________________________________________________________________________ P  \  B]   ݌    ^ (#(#  Ќ                A  XT  X  XA XT 	             0]             P    A  XT  X  XA XT                             _             P  _         P  _  f`   ݌   	 J    Ќ                A  XT  X  XA XT 	      P    A  XT  X  XA XT                             T`             P  `             &#   XT  X  XA XT]  #  A  XT  X  X XT 0     whilelessthan10yearsofagecommittedtheoffensedefinedinK.S.A.214204a,and   	 6!   amendmentsthereto;_______________________________________________________   	 ""    ________________________________________________________________________ P  `  za   ݌    #l! (#(#  Ќ                A  XT  X  XA XT 	             ha             P    A  XT  X  XA XT                             c             P  c         P  c  0d   ݌   	 #X"   Ќ                A  XT  X  XA XT 	          &#   XT  X  XA XTa  #  A  XT  X  X XT 0     hashadapermanentcustodianappointedandthepermanentcustodianisnolongerable   	 $D #   orwillingtoserve;_______________________________________________________   	 %0!$   ________________________________________________________________________    &"% (#(#             X #   XT  X  XA XTd  #  A  XT  X  X XT      andeachchildnamedaboveisaChildinNeedofCare.#   XT  X  XA XTf  #  A  XT  X  X XT    	 (#'   @    uu)  or#   XT  X  XA XTg  #  A  XT  X  X XT Ԁ#   XT  X  XA XTg  #  A  XT  X  X XT Ԉ   	 n*%)   &#   XT  X  XA XTg  #  A  XT  X  X XT ther#   XT  X  XA XT*h  #  A  XT  X  X XT eisnotsufficientevidencetosupportthepetition.   	 ^+&*         #   XT  X  XA XTph  #  A  XT  X  X XT 0           3.     HAVINGSOFOUND,THECOURTORDERS:      (#(#  #   XT  X  XA XT
i  #  A  XT  X  X XT &#   XT  X  XA XTi  #  A  XT  X  X XT Thefollowingpartiesaredischarged:_____________________________________________.   	 z   #   XT  X  XA XTi  #  A  XT  X  X XT #   XT  X  XA XTj  # 4.0     THECOURTFURTHERFINDSTHATtheCourtspreviousfindingsandorders:    R (#(#  &0     shallremaininfullforceandeffect.    >	 (#(#  &0     shallremaininfullforceandeffecttotheextentthattheyarenotinconsistentwithany   	 *
   findingsorordersinthepresentorder,andexceptthatitisnowinthebestinterestofthe   	 t   child(ren)forcustodytobeplacedwith______________________andthat:(ifthisisthe   	 `   firstorderremovingcustody,complete reasonableeffortsand contrarytowelfare   	 L	   findingsbelow)    8	
 (#(#  -      , X  X- % Q    % Q   m    M  XT  X  X XT      &#   XT  X  XM XTn  #  M  XT  X  X XT     4 Reasonableeffortshavebeenmadeandhavefailedtomaintainthefamilyandprevent   	 $
   0     the

removalofthechild(ren)fromthechild(ren)shomeasfollows:(Specifybasisfor   	    findingforeachchild.)________________% [    -     ____________________________________     (#(#       ________________________________________________________________________-     % [   o   Ԁ   	         ________________________________________________________________________   	 v        or   	 b      X              % \    % \   Qq   -     4(#   , X- 0     &    4 Reasonableeffortsarenotrequiredtomaintainthechild(ren)inthehomebecause#   XT  X  XM XT^n  # Ԁan   	 N   emergencyexistswhichthreatensthesafetyofthechild(ren).(Specifybasisforfinding   	 :   foreachchild.)_______ M  XT  X  X XT -     ___________________________________________________    & (#(#       _______________________________________________________________________-        	 p   _______________________________________________________________________   	 \        #   XT  X  XM XTr  #  M  XT  X  X XT Թ           X $     (#  4(#$      or   	 4   '      4(#  (#'      % _    % _   u   #   XT  X  XM XT]t  #  M  XT  X  X XT 0     &#   XT  X  XM XT]u  #  M  XT  X  X XT     4 Reasonableeffortsarenotrequiredwithrespecttoaparentbecausetheparenthas   	     beenfoundbyacourttohave:     (#(#        E  + `	 4 `	   h   p    x   (#   4(#E       % g        4 &% g   v   0    `	 committedmurderinthefirstdegree,K.S.A.213401,andamendmentsthereto;   	    murderintheseconddegree,K.S.A.213402,andamendmentsthereto;capital   	    murder,K.S.A.213439,andamendmentsthereto;voluntarymanslaughter,   	 r   K.S.A.213403,andamendmentsthereto;orviolatedalawofanotherstatewhich   	 ^   prohibitssuchmurderormanslaughter;ofanotherchildoftheparent;    J  `	(#`	(#  E  . `	  4 `	   h   p    x   (#`	 4 `	XE % h    0    4 &% h   Iy   0    `	4(#4(# aidedorabetted,attempted,conspired,orsolicitedtocommitsuchmurderor   	 6!   voluntarymanslaughterofanotherchildoftheparentasprovidedabove;    ""  `	(#`	(#     _  .  *   `	  4 `	(#`	 , X* % i        4 &% i   z   0    `	 committedafelonybatterythatresultedinbodilyinjurytothechildoranother   	 #l!   childoftheparent;    #X" `	(#`	(#     .  _   E  . `	  4 `	   h   p    x   (#`	 ,(#E % j    0    4 &% j   {   0    `	4(#4(# subjectedthechildtoaggravatedcircumstancesasdefinedinK.S.A.382202(c);    $D # `	(#`	(#     _  .   *   `	  4 `	(#`	 , X* % k        4 &% k   |   0    `	 parentalrightsoftheparenttoasiblinghavebeenterminatedinvoluntarily.    %0!$ `	(#`	(#      4 (Specifydeterminingfactors.)% l    ___________________________________________   	 &"%   _________________________________________________________________   	 '#&   _________________________________________________________________   	 (#'       4 0    `	 0 @  `	    % l   }       `	(#`	(#                   $     (#`	 ,(#$ or   	 n*%)        % m    % m   L   #   XT  X  XM XTu  #  M  XT  X  X XT '      4(#  (#' 0     &#   XT  X  XM XT  #  M  XT  X  X XT 0    4(#(# Reasonableeffortshavenotbeenmade.(Specifybasisforfindingforeach_      child.)   	 Z+&*   _____________________________________________________________________   	       _____________________________________________________________________   	     _____________________________________________________________________    z 4(#4(#            or   	 R        0     &#   XT  X  XM XT  #  M  XT  X  X XT 0    4(#(# Reasonableefforts&havebeenmade#   XT  X  XM XTD  #  M  XT  X  X XT &#   XT  X  XM XTȂ  #  M  XT  X  X XT ԁhavenotbeenmadetofacilitatethe   	 >	   permanencyplan.(Specifybasisforfindingforeachchild.)#   XT  X  XM XT  #  M  XT  X  X XT Ԁ___________________   	 .
   ____________________________________________________________________   	 x   ____________________________________________________________________#   XT  X  XM XTك  #  M  XT  X  X XT     d 4(#4(#  @    *  #   XT  X  XM XT  #  M  XT  X  X XT Ԉ   .  _   H  .    `	   h   p    x   (#   4(#H 5.     THECOURTFURTHERFINDSTHAT&#   XT  X  XM XT[  # Ԁthechild(_      ren_      )islikelytosustainharmif   	 (
   notimmediatelyremovedfromthehome;&% n    % n      Ԁremaininginthehomeorreturninghome   	    wouldbecontrarytothewelfareofthechild(_      ren_      );and/or&% o    % o   }   Ԁimmediateplacementisinthe   	    bestinterestofthechild(_      ren_      ),specifically:(Specifybasisforfindingforeachchild.) M  XT  X  X XT       #   XT  X  XM XTQ  #  M  XT  X  X XT -        	    Name:_______________________________________________________________________   	         ________________________________________________________________________-        	 r   Name:_______________________________________________________________________   	 ^        ________________________________________________________________________   	 J   #   XT  X  XM XT  #  M  XT  X  X XT Name:_______________________________________________________________________   	 6        ________________________________________________________________________   	 "   #   XT  X  XM XT  #  M  XT  X  X XT      #   XT  X  XM XTϋ  #  M  XT  X  X XT 6.0     TheCourt#   XT  X  XM XT   #  M  XT  X  X XT 0#   XT  X  XM XT~  #  M  XT  X  X XT Ԁapprovesandadoptstheproposedpermanencyplanastheplanfor   	 X   permanencyinthepresentmatteror#   XT  X  XM XTǌ  #  M  XT  X  X XT 0#   XT  X  XM XT  #  M  XT  X  X XT Ԁdoesnotapprovetheproposedpermanency   	 H   planandordersanewpermanencyplansubmittedtotheCourtwithin30days.    4 (#(#  #   XT  X  XM XTʍ  #  M  XT  X  X XT 7.0     &THECOURTFURTHERFINDS:     (#(#       _______________________________________________________________________   	         _______________________________________________________________________   	         _______________________________________________________________________.   	 v   #   XT  X  XM XT  #  M  XT  X  X XT #   XT  X  XM XT  #  M  XT  X  X XT 8.     THECOURTTHEREFOREORDERSTHATtheabovenamedchild(_      ren_      )&% p    % p   X   Ԁshallbe   	 N!   % q    % q      &shallremainplacedinthecustodyof:   	 >"         % r    &% r      ԀTheSecretary,or   	 .#!        % s    &% s   Y   Ԁ% t    -     ____________________________________________________________________-     % t      .   	 $x"   @    \\)  and   	 %P!$        &#   XT  X  XM XTɐ  #  M  XT  X  X XT ԀAchildsupportordershallissue.   	 &<"%   #   XT  X  XM XTx  #  M  XT  X  X XT      &#   XT  X  XM XT  #  M  XT  X  X XT ԀEachparentshallsubmitinformationtothechildsupportofficeforachildsupport   	 '(#&   ordertobeprepared,orpresentdocumentationofacurrentchildsupportorderwithin____days#   XT  X  XM XTD  #  M  XT  X  X XT .#   XT  X  XM XTP  #  M  XT  X  X XT    	 ($'   #   XT  X  XM XT  #  M  XT  X  X XT #   XT  X  XM XT  #  M  XT  X  X XT      9.     #   XT  X  XM XT-  #  A  XT  X  X XT dTHECOURTORDERSallprovidersofservices#   XT  X  XA XT  # L
   
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  A  XT  X  X XT Ԁ#   XT  X  XA XT  # L
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  A  XT  X  X XT includingeducationalservices#   XT  X  XA XTl  # L
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  A  XT  X  X XT ,treatment,   	 *%)   #   XT  X  XA XT  # L
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  A  XT  X  X XT education#   XT  X  XA XTW  # L
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  A  XT  X  X XT Ԁorcareofthechildandfamily,evenifnotspecificallyreferredtoherein,toprovide   	 ~+&*   information A  &
 %  XA XT #   &
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 #   XT  X
 % &O  #  A  XT  X  X XT including#   XT  X  XA XTș  # L
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  A  XT  X  X XT anyandalleducationalrecords#   XT  X  XA XT~  # L
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  A  XT  X  X XT Ԁtothesecretary,anyentityprovidingservices   	       tothechildandfamily,counselforthepartiesincludingthecountyordistrictattorney,appointed   	     CASA,CitizenReviewBoardmembers,thecourt,andeachothertotheextentneededtoensurethe   	 z   safetyofthechild,preventfurtherabuseorneglect,andtoprovideappropriatetreatment#   XT  X  XA XT  # L
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  A  XT  X  X XT ,careand   	 f   services#   XT  X  XA XT؜  # L
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  A  XT  X  X XT Ԁtothechildandfamily.Thisorderencompasses#   XT  X  XA XTU  # L
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  A  XT  X  X XT andcomplieswith#   XT  X  XA XTܝ  # L
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  A  XT  X  X XT Ԁtheprovisionsofthe   	 R   #   XT  X  XA XTC  # L
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  A  XT  X  X XT FamilyEducationRightsandPrivacyAct(20U.S.C.1232g;34_      C.F.R._      Ԁ99#   XT  X  XA XTĞ  # L
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  A  XT  X  X XT Ԁ A  &
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 % &렟  #  A  XT  X  X XT andthe#   XT  X  XA XT  # L
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  A  XT  X  X XT ԀPrivacyRuleof   	 >	   theHealthInsurancePortabilityandAccountabilityActof1996(_      HIPAA_      ),45_      C.F.R._      Ԁ164.512(e)(1).#   XT  X  XA XTv  # d M  XT  X  X XT    	 *
   #   XT  X  XM XT  #  M  XT  X  X XT B  .    `	   h   p    x   (# XB #   XT  X  XM XTܡ  #  M  XT  X  X XT &#   XT  X  XM XTa  #  M  XT  X  X XT      THECOURTFURTHERORDERS:   	 `   #   XT  X  XM XT  #  A  XT  X  X XT 0     ______________________________________________________________________0 @  `" &        _____    L	 (#(#  0     _______________________________________________________________________0 @  "(#(#     8	
 (#(#       ________________________________________________________________________   	 $
   #   XT  X  XA XT#  #  M  XT  X  X XT &#   XT  X  XM XT  #  A  XT  X  X XT ԀArestrainingordershallbefiledagainst__________________________________________.#   XT  X  XA XT1  #  A  XT  X  X XT    	    #   XT  X  XA XTʥ  #  M  XT  X  X XT &#   XT  X  XM XT"  #  A  XT  X  X XT ԀTheSecretary#   XT  X  XA XTk  #  M  XT  X  X XT &CourtServices#   XT  X  XM XT  #  A  XT  X  X XT Ԁ#   XT  X  XA XT  #  M  XT  X  X XT &____________________________________________   	 v   shallcompletereportsandsubmitthemtotheCourtby___________________________.#   XT  X  XM XTV  #  A  XT  X  X XT    	 f   #   XT  X  XA XT4  #  A  XT  X  X XT      THECOURTFURTHERORDERSthismattersetfor_      dispositional_      Ԁhearing#   XT  X  XA XT  #  A  XT  X  X XT onthe_____   	 >   dayof_______________,________,at_______#   XT  X  XA XT=  #  M  XT  X  X XT &#   XT  X  XM XTͩ  #  A  XT  X  X XT Ԁa.m.#   XT  X  XA XT  #  M  XT  X  X XT Ԁ&#   XT  X  XM XT^  #  A  XT  X  X XT Ԁp.m.   	 *   #   XT  X  XA XT  #  A  XT  X  X XT      ITISSOORDEREDTHIS______dayof___________________,________.   	 d   #   XT  X  XA XT  #          `	               h               p ________________________   	 (            `	               h               p JudgeoftheDistrictCourt   	          A  XT  X  X XT #   XT  X  XA XT֬  # @    jj&  @ @  jj&  Authority   	 z   _      K.S.A._      Ԁ382247,382251and A  XT  X  X XT 42U.S.C.#   XT  X  XA XT  #  M  XT  X  X XT 671etseq.#   XT  X  XM XT  # .   	 R    @    $  NotesonUse   	 #t!        Thisisthelongformfortemporarycustody.Whenusingthisformnootherjournalentry   	 $L #   isrequiredoradvised.Thisformiscompleteinandofitself,recitingappearancesandallowing   	 %8!$   spaceforfindingsandordersofthecourt.   	 &$"%        Ifthecourt,inissuingthisorder,removesthechildfromthehome,andifitisthefirstorder   	 '#&   removingthechildfromthehomeorthefirstorderofremovalwhenthechildhasbeenhomeforsix   	 (#'   monthsorlonger(asinaninformalsupervision),SupremeCourtAdministrativeOrderNo.155   	 )$(   appliesandrequirestheuseofthisformoranotherformapprovedbytheSupremeCourtasmeeting   	 v*%)   _      ASFA_      Ԁrequirements.Failuretomakeandproperlydocumentthefindingsrequiredby_      ASFA_      Ԁwill   	 b+&*     S N  
   S        
     S  
   
 resultinthelossoffederalfundingfortheplacement,oranysubsequentplacement,ofthechildin   	       _      thepresentcase.Federalfundingisnotavailablewhenthecourtfindsreasonableeffortshavenot   	     beenmadeunlessthecourtalsofindstheeffortswerenotrequired.Findingthatreasonableefforts   	 z   werenotmadedoesnotbarthecourtfromremovingthechildandfailuretomakethesefindings   	 f   doesnotbarthecourtfromremovingthechild.   	 R        Whenacourthasreasontobelieveachildinvolvedinachildinneedofcareproceedingis   	 >	   anIndianchild,ICWAapplies;noticerequirements,findingsandprocedurearedictatedbyICWA,   	 *
   andtheICWAforms(Forms210!223)mustbeused.Thecircumstancesunderwhichacourthas   	 t   reasontobelieveachildisanIndianchildinclude,butarenotlimitedto,thefollowing:anyparty   	 `   tothecase,Indiantribe,oragencyinformsthecourtthatthechildisanIndianchild;anyagency   	 L	   involvedinchildprotectionservicesorfamilysupporthasdiscoveredinformationsuggestingthat   	 8	
   thechildisanIndianchild;thechildgivesthecourtreasontobelieveheorsheisanIndianchild;   	 $
   theresidenceofthechild,parent(s),orcustodianisknowntobeapredominantlyIndiancommunity;   	    aparentofthechildisenrolledinatribe;oranofficerofthecourthasknowledgethatthechildmay   	    beanIndianchild.RemovalofanIndianchildfromthehomeisprohibitedwithoutthespecific   	    findingsrequiredbyICWAeitherenteredwiththeorderofremoval,orwithin90daysiftheremoval   	 v   wasduetoanemergency.DepartmentoftheInterior,BIAGuidelinesforStateCourts,IndianChild   	 b   CustodyProceedings.   	 N        Adjudicationhearingsarenowopentothepublic,unlessthecourtdeterminesthatclosed   	 :   proceedings,ortheexclusionofaspecificperson,areinthebestinterestsofthechildorare   	 &   necessarytoprotecttheprivacyrightsoftheparents.Thecourtmayexcludethepublicduringthe   	 p   presentationofevidencethatisconfidential(seeK.S.A.382209)orconductanincamera   	 \   inspection.Thecourtmaynotexcludetheguardianadlitem,partiesorinterestedparties.Thecourt   	 H   shallpermittheattendanceofuptotwopeoplewhohavebeendesignatedbytheparentasallies,if   	 4   theyhaveparticipatedinaparentallyorientationprogramapprovedbythejudicialadministrator.   	     Anallymayberemovediftheallybecomesdisruptiveorhasbeendisruptiveinapriorproceeding.   	    K.S.A.382247.   	         Onceacaseisfiled,anadjudicatoryhearingshallbeheldwithoutunduedelay,andwithin   	    60daysfromthedatethechildwasremovedfromthehome,ifapplicable.K.S.A.382251provides   	 r   thatifthecourtdoesnotfindbyclearandconvincingevidence,pursuanttoK.S.A.382250,thatthe   	 ^   childisachildinneedofcare,thenthecourtshalldismisstheproceedings.Thisformprovidesfor   	 J    dismissalastosomepartiesandadjudicationastoothers.   	 6!        Thecourtmayenteranorderforoneorbothparentstopaychildsupportifthechildis   	 ""    placedwithapersonotherthanaparent,andshallenterachildsupportorderifthesecretaryis   	 #l!   grantedcustodyofthechild.Ifthecourtawardscustodyofthechildtothesecretarythenthe   	 #X"   secretaryshallhavetheauthoritytoplacethechild,andthecourtmaymakeplacement   	 $D #   recommendations.Ifthecourtawardscustodytothesecretary,thenthecourtshallprovidethe   	 %0!$   secretarywithacopyofanyordersentered.   	 &"%        Whentheterm orstandsalonebetweenoptionalfindings/orders,morethanonechoicemay   	 '#&   bechecked.Eachchoicecheckedmustbejustifiedasinstructed,e.g.specifybasisforfinding.   	 (#'   @    ::&  Comments   	 n*%)        AnadjudicationhearingisrequiredwhenapartyfilesaCINCpetitionandnostipulationhas   	 F,'+   beenentered.InreK.W.,24Kan.App.2d724,953P.2d229(1998).   	            Acourtisnotrequiredtodeterminewhetherreintegrationwiththecustodialparentisaviable   	     alternativebeforeplacingthechildwiththenoncustodialparent.InreT.S.,276Kan.282,74P.3d   	 z   1009(2003).
