WPC7  
      T     \ 2"_^FxO2.,}se]x!Ud ^F?Hk-%N)|W;zJ@({T'Q=YNu7vOP.Րj=lڪH&jŨGKz@[bʣUe3;#|PYXبACresQ>%!q[ET-qgcJo@-	۠m,O[3BIe0,ػ7ɂ,ݰ\&k.?ٽg([yT@d{n/~&XoHC!@/RT5d9-eaY-չΩ%fa WM[W@"l
7^|\ON|OF+H>Yg??o[e&O]x1bON=wJ	5sA&cnsͭyco (           #     0   U   N     	%      G  0   :   M  0   d     U   >      Uk   >   )	        g	  0   U   \
  ^      
  w      
   	      
   	      
   	      
   	      
   	         	         	      !   	      3  4      E        Y        h  	m      j  N         b                                                                                                                                                                    07         H P L J 3 3 0 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    (                  $          USUS. ,      0                . H e a d e r           (#     X      XX S            \	  	   `   & T i m e s   N e w   R o m a n         S  A  7        X   `	   h   p    x   (#A S            \	  	   `   & T i m e s   N e w   R o m a n         S     X      XX  \	  	   `   & T i m e s   N e w   R o m a n          \	  	   `  & T i m e s   N e w   R o m a n          
      
 	  '    USUS. ,      _            $      (#   X$    X  X  X X      X  X  X X              =         8/1/07    (   -               2$       
   !    USUS. ,      Aj6Z          T e x t 1    T e x t 2    T e x t 3    T e x t 4    T e x t 5    T e x t 6    C h e c k 1    C h e c k 2   DM6    :i +003| x                    U    -  -       H   2           2   4 B o d y   T e x t   B o d y   T e x t       X      XX                                   
   !    USUS. ,      _            X        @    VV)  105   	 D              ,                       8    X  X       d                  d  8 =      X   X       d                 d=    X  X  X X   INTHEDISTRICTCOURTOF     %     -     ________________-     %       ԀCOUNTY,KANSAS   	 0         3   	    p    x   (#   X3    33     INTHEINTERESTOF:   	    Ѐ   	       _  .  0      p" (#    pX0 Name%     -     __________________________________-     %           p CaseNo.%     -     __________________-     %    O      	 *	      .  _   <   	    z    x   (#   p" (#<       33  DOB%     -     xx/xx/____%       %     %    Y   %     -     %    w   0     A#   X  X  X XF  #    X  X  X X &#   X  X  X X  #    X  X  X X %     %    :   Ԁmale%     #   X  X  X X  #    X  X  X X Ԁ#   X  X  X X  #    X  X  X X &#   X  X  X X  # %    ]      X  X  X X Ԁfemale    E
 (#(#     _  .   <        z p" (#    z X<    33     #   X  X  X X(  #    X  X  X X @    ww  APPLICATIONFOREXPARTEORDEROFPROTECTIVECUSTODY   	 g#

   @      PursuanttoK.S.A.382242   	 >   @    *             33       COMESNOW__________________________&County/DistrictAttorneyordesignee   	 t   &#   X  X  X X  #    X  X  X X Ԁother______________________,andmakesapplicationforanexparteOrderofProtective   	 `   Custody.TheapplicantbelievesthattheabovecaptionedchildisaChildinNeedofCare.The   	 L   applicantfurtherstatesthatthechildislikelytosustainharmifnotimmediatelyremovedfromthe   	 |8   homeandallowingthechildtoremaininthehomeiscontrarytothewelfareofthechild.   	 h$   (Sections1through6areforusewhenthisapplicationissubmittedtothecourtwithoutapetition.   	 @   Theymaybedeletedifapetitionisonfileorsubmittedforfilingwiththisapplication.)   	 ,   <      X  ' X     z p" (#< 1.              ' CHILD:   	        ' Name:    `	      0     DOB:xxxx______    p 0    (#(# _        SSN_        :0     (#(# xxxxx______      (# (#      ' Address:    `	 0     0    (#(# 0    h(#(# 0    h(#h(#      0    p(#(# 0    p(#p(# 0     (#(# 0seecoversheet      (# (#      ' Phone:    `	 0     0    (#(# 0    h(#(# 0    h(#h(# 0    (#(# 0    p(#(# 0    p(#p(# 0     (#(# 0unknown      (# (#  2.    ' MOTHER:   	 p       ' Name:    `	      0     DOB:0seecoversheet    p 0    (#(# SSN:0     (#(# xxxxx______    \  (# (#      ' Address:    `	 0     0    (#(# 0    h(#(# 0unknown0    h(#h(# 0    p(#(# 0    p(#p(# 0     (#(# 0seecoversheet    H  (# (#      ' Phone:    `	 0     0    (#(# 0    h(#(# 0    h(#h(# 0    (#(# 0    p(#(# 0    p(#p(# 0     (#(# 0unknown    x4  (# (#  3.    ' FATHER:   	 P!   0    ' Name:    `	      0    '(#'(# DOB:0seecoversheet0    p(#(# 0    p(#p(# SSN:0     (#(# xxxxx______    <"   (# (#      ' Address:    `	 0     0    (#(# 0    h(#(# 0unknown0    h(#h(# 0    p(#(# 0    p(#p(# 0     (#(# 0seecoversheet    (#!  (# (#      ' Phone:    `	 0     0    (#(# 0    h(#(# 0    h(#h(# 0    (#(# 0    p(#(# 0    p(#p(# 0     (#(# 0unknown    $ "  (# (#  4.    ' CUSTODIAN(ifotherthanaparent):   	 %"$       ' Name:   	 &#%       ' Address:   	 '$&       ' Phone:   	 (l%'   5.    ' MATERNALGRANDPARENTS:   	 *D')       ' Name:   	 t+0(*       ' Address:   	 `,)+       ' Phone:   	 L-*,      	 $/+.   6.    ' PATERNALGRANDPARENTS:   	 D          ' Name:   	 0        ' Address:   	        ' Phone:   	                  JURISDICTION   	                 0    '       5.    ' a.TheIndianChildWelfareAct0isapplicable0isnotapplicable0applicabilityis   	 
`   undetermined.    
 '(#'(#      ' b.0     TheCourthasjurisdictiontomakeachildcustodydeterminationpursuanttoK.S.A.   	 n*
   38-1351(a),andamendmentsthereto.     (#(#      ' c.0     TheCourthasjurisdictionofthepartiesandthesubjectmatterofthisproceedingpursuant   	 8   toK.S.A.382203,andamendmentsthereto.    \ (#(#      VENUE   	        6.    ' 0     PursuanttoK.S.A.382204,andamendmentsthereto,venuein__________County,Kansas   	 d    isproper.#   X  X  X X  #    X  X  X X      (#(#              ' &#   X  X  X X   #    X  X  X X ԀReasonableeffortshavebeenmadeandfailedtomaintainthefamilyandpreventremoval   	 L   ofthechild.(Specifytheeffortsmade)______________________________________________   	 |8   ______________________________________________________________________________   	 h$   ______________________________________________________________________________   	 T   ______________________________________________________________________________   	 @    ______________________________________________________________________________   	 ,!   ______________________________________________________________________________.   	 "   @    )  or   	 $       ' &#   X  X  X X  #    X  X  X X ԀAnemergencyexistswhichthreatensthesafetyofthechildandreasonableeffortsarenot   	 !&   requiredtomaintainthechildinthehome.(Specifythebasisfortheallegation)_____________   	 "p'   _        ______________________________________________________________________________           	 #\ (   _______________________________________________________________________________   	 $H!)   ______________________________________________________________________________   	 x%4"*   ______________________________________________________________________________.   	 d& #+          _       ' &#   X  X  X X  #    X  X  X X ԀAstatementoffactsisattachedandincorporatedbyreferencethereto.   	 (n%.       ' WHEREFORE,yourapplicantrequestsanExParteTemporaryOrderofProtectiveCustody,   	 v+2(2   pursuanttoK.S.A.382242.   	 ,)4    '      X  X  X X                              '  "            '          `	               h           ________________________________ '  "  "   ݌   	 :.*6   Ќ                X  X  X X 	      '      X  X  X X                              '  #            ' 0     0    `	(#(# 0    `	(#`	(# 0    (#(#     h           Applicant '  #  $   ݌    &/+7 (#(#  Ќ                X  X  X X 	         '     VERIFICATION   	 b    '      X  X  X X    X  X  X X                              '  l%         '  l%  %   ݌̌                X  X  X X    X  X  X X 	                   STATEOFKANSAS0     )     (#(#      '          `	           )ss:    h               p       '      X  X  X X                      '  o'        COUNTYOF__________0     ) '  o'  '   ݌     (#(#  Ќ                  X  X  X X 	     #   X  X  X X   #    X  X  X X %   X  X  XX  X X%  '      X  X  X X    X  X  X X    X  X  X X    X  X  X X                                '  (         '  (  )   ݌̌                  X  X  X X    X  X  X X    X  X  X X    X  X  X X 	      '      X  X  X X    X  X  X X    X  X  X X    X  X  X X                      '  *            ' COMESNOW____________________,oflawfulage,beingfirstdulyswornandunderoath,   	 L
   andstates: '  *  H+   ݌   	 h$
   Ќ                  X  X  X X    X  X  X X    X  X  X X    X  X  X X 	      '      X  X  X X    X  X  X X    X  X  X X    X  X  X X                      '  ,            ' Iamtheapplicantabovenamed,andIhavereadandunderstandtheaboveandforegoing   	 @   ApplicationforExParteOrderofProtectiveCustody,andbelievethatallofthecontentthereofis   	    trueandcorrect. '  ,  p-   ݌   	    Ќ                  X  X  X X 	     )   X  X  XX  X X(  )  '      X  X  X X                                '  5/            '          `	               h               p _________________________ '  5/  /   ݌   	    Ќ                  X  X  X X 	      '      X  X  X X                                '  0            '          `	               h               p Applicant '  0  "1   ݌   	 p   Ќ                  X  X  X X 	     %   X  X  XX  X X%  '      X  X  X X    X  X  X X    X  X  X X    X  X  X X                                '  P2            ' 0     0    `	(#(# 0    `	(#`	(#  '  P2  3   ݌    (#(#  Ќ                  X  X  X X    X  X  X X    X  X  X X    X  X  X X 	      '      X  X  X X    X  X  X X    X  X  X X    X  X  X X                                '  K4         '  K4  5   ݌̌                  X  X  X X    X  X  X X    X  X  X X    X  X  X X 	      '      X  X  X X    X  X  X X    X  X  X X    X  X  X X                                '  5            ' Subscribedandsworntobeforemethis_____dayof_______________,_______. '  5  6   ݌   	 x4   Ќ                  X  X  X X    X  X  X X    X  X  X X    X  X  X X 	      '      X  X  X X    X  X  X X    X  X  X X    X  X  X X                                '  8         '  8  8   ݌̌                  X  X  X X    X  X  X X    X  X  X X    X  X  X X 	      '      X  X  X X    X  X  X X    X  X  X X    X  X  X X                                '  9         '  9  n:   ݌̌                  X  X  X X    X  X  X X    X  X  X X    X  X  X X 	      '      X  X  X X    X  X  X X    X  X  X X    X  X  X X                                '  L;            '          `	               h               p ___________________________ '  L;  <   ݌   	 <   Ќ                  X  X  X X    X  X  X X    X  X  X X    X  X  X X 	      '      X  X  X X    X  X  X X    X  X  X X    X  X  X X                                '  =            '          `	               h               p NotaryPublic/ClerkoftheCourt/Deputy '  =  S>   ݌   	 (   Ќ                  X  X  X X    X  X  X X    X  X  X X    X  X  X X 	      '      X  X  X X    X  X  X X    X  X  X X    X  X  X X                      '  ?        #   X  X  X X(  #  '  ?  @   ݌̌                  X  X  X X 	     )   X  X  XX  X X+2  )  '      X  X  X X                      '  ZA        @    jj&  Authority '  ZA  A   ݌   	    Ќ                  X  X  X X 	     K.S.A.382242.   	 !l"   @    $  NotesonUse   	 t$0!%            ' Uponreceiptofaverifiedapplicationforprotectivecustodyandfindingprobablecauseto   	 L&#'   believetheallegationsinitaretrue,thecourtmayissueanexparteorderofprotectivecustody.In   	 8'#(   additiontotheinformationrequiredbythestatute,theformalsocontainslanguagethatwillassist   	 $($)   thecourtinmakingrequisiteASFAfindings.Thisapplicationmustincludethefactsreliedupon   	 )%*   tosupporttherequestforprotectivecustody,includingeffortsthathavebeenmadetoprevent   	 )&+   unnecessaryremovalofthechildorfactsrelatingtotheemergencywhichthreatensthesafetyofthe   	 *',   child.   	 +(-       ' NochildshallbeheldinprotectivecustodypursuanttoK.S.A.382232formorethan72hours.   	 ,|).   Thetimebeginstorunwhenthechildisadmittedtoafacilityordeliveredforcustody,regardless   	 -h*/   ofwhetheranorderforprotectivecustodywasissued.Timespentinpoliceprotectivecustody,prior   	 .T+0   totheissuanceofanorder,shallbeincludedinthe72hourcalculation.Aprotectivecustodyorder   	 /@,1   maynotbeusedinconjunctionwithpolicecustodytoextendthetotal72hours(notincluding   	 D      Saturday,Sundayandlegalholidays)thatachildmaybeinprotectivecustodywithoutatemporary   	 0    custodyhearing.   	    
