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Bc D1 D5 B* D5 B*E D5o B* D5 B* D5- B7b B7HPLJ33000(9 Z6Times New Roman RegularX($USUS.,http://www.kscourts.org = ]"USUS.,  _ ]"USUS.,  _  ,,XX ,,,,ForOfficeUseOnly3H $AZVerdana (9 Z(Times New Roman ͩ6Z DM6:i+003|xU(O$ԈTABLE ALevel 1Level 2Level 3Level 4Level 5(-2$ !USUS.,  - - p 'USUS.,  _"X C"8/1/07(.3$ !USUS.,  \\\\)!dxdx d(.3$ !USUS.,  d]Ze[E<<CLevel 1Level 2Level 3Level 4Level 5($$   1  gggg)!dxdx  diiii)!dxdxP Pdkkkk)!dxdx dmmmm)!dxdx dii)! dxdxpppp)!dxdx&0 d drrrr)!dxdx&P d dtttt)!dxdx&p d Pdvvvv)!dxdx&p Pd dxyxy)!dxdx3+0 d d d3+0 d d d !USUS.,  _XXsc?/+b~tP_ `@EP_tth+scH84nz} `@E)vv)v8XXdd8=XXdd=@VV)302       `      JUVENILEINFORMATIONSHEET p  uXX  Thejuvenileinformationsheetneitherreplacesnorsupplementsthefilingandserviceofpleadingsorotherpapersasrequiredbylaw.Thisformis \ requiredforusebytheClerkoftheDistrictCourtforthepurposesofinitiatingthejuveniledocketsheet.Thisinformationwillnotbeavailabletothe  ` publicandthisdocumentwillbestoredinaseparatelocationfromthecasefileandthendestroyedwithinareasonabletime.Anewcase willnotbe  accepted withoutacoversheetattached.(THISFORMMUSTBETYPEDORPRINTEDLEGIBLY).Thisformcanbefoundat4 !O  5  www.kscourts.org.6aOu  7 % p    *\ddd Xdd Xdd XX%X%,(#dd +  "p (  ( "gu gJUVENILE #g4# $8  p $ ugNATUREOFSUIT (PlaceanXinallboxesthatapply)#gu#    ^p \gp JUVENILEOFFENDER  2  CHILDINNEEDOFCARE  H    g \^ppAbuse   l    pNeglect t    $  | pDependent(nofault) \  pTerminationofParentalRights   t pOtherDependency/ChildVictim   , pStatusOffense/Petition D  #^p \g# 6  g \^p *X,XXuXX*(hXh@X%X%(CHILDSINFORMATION , ,,g (ATTACHADDITIONALSHEET,IFNECESSARY) v g,,NAME:       `     h  u  b ADDRESS:   `     h  u  T      `     h  u DLORSTATEIDNO: `     h  u  <  ,,g 0  00` StateandNumber."` `  g,, _SSN_:     ` DOB:    h  u  P$ RACE:0  ,,gWhiteBlackAsianAmericanIndian/AlaskanB&       PacificIslandUnknown x( g,,ETHNICITY:,,gHispanicNon_hispanic_ԀUnknown B* g,,SEX:     `  x, ALIASNAMESUSED: `     h  u  j.      `     h  u _KDR_ԀTransactionNumber `     h  R2 ATTORNEYS 6 jg(FirmName,Address,TelephoneNumberandSupremeCourtIDNumber) ,8 gj     `     h  u      `     h  u      `     h  u      `     h  u  OTHERPARTYSINFORMATION !IE ,,g(ATTACHADDITIONALSHEET,IFNECESSARY) "G #g,,`#NAME:     `     h  u  #K ADDRESS:   `     h  u  $q M      `     h  u DLORSTATEIDNO: `     h  u  Y%!Q ,,g 0  00` StateandNumber%K"S` `  #g,,# _SSN_:     ` DOB:    h  u  m&"U RELATIONSHIPTOCHILD:,,gCustodianFosterParent(s)  '_#W   Grandparent(s)GuardianParentOther '#Y g,,PHONE:     ` SEX:    h   (_$[ ALIASNAMESUSED: `     h  u  ($]      `     h  u      `     h  u ATTORNEYS *&'d jg(FirmName,Address,TelephoneNumberandSupremeCourtIDNumber) p+'f #gj#     `     h  u      `     h  u      `     h  u      `     h  u      `     h  -Q*o OTHERPARTYSINFORMATION ,o ,,g(ATTACHADDITIONALSHEET,IFNECESSARY) vq #g,,#NAME: p      x   (#  5%  bu ADDRESS:     x   (#  5%  Tw  p      x   (#  5% DLORSTATEIDNO:   x   (#  5%  <{ ,,g 0 p 0p%p%0 %%StateandNumber.} % % #g,,># _SSN_: p     DOB: x   (#  5%  P RELATIONSHIPTOCHILD:,,gCustodianFosterParent(s) B  p Grandparent(s)GuardianParentOther x #g,, #PHONE: p     SEX: x   (#  B ALIASNAMESUSED:   x   (#  5%    p      x   (#  5%  p      x   (#  5% ATTORNEYS(ifknown)  jg(FirmName,Address,TelephoneNumberandSupremeCourtIDNumber) @ #gjX## p      x   (#  5%  p      x   (#  5%  p      x   (#  5%  p      x   (#  5%  p      x   (# OTHERPARTYSINFORMATION  "] ,,g(ATTACHADDITIONALSHEET,IFNECESSARY) " #g,,%#NAME: p      x   (#  5%  # ADDRESS:     x   (#  5%  1$   p      x   (#  5% DLORSTATEIDNO:   x   (#  5%  m%! ,,g 0 p 0p%p%0 %%StateandNumber &_" % % #g,,'# _SSN_: p     DOB: x   (#  5%  &" RELATIONSHIPTOCHILD:,,gCustodianFosterParent(s) 's#  p Grandparent(s)GuardianParentOther '# #g,,j)#PHONE: p     SEX: x   (#  (s$ ALIASNAMESUSED:   x   (#  5%  (%  p      x   (#  5% ATTORNEYS(ifknown) *:' jg(FirmName,Address,TelephoneNumberandSupremeCourtIDNumber) +' #gj+# p      x   (#  5%  p      x   (#  5%  p      x   (#  5%  p      x   (#  5%  p      x   (#  .e* (hXh@XX(TherequirementthatSocialSecuritynumbersbeincludedonjuvenilecasesisnotmandatory.Thenumberisusedforpurposesofidentificationandmaybedisclosed M/+ aspermittedbylaw.Thisformisnotconsideredtobeapublicrecord. /?,   05042005  :0, _  XXg XXXXADDITIONALJUVENILEPARTYINFORMATION @  @  @  @  "v (X@X%X%(  XuXX XrXXu OTHERPARTYSINFORMATION N ,.,r(ATTACHADDITIONALSHEET,IFNECESSARY)  r,,.NAME:   `     h  u   f   ADDRESS:   `     h  u         `     h  u DLORSTATEIDNO: `     h  u  F ,.,r 0  00` StateandNumber ` `  r,,. _SSN_:     ` DOB:    h  u   ^ RELATIONSHIPTOCHILD:,.,rԀCustodianFosterParent(s)     Grandparent(s)0 ` Guardian0 ` ` ParentOther6    r,,.PHONE:   `  SEX:   h  u    ALIASNAMESUSED: `     h  u  N       `     h  u ATTORNEYS  2  )r(FirmName,Address,TelephoneNumberandSupremeCourtIDNumber) ~ " r)     `     h  u      `     h  u      `     h  u      `     h  u  OTHERPARTYSINFORMATION T/ ,.,r(ATTACHADDITIONALSHEET,IFNECESSARY) H1 #r,,.8#NAME:   `     h  u   l3  ADDRESS:   `     h  u   `5      `     h  u DLORSTATEIDNO: `     h  u  L9 ,.,r 0  00` StateandNumber@;` `  #r,,.;# _SSN_:     ` DOB:    h  u  d= RELATIONSHIPTOCHILD:,.,rԀCustodianFosterParent(s) X?   Grandparent(s)0 ` Guardian0 ` ` ParentOtherA   #r,,.<#PHONE:   `  SEX:   h  u  \C ALIASNAMESUSED: `     h  u  E      `     h  u ATTORNEYS 8J )r(FirmName,Address,TelephoneNumberandSupremeCourtIDNumber) ,L #r)>#     `     h  u      `     h  u      `     h  u      `     h  u  OTHERPARTYSINFORMATION Y ,.,r(ATTACHADDITIONALSHEET,IFNECESSARY) N[ #r,,.A#NAME:   `     h  u   ]  ADDRESS:   `     h  u  f _      `     h  u DLORSTATEIDNO: `     h  u  !c ,.,r 0  00` StateandNumberF"e` `  #r,,.-C# _SSN_:     ` DOB:    h  u  "g RELATIONSHIPTOCHILD:,.,rԀCustodianFosterParent(s) ^#i   Grandparent(s)0 ` Guardian0 ` ` ParentOther#> k   #r,,.D#PHONE:   `  SEX:   h  u  b$ m ALIASNAMESUSED: `     h  u  %V!o      `     h  u ATTORNEYS &"t )r(FirmName,Address,TelephoneNumberandSupremeCourtIDNumber) 2'#v #r)F#     `     h  u      `     h  u      `     h  u      `     h  u  )&  OTHERPARTYSINFORMATION N ,.,r(ATTACHADDITIONALSHEET,IFNECESSARY)  #r,,.,I#NAME:     x   (#  5%   f  ADDRESS:     x   (#  5%    p      x   (#  5% DLORSTATEIDNO:   x   (#  5%  F ,.,r 0 p 0p%p%0 %%StateandNumber  % % #r,,.SK# _SSN_: p     DOB: x   (#  5%   ^ RELATIONSHIPTOCHILD:,.,rԀCustodianFosterParent(s)    p Grandparent(s)0  Guardian0x % %ParentOther6 x%x% #r,,.L#PHONE:     x SEX:  (#  5%    ALIASNAMESUSED:   x   (#  5%  N   p      x   (#  5% ATTORNEYS(ifknown)  2  )r(FirmName,Address,TelephoneNumberandSupremeCourtIDNumber) ~  #r)O# p      x   (#  5%  p      x   (#  5%  p      x   (#  5%  p      x   (#  5%  OTHERPARTYSINFORMATION T ,.,r(ATTACHADDITIONALSHEET,IFNECESSARY) H #r,,.RQ#NAME:     x   (#  5%   l  ADDRESS:     x   (#  5%   `  p      x   (#  5% DLORSTATEIDNO:   x   (#  5%  L ,.,r 0 p 0p%p%0 %%StateandNumber@ % % #r,,.yS# _SSN_: p     DOB: x   (#  5%  d RELATIONSHIPTOCHILD:,.,rԀCustodianFosterParent(s) X  p Grandparent(s)0  Guardian0x % %ParentOtherx%x% #r,,.T#PHONE:     x SEX:  (#  5%  \ ALIASNAMESUSED:   x   (#  5%    p      x   (#  5% ATTORNEYS(ifknown) 8 )r(FirmName,Address,TelephoneNumberandSupremeCourtIDNumber) , #r)BW# p      x   (#  5%  p      x   (#  5%  p      x   (#  5%  p      x   (#  5%  OTHERPARTYSINFORMATION  ,.,r(ATTACHADDITIONALSHEET,IFNECESSARY) N #r,,.xY#NAME:     x   (#  5%     ADDRESS:     x   (#  5%  f   p      x   (#  5% DLORSTATEIDNO:   x   (#  5%  ! ,.,r 0 p 0p%p%0 %%StateandNumberF" % % #r,,.[# _SSN_: p     DOB: x   (#  5%  " RELATIONSHIPTOCHILD:,.,rԀCustodianFosterParent(s) ^#  p Grandparent(s)0  Guardian0x % %ParentOther#> x%x% #r,,. ]#PHONE:     x SEX:  (#  5%  b$  ALIASNAMESUSED:   x   (#  5%  %V!  p      x   (#  5% ATTORNEYS(ifknown) &" )r(FirmName,Address,TelephoneNumberandSupremeCourtIDNumber) 2'# #r)h_# p      x   (#  5%  p      x   (#  5%  p      x   (#  5%  p      x   (#  5%  p      x   (#  )& (X@XX(,.,rTherequirementthatSocialSecuritynumbersbeincludedonjuvenilecasesisnotmandatory.Thenumberisusedforpurposesofidentificationandmaybedisclosedas +\' permittedbylaw.Thisformisnotconsideredtobeapublicrecord. +' r,,.  05042005 +L(   grXXg@*@jj&Authority -* SupremeCourtRuleNo.123. .*      `   /P, Ї@$NotesonUse    SupremeCourtRuleNo.123requiresacoversheet,whichisnottoberetainedinthecourtcasefile.It  furtherprovidesthatpersonalidentifiersshallberedactedfromallpleadingsfiledwiththecourt,unlessotherwise  requiredbylaw.#XuXXXwc##rXXuc#