WPCe  
      }\     Y7qc4N69Æ+K|͡[أHBݯ[1>Qu;n2$m%ɹ8HE7k)YF>a8N>tDS1[S׋{quAqK]B҄lBx3\~>Q G4c觟!}pU.
a8@ݵ{y2o%<q#ON!(>vkBcFIiK]_ ?'$xZazKw]譴y(v㔤m>I)2j׭C9M>z |Nlp[wϲ#ef=
Ih}=$Ζ/mV(Ts
wvbX7"̽F4ʋpַ|O<-F-ew.Frwx*ˬƌ4}?W۝BՄZ7u$*<            M      l
   U?   >   p
  0     
  0   <   K  0   d    0   2       &       Z   C  0              *  0      @            @            @            @            @   b                                         U2   >                    (      U   >                                                                                                                                          	      +   	      =   	      O            O            O            O            O            O            O            O            O            O            O            O            O            O            O            O            O            O            O            O            O            O            O            O            O            O            O            O   	      a   	      u            u   	         	                                             	                                                                     	         	                                                                     	         	                                                                     	         	      #   	      7            7            7            7            7            7            7            7            7            7            7            7            7            7            7            7            7            7   	      I        [  0   r   k  #        U	   N     	%        N        ^        w        4                 	m      "            "            "            "            "            "            "            "            "            "            "            "            "            "            "            "            "            "            "            "   	      9            9            9            9            9            9            9            9            9   	      M      \	  	   `   & T i m e s   N e w   R o m a n             6                4 H e a d i n g   1                  x   (#      X      XX S            \	  	   `   & T i m e s   N e w   R o m a n         S 
                  8  .    `	   h   p    x   (#8 S            \	  	   `   & T i m e s   N e w   R o m a n         S     X      XX     <                    : D e f a u l t   P a r a         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     0   m             . F o o t e r           (# 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  '                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
       
       
 0      
 .      
       
            I N   T H E   D I S T R I C T   C O U R T   O F                                                                                                         C O U N T Y ,   K A N S A S   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     (   e               2n@$       
 s  \!        u  X i  X  Xu X      X i  X  Xu X i      
              (   e               2n@$       
 s  \!        u  X i  X  Xu X      X i  X  Xu X i     -  -    
      
 	  n@'        u  X<q  X  Xu X      X<q  X  Xu X<q     _           "   X       C " 8/1/07  \	  	   `   & 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          T e x t 5 2    T e x t 5 3    T e x t 5 4    C h e c k 2 0    T e x t 2 7    T e x t 2 9    C h e c k 2 1    C h e c k 2 2    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 3 1    C h e c k 3 2    T e x t 3 9    T e x t 5 1   #| x            (   J               \$              u  X  X  Xu X      X  X  Xu X  \ \ 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          u X  ~q=e         }i=    D M I N   0             U   C h e c k 7 1    D r o p d o w n 1   
 s  \!        u  X<q  X  Xu X      X<q  X  Xu X<q     _             @    VV)  312@ @  *     	                `	               h               p             
  [         8 u  <qu X  X       d                  d  8 =    <q  X   X       d                 d=              X<q  X  X X<q @    @@  INTHEDISTRICTCOURTOF__________________COUNTY,KANSAS   	 z         INTHEMATTEROF   	 R         Name_________________________,Juvenile         p      CaseNo._____________   	 *
   DOBxx/xx/____#   X<q  X  X X<q  #    X<q  X  X X<q A&#   X<q  X  X X<qT  #    X<q  X  X X<q Ԁmale&#   X<q  X  X X<q  #    X<q  X  X X<q Ԁfemale#   X<q  X  X X<q  #    	 t      X<q  X  X X<q #   X<q  X  X X<qH  #          *        x   (#   X*    X<q  X  X X<q    X<q  X  X X<q 
                      0         x   (#  X0        X X<q *#   X<q  X   ̀  # ORDERAUTHORIZINGREMOVALOFJUVENILE     .        
   Ԍ   	 8	
   Ќ     $  
    X   X$    X<q  X  X X<q    X<q  X  X X<q 	     @    tt  PursuanttoSupremeCourtAdministrativeOrder155   	 r
   @    <<  Separatejournalentryorordermustbeattached   	  ^   !     (#   X!    &PK %  X X<q           Onthis% #       X<q  X % &PK    X<q  X  X X<q _____% #      Ԁdayof% $    -     __________________-     % $   @   ,_        % %    -     20____-     % %      ,_        ԀthismattercomesbeforetheCourt,   	 "   Judge___________________presiding.   	         THECOURTHEREBYFINDSTHAT:(Checkallthatapply)   	 t   !  
    X  (#! % A    % A   	      X<q  X  X X<q &#   X<q  X  X X<q
  # 0     Reasonableefforts   X<q  X  X X<q &#   X<q  X  X X<qs
  # Ԁhavebeenmadeandhavefailed   X<q  X  X X<q &#   X<q  X  X X<q
  # Ԁhavenotbeenmadetomaintain   	 L   thefamilyandpreventthe

removalofthejuvenilefromthejuvenileshomeasfollows:    < (#(#       (Specifybasisforfinding.)__________________________________________________   	 (   Ѐ     ______% B    -     __________________________________________________________________   	 r        % B   i   ________________________________________________________________________% D    % D   D      	  ^       and/or   	 6      X          
  (#   X       % E    % E      &     Reasonableeffortsarenotrequiredtomaintainthejuvenileinthehomebecausean   	 "   emergencyexistswhichthreatensthesafetyofthejuvenile.(   X<q  X  X X<q Specifybasisforfinding#   X<q  X  X X<q  # .)   	    ________________________________________________________________________   	         ________________________________________________________________________   	     ________________________________________________________________________   	 t!      	 `"       	 L#!              X !     (# (#!      and/or   	 8$"        % I    % I         X<q  X  X X<q &#   X<q  X  X X<q"  #      Reasonableeffortsarenotrequiredduetotherisktopublicsafety,specifically:   	 $% #         B  + `	 4 `	   h   p    x   (#  (#B       (Specifybasisforfinding% O    .)_________________________________________________   	 &n!$   _______________________________________________________________________   	 &Z"%   _______________________________________________________________________   	 'F#&      	 (2$'       4 0    `	 % O   Z       `	(#`	(#                   $     (#`	 4 `	X$ and/or   	 *
&)        % P    % P   6      X<q  X  X X<q 0           &#   X<q  X  X X<qT  #      Reasonableefforts   X<q  X  X X<q &#   X<q  X  X X<q  # Ԁhavebeenmade   X<q  X  X X<q &#   X<q  X  X X<q,  # Ԁhavenotbeenmadetofacilitatethe   	 +&*   permanencyplan.(Specifybasisforfinding.)__________________________________   	       _______________________________________________________________________   	     _______________________________________________________________________    z (#(#     .  .  E  .    `	   h   p    x   (#  (#E '     , X X'          4 THECOURTFURTHERFINDSTHAT&% V    % V      Ԁremaininginthehomeorreturning   	 >	        homeiscontrarytothewelfareofthejuvenileand/or&% W    % W   =   Ԁimmediateplacementisin   	 .
        thebestinterestofthejuvenile.(Specifybasisforfinding.)______________________   	 |      _  .   *     (#  , X*      _______________________________________________________________________   	 l        _______________________________________________________________________   	 X	   @    )  or   	 0
   '      4(#  (#'      &   X<q  X  X X<q Ԁ0    4 TheCourthasdeterminedthatthejuvenile'sremovalfromthehomeisduetotherisk   	    thejuvenilepresentstothesafetyofthecommunityandacontrarytothewelfare   	    findingisnotnecessary.(Specifybasisforfinding.)    (#(#K (#_  J       4(#4(#       _______________________________________________________________________   	         _______________________________________________________________________   	 r      e Ҁ#   X<q  X  X X<q  #      THECOURTTHEREFOREORDERSTHATthefollowingorderforremovalshallissue:   	 6        (AttachthefollowingorderforremovaltothisOrderAuthorizingRemoval.)   	 "      e      % ]    &% ]      ԀWarrant(Form311,attachcopyhereto.)   	 l        % ^    &% ^   w   Ԁ% _    Orderfordetention(Form314or316,attachoriginalhereto.)   	 X        -     % _         X<q  X  X X<q &#   X<q  X  X X<q7  # 0    4 Ordercommittingincompetentjuvenile   X<q  X  X X<q (Form324or325,attachoriginalhereto.)#   X<q  X  X X<q  #     D 4(#4(#          X<q  X  X X<q &#   X<q  X  X X<qL   #    X<q  X  X X<q 0    4 Adjudicationwithtemporarycustodyorder(Form341,attachoriginalhereto.)#   X<q  X  X X<q   #     0 4(#4(#          X<q  X  X X<q &#   X<q  X  X X<q^!  #     4 Adjudicationwithimmediatesentencing(Form342,attachoriginalhereto.)   	            X<q  X  X X<q &#   X<q  X  X X<q!"  # 0    4 Sentencingorder   X<q  X  X X<q (Form350or351,attachoriginal#   X<q  X  X X<q"  #    X<q  X  X X<q hereto.)#   X<q  X  X X<q"  #      4(#4(#          X<q  X  X X<q &#   X<q  X  X X<qc#  # 0    4 Probationviolationorder   X<q  X  X X<q (Form370,attachoriginal#   X<q  X  X X<q#  #    X<q  X  X X<q hereto.)#   X<q  X  X X<q/$  #      4(#4(#          X<q  X  X X<q &#   X<q  X  X X<q$  # 0    4 Modificationofsentenceorder   X<q  X  X X<q (Form373,attachoriginal#   X<q  X  X X<q%  #    X<q  X  X X<q hereto.)#   X<q  X  X X<qx%  #      4(#4(#          X<q  X  X X<q &#   X<q  X  X X<q%  # 0    4 Orderrescindingconditionalrelease/aftercare(Form376,attach   X<q  X  X X<q original#   X<q  X  X X<q&  # hereto.)    n 4(#4(#            THECOURTTHEREFOREORDERSTHATtheabovenamedjuvenile   X<q  X  X X<q &#   X<q  X  X X<qV'  # Ԁshallbe   X<q  X  X X<q Ԁ   	 F!   &#   X<q  X  X X<q'  # Ԁshallcontinuetobeplacedinthecustodyof:   	 6"            X<q  X  X X<q &#   X<q  X  X X<qY(  # 0    4 TheCommissioner,or    &#! 4(#4(#          X<q  X  X X<q &0    4 _________________________________________________________________#   X<q  X  X X<q(  #     $p" 4(#4(#     X<q  X  X X<q @    \\)  and   	 $\ #        &#   X<q  X  X X<q)  #    X<q  X  X X<q ԀAchildsupportordershallissue.   	 %H!$   #   X<q  X  X X<q*  #    X<q  X  X X<q      &#   X<q  X  X X<q*  #    X<q  X  X X<q ԀEachparentshallsubmitinformationtothechildsupportofficeforachildsupport   	 &4"%   ordertobeprepared,orpresentdocumentationofacurrentchildsupportorderwithin____days#   X<q  X  X X<q*  #    X<q  X  X X<q .#   X<q  X  X X<q+  #    X<q  X  X X<q    	 ' #&   #   X<q  X  X X<q8,  #      THECOURTFURTHERORDERSallprovidersofservices,treatmentorcareofthe   	 *%)   juvenileandfamily,evenifnotspecificallyreferredtoherein,toprovideinformationtothe   	 r+&*   commissioner,anyentityprovidingservices,counselforthepartiesincludingthecountyor   	       districtattorney,appointedCASA,CitizenReviewBoardmembers,thecourt,andeachotherto   	     theextentneededtoensurethesafetyofthejuvenile,preventabuseorneglect,andtoprovide   	 z   appropriatetreatmentandrehabilitation.ThisorderencompassestheprovisionsofthePrivacy   	 f   RuleoftheHealthInsurancePortabilityandAccountabilityActof1996(_        HIPAA_        ),45_        C.F.R._           	 R   164.512(e)(1).   	 >	      .  _   H  .    `	   h   p    x   (#   4(#H         X<q  X  X X<q      %     %    0   #   X<q  X  X X<q0  #    X<q  X  X X<q 3   	  r  p    x   (# X3      THECOURTFURTHERORDERSthismattersetfor-     ______________-     _____hearing   	 t   before0#   X<q  X  X X<q0  #    X<q  X  X X<q ԀtheCourt0#   X<q  X  X X<q1  #    X<q  X  X X<q Ԁ#   X<q  X  X X<qP2  #    X<q  X  X X<q the#   X<q  X  X X<q2  #    X<q  X  X X<q _        CRB_        #   X<q  X  X X<q2  #    X<q  X  X X<q Ԁonthe________dayof______________,_____,at-     ________   	 `   Ѐ0#   X<q  X  X X<qA3  #    X<q  X  X X<q Ԁa.m0#   X<q  X  X X<q3  #    X<q  X  X X<q Ԁp.m.%     %    m4      	 P	   #   X<q  X  X X<qB4  #    X<q  X  X X<q     r ITISSOORDERED#   X<q  X  X X<q4  # THIS___________dayof_________________,% q    _____-     % q   T5   .   	 ,
   -      p(#  r  pX-      0    p _____________________________    ~ p(#p(#  -      p 2(#   p(#-          p JudgeoftheDistrictCourt    (#(#K (#    	 j    u  X<q  X  X X<q      @    jj&  Authority   	 .            p     2 K.S.A.382334,382336,andSupremeCourtAdministrativeOrderNo.155.   	 d   @    $  NotesonUse   	 <        ThisformprovidesfortherequirementsoftheAdoptionandSafeFamiliesAct(_        ASFA_        ),42   	    _        USC_        Ԁ671etseq.,assetoutinK.S.A.382334and382335,andSupremeCourtAdministrative   	     OrderNo.155.Thoserequirementsmandatetheuseofthisformoranother_        ASFA_        Ԁformapproved   	    bytheSupremeCourtwhenajuvenileisremovedfromthehome.Itmustbeattachedtoajournal   	 z   entryoftheproceedinginwhichremovalwasorderedbythecourt,ortheorderdirectingremoval   	 f   iftherewasnohearing,asinthecircumstancesofawarrant.Theoriginaljournalentryororder   	 R    mustbeattachedexceptwhentheorderisawarrant.Acopyofthewarrantispermittedtobe   	 >!   attached,becausetheoriginalwarrantisissuedtolawenforcementforexecution.   	 *"         Priortoanorderremovingajuvenilefromthehome,orremovingajuvenilefromthehome   	 #t!   after6monthsplacementinthehome,reasonableeffortsfindingsmustbemadetocomplywith   	 $`"   K.S.A.382334and382335.Alsorequiredisa contrarytothewelfareor bestinterestfinding,   	 $L #   unlessthejuvenileisremovedfromthehomeduetotheriskthejuvenileposes.Thosefindingsare   	 %8!$   setoutinthisform.   	 &$"%        Thereislanguageprovidedtoallowachildsupportordertoissue,ortorequiretheparents   	 '#&   toprovideinformationsothatachildsupportordermaybeissued.Thejuvenilejusticecode   	 (#'   requiresthecourttoorderchildsupport,unlessgoodcauseisshowntothecontrary.K.S.A.38   	 )$(   2319.   	 v*%)        Ifajuvenileisremovedduetotheriskthejuvenileposestothecommunityorpublicsafety,   	 b+&*     
 [  
   
        
     
  
   
 andreasonableeffortsarenotrequiredforthatreason,federalfundingisnotprovidedtosupportthe   	       placement.#   X<q  X  Xu X<q6  #    	                 X X<q *#   X<q  X   @  #  u  X<q  X  X X<q ThisformhasbeenapprovedbytheJudicialAdministratorpursuanttoSupremeCourt   	 >	   AdministrativeOrderNo.155,firstenteredSeptember22,2000.#   X<q  X  Xu X<q/A  # 
