IN THE CIRCUIT COURT, JUDICIAL CIRCUIT, IN AND FOR COUNTY FLORIDA.
CASE NO.:
DIVISION:
IN THE INTEREST OF:
A CHILD
______/
MOTION FOR ORDER TO TAKE A CHILD INTO CUSTODY
COMES NOW, the Florida Department of Children and Families by through its undersigned attorney and respectfully moves this Court for an Order to Take a Child into Custody, pursuant to Section 39.401, Florida Statutes, (1998 Supplement). In support thereof, the Department will show.
1. The child was adjudicated dependent by order of this Court. Said child left placement without authorization. The placement of the child is more particularly described by the accompanying affidavit, which is hereby incorporated by reference.
The child has not been adjudicated dependent but is in imminent danger and harm because .
2. The Department has contacted the child’s parent(s) to inform them of the current status of the child. The Department has made unsuccessful attempts to contact the child’s parent(s). The child’s parent(s)’ whereabouts unknown, therefore, the Department is unable to contact . The Department has informed the parent(s) attorney(s). The child is permanently committed to the Department.
WHEREFORE, the Department requests that the Court enter an order to take into custody.
I HEREBY CERTIFY, that a copy of the foregoing Motion has been provided to the below named individuals by fax/hand/U.S. Mail this day of .
Respectfully submitted,
FLORIDA DEPARTMENT OF
CHILDREN AND FAMILIES
______
, Esquire
Florida Bar Number: ______
Assistant District Legal Counsel
921 Davis Street, B260
Jacksonville, Florida 32209
(904) 798-4900
Copies Furnished to:
Attachment:
Affidavit for Order to Take Into Custody
IN THE CIRCUIT COURT, JUDICIAL CIRCUIT, IN AND FOR COUNTY FLORIDA.
CASE NO.:
DIVISION:
IN THE INTEREST OF:
A CHILD
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AFFIDAVIT TO TAKE A CHILD INTO CUSTODY
STATE OF FLORIDA }
}
COUNTY OF DUVAL }
BEFORE ME personally appeared Affiant who being first duly sworn, made the following allegation of facts:
1. Said child was adjudicated dependent on and is in the placement of. Said child ran from placement on.
Said child has not been adjudicated dependent but the child is in imminent danger from surroundings and the removal is necessary to protect the child.
a) NAME OF THE CHILD:
b) AGE OF THE CHILD:
c) ADDRESS OF THE CHILD:
d) RACE & SEX :
e) DESCRIPTION OF THE CHILD:
______
Child Protective Investigator
FLORIDA DEPARTMENT OF
CHILDREN AND FAMILIES
921 Davis Street, Suite 380, Unit 480
Jacksonville, Florida 32209
(904) 359-6022
SWORN TO (OR AFFIRMED) AND SUBSCRIBED BEFORE ME THIS ______DAY OF ______, BY ______WHO IS PERSONALLY KNOWN TO ME OR PRODUCED IDENTIFICATION:
______
NOTARY PUBLIC, STATE OF FLORIDA
______
TYPE OF IDENTIFICATION
I HAVE REVIEWED THIS AFFIDAVIT OF LEGAL SUFFICIENCY.
______
Assistant District Legal Counsel
Florida Department of
Children and Families
IN THE CIRCUIT COURT, JUDICIAL CIRCUIT, IN AND FOR COUNTY FLORIDA.
CASE NO.:
DIVISION:
IN THE INTEREST OF:
A CHILD
______/
ORDER TO TAKE CHILD INTO CUSTODY
The child named and described below is not a dependent child but is in imminent danger and harm from his surroundings. The child is within the jurisdiction of this Court.
it is, therefore,
ORDERED that:
- The Jacksonville Sheriff’s Office shall take into custody the child named and described below:
a) NAME OF THE CHILD:
b) AGE OF THE CHILD:
c) ADDRESS OF THE CHILD:
d) RACE & SEX :
e) DESCRIPTION OF THE CHILD:
- Upon taking the child into custody, the Jacksonville sheriff’s Office shall:
a) between the hours of 8:00 a.m. and 6:00 p.m., deliver the child to the Jacksonville Regional Service Center at 921 North Davis Street, Building B, Suite 250, Jacksonville, Florida 32209, and
b) Between the hours of 6:00 p.m. and 8:00 a.m., call the Department Mediphone at (904) 634-8353 for instructions.
- The child shall not be placed in the Duval County Detention Center and shall not be held in secure detention.
- This order will expire after the child reaches 18 years of age or recalled by an Order to Vacate.
DONE AND ORDERED at Jacksonville, Duval County, Florida, this ______day of .
______
CIRCUIT JUDGE
Copies furnished to:
Central Records, Warrants Unit, Room 207, Police Memorial Building
Revised 4/99