TEMPORARY GUARDIANSHIP WORKSHEET

Name - Worker
[TM1] / Telephone Number
[TM2] / Date
[TM3]
County
[TM4] / Region
[TM5] / Court Number
[TM6]
I. /

Family Composition

ChildJuvenile[TM7]
Name (Last, First MI)
[TM8] / Birthdate
[TM9] / Age
[TM10]
Address (Street, City, State, Zip Code)
[TM11] / Telephone Number
[TM12]
Mother [TM13] Unknown [TM14] Deceased
Name (Last, First MI) Status: [TM15] Birth [TM16] Adoptive
[TM17] / Birthdate
[TM18]
Address (Street, City, State, Zip Code)
[TM19] / Telephone Number
[TM20]
Father [TM21] Unknown [TM22] Deceased
Name (Last, First MI)
[TM23] / Birthdate
[TM24]
Address (Street, City, State, Zip Code)
[TM25] / Telephone Number
[TM26]
Status: [TM27] Adjudicated [TM28] Adoptive [TM29]Alleged [TM30]Presumptive
Legal Guardian (if different than natural parents)
Name - Guardian
[TM31]
Address (Street, City, State, Zip Code)
[TM32] / Telephone Number
[TM33]

START_DYNAMIC_TABLE=NonDetainedChildInfo

II. /
Complete the following paragraph:
On [TM34] said child [TM35]was found to be in need of protection or services pursuant to Wis. Stats. s. 48.13 ([TM36]). Based upon finding, the Honorable [TM37]transferred legal custody of said child totransferred legal custody of said children toordered placement by[TM38][TM39] for a period of [TM40]. That order now expires on [TM41]. Said child was placed with [TM42] under the court's order.
III. / Reasons why temporary guardianship is needed. (Be specific and use complete sentences.)

[TM43]

IV. / Why current guardian will not sign and attempts made to locate and / or have signed. Indicate when and how notice of hearing was given. (Use complete sentences.)

[TM44]

V. /
Signatures
[TM45]
Name - Worker
SIGNATURE - Worker / Date Signed
[TM46]
Name - Supervisor
SIGNATURE - Supervisor / Date Signed

Temporary Guardianship WorksheetPage 1 of 2

CFS-2075 (04/2002)

[TM1]This field is pre-filled. This field is not editable on the template. The data can be corrected as follows: the worker’s supervisor can update the worker’s Person Management page.

[TM2]This field is pre-filled. This field is editable on the template. The data can be corrected on the template.

[TM3]This field is pre-filled. This field is not editable on the template. The data cannot be corrected.

[TM4]This field is pre-filled. This field is not editable on the template. The data can be corrected as follows: update the worker’s Maintain Worker Information page.

[TM5]This field is pre-filled. This field is not editable on the template. The data can be corrected as follows: update the worker’s Maintain Worker Information page.

[TM6]This field is pre-filled. This field is not editable on the template. The data can be corrected as follows: update the Legal Documentation page.

[TM7]This field is user selected. This field is editable on the template. The data can be corrected on the template. The values are: Child, Juvenile.

[TM8]This field is pre-filled. This field is not editable on the template. The data can be corrected as follows: update the child's Person Management page. The child is identified with the role of Child on the Legal Documentation page.

[TM9]This field is pre-filled. This field is not editable on the template. The data can be corrected as follows: update the child's Person Management page.

[TM10]This field is pre-filled. This field is not editable on the template. The data can be corrected as follows: update the child's Person Management page.

[TM11]This field is pre-filled. This field is not editable on the template. The data can be corrected as follows: update the child's Out of Home Placement page. The address of the provider will pre-fill.

[TM12]This field is pre-filled. This field is not editable on the template. The data can be corrected as follows: update the child's Out of Home Placement page. The phone number of the provider will pre-fill.

[TM13]This field is user selected. This field is editable on the template. The data can be corrected on the template.

[TM14]This field is pre-filled. This field is not editable on the template. The data can be corrected as follows: update the child's mother's Person Management page. The child's mother is identified on the Parent Into tab of the child's Person Management page.

[TM15]This field is user selected. This field is editable on the template. The data can be corrected on the template.

[TM16]This field is user selected. This field is editable on the template. The data can be corrected on the template.

[TM17]This field is pre-filled. This field is not editable on the template. The data can be corrected as follows: update the child's mother's Person Management page. The child's mother is identified on the Parent Into tab of the child's Person Management page.

[TM18]This field is pre-filled. This field is not editable on the template. The data can be corrected as follows: update the child's mother's Person Management page.

[TM19]This field is pre-filled. This field is not editable on the template. The data can be corrected as follows: update the Address tab of the child's mother's Person Management page.

[TM20]This field is pre-filled. This field is not editable on the template. The data can be corrected as follows: update the Address tab of the child's mother's Person Management page.

[TM21]This field is user selected. This field is editable on the template. The data can be corrected on the template.

[TM22]This field is pre-filled. This field is not editable on the template. The data can be corrected as follows: update the child's father's Person Management page. The child's father is identified on the Parent Into tab of the child's Person Management page.

[TM23]This field is pre-filled. This field is not editable on the template. The data can be corrected as follows: update the child's father's Person Management page. The child's father is identified on the Parent Into tab of the child's Person Management page.

[TM24]This field is pre-filled. This field is not editable on the template. The data can be corrected as follows: update the child's father's Person Management page.

[TM25]This field is pre-filled. This field is not editable on the template. The data can be corrected as follows: update the Address tab of the child's father's Person Management page.

[TM26]This field is pre-filled. This field is not editable on the template. The data can be corrected as follows: update the Address tab of the child's father's Person Management page.

[TM27]This field is pre-filled. This field is not editable on the template. The data can be corrected as follows: update the Parent Info tab of the child's Person Management page.

[TM28]This field is pre-filled. This field is not editable on the template. The data can be corrected as follows: update the Parent Info tab of the child's Person Management page.

[TM29]This field is pre-filled. This field is not editable on the template. The data can be corrected as follows: update the Parent Info tab of the child's Person Management page.

[TM30]This field is pre-filled. This field is not editable on the template. The data can be corrected as follows: update the Parent Info tab of the child's Person Management page.

[TM31]This field is pre-filled. This field is not editable on the template. The data can be corrected as follows: update the Parent Info tab of the child's Person Management page.

[TM32]This field is pre-filled. This field is not editable on the template. The data can be corrected as follows: update the Address tab of the guardian's Person Management page.

[TM33]This field is pre-filled. This field is not editable on the template. The data can be corrected as follows: update the Address tab of the guardian's Person Management page.

[TM34]This field is user entered. This field is editable on the template. The data can be corrected on the template.

[TM35]This field is pre-filled. This field is not editable on the template. The data can be corrected as follows: update the child's Person Management page. The child is identified with the role of Child on the Legal Documentation page.

[TM36]This field is user entered. This field is editable on the template. The data can be corrected on the template.

[TM37]This field is pre-filled. This field is not editable on the template. The data can be corrected as follows: update the Legal Documentation page.

[TM38]This field is user selected. This field is editable on the template. The data can be corrected on the template. The values are: transferred legal custody of said child to, transferred legal custody of said children to, ordered placement by.

[TM39]This field is user entered. This field is editable on the template. The data can be corrected on the template.

[TM40]This field is user entered. This field is editable on the template. The data can be corrected on the template.

[TM41]This field is user entered. This field is editable on the template. The data can be corrected on the template.

[TM42]This field is user entered. This field is editable on the template. The data can be corrected on the template.

[TM43]This field is user entered. This field is editable on the template. The data can be corrected on the template.

[TM44]This field is user entered. This field is editable on the template. The data can be corrected on the template.

[TM45]This field is pre-filled. This field is not editable on the template. The data can be corrected as follows: the worker’s supervisor can update the worker’s Person Management page.

[TM46]This field is pre-filled. This field is not editable on the template. The data can be corrected as follows: update the supervisor's Person Management page.