FRANKLINCOUNTYCOURT OF COMMON PLEAS – DIVISION OF DOMESTIC RELATIONS

JUVENILE BRANCH

ADMISSION/FILING SHEET

CASE NAME / CASE NO. / NCR
DATE/TIME ADMITTED
AM
PM / LINK TO CASE # / HEARING TYPE
OC IC PH CV PV / *HEARING DATE/TIME
AM
PM / *COURT ROOM # / *JUDGE/MAGISTRATE
*LOCK-UP / * Unruly Delinquent /  Formal  Informal / CERTIFICATION 1 2 / *FCCS
**COMMENTS TO MAGISTRATE
** DEMOGRAPHIC INFORMATION
CITE YES / FULL NAME OF YOUTH: LAST, FIRST MIDDLE / ALIAS / # PRIOR DETS
CURRENT ADDRESS / CITY, STATE, ZIP / PHONE
SS# / SCHOOL / GRADE
Choose:5th6th7th8th9th10th11th12th / STATE DRIVER’S LICENSE # / EMPLOYER
LIVING WITH Choose: (AU) Aunt (FA) Father (CS) FCCS (BR) Brother (FP) Foster Parents (FS) Father & Stepmother (GH) Group Home (GF) Grandfather (GM) Grandmother (GU) Guardian (IN) Independent (MO) Mother (MS) Mother & Stepfather (NI) No Information (OT) Other Non-defined Party (PT) Parents (RF) Residential Facility (SF) Stepfather (SI) Sister (SM) Stepmother (UN) Uncle / PARENT MARITAL STATUS Choose: (00) No Information (01) Married (02) Common Law (03) Legally Separated (04) Parents Divorced/Neither Married (05) Parents Divorced/Father Remarried (06) Parents Divorced/Mother Remarried (07) Parents Divorced/Both Remarried (08) Never married (09) Father Deceased/Mother Remarried (10) Father Deceased/Mother Not Remarried (11) Mother Deceased/Father Remarried (12) Mother Deceased/Father Not Remarried (13) Both Parents Deceased
DOB / AGE / RACE
Choose: Asian Black Indian Latino Other White / HEIGHT / WEIGHT / HAIR
Choose: Bald Black Blonde Brown Gray Red Other / EYES
Choose: Blue Brown Gray Green Hazel Other / SEX
Choose: Female Male
SCARS, TATTOOS, BIRTHMARKS / PO/DYS PO
RELATIONSHIP / ADDRESS / CITY, STATE, ZIP / HOME PHONE / WORK PHONE
CITE
YES / MOTHER
CITE YES / FATHER
CITE YES / STEPMOTHER
CITE YES / STEPFATHER
CITE YES / CUSTODIAN
** ADMISSION RELEASE INFORMATION
SLATED BY / CUSTODIAN NOTIFIED ( ) / DATE / TIME
AM
PM / ( ) YOUTH SPOKE
( ) CRUISER SENT
( ) NO ANSWER / ( ) YOUTH/PARENT REFUSED
( ) MESSAGE ON MACHINE
( ) LINE BUSY
RELEASED HA BY / TO WHOM / DATE / TIME
AM
PM / ( ) MESSAGE LEFT WITH:
REASON FOR HOLD
(CIRCLE ONE) / 1. PROTECT FROM IMMEDIATE OR THREATENED PHYSICAL HARM.
2. NO PROVISIONS FOR SUPERVISIONS, CARE OR RETURN TO
COURT. / 3. MAY BE REMOVED OR ABSCOND FROM JURISDICTION.
4. COURT ORDERED DETENTION OR SHELTER CARE.
** ARREST INFORMATION
x / ADMITTING / FILING PERSON
J. S. Saeger / DEPT/ MUNI
1000012 / CODEFENDANT (S)
OFFENSE and ORC SECTION / DEGREE F / M / U / T / DATE OF OFFENSE
(MOST RECENT DATE, AS LISTED IN THE COMPLAINT)
Choose: School Truancy Chronic - ORC 2152.02(D) School Truancy Habitual - ORC 2151.01.1(B)(17)
Choose: School Truancy Chronic - ORC 3321.19(A)(2) / 9/20/12
COMPLAINANT TYPE
SCHL / COMPLAINANT (IF NOT VICTIM) / ADDRESS / PHONE

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