State of AlabamaUnified Judicial System

Form JU-6 Rev.06/13PETITION

Court Case Number

IN THE JUVENILE COURT OF _________________________________COUNTY, ALABAMA

In the Matter of _________________________________________________, a child. Date of Birth or Age: _________________Child’s Residence Address:_____________________________________________________________________________________

Child’s Father: ______________________________________Residence ___________________________________________Address: ____________________________________________

Child’s Mother: ______________________________________Residence ___________________________________________Address: ____________________________________________

Child’s Legal Guardian(s) Or Residence ___________________________________________Address: ____________________________________________

Other Adult Relative(If required by law): ______________________________________

Residence ___________________________________________Address: ____________________________________________

Petitioner: __________________________________________Address ___________________________________________for Notice: __________________________________________

The child is alleged to be DELINQUENT DEPENDENT IN NEED OF SUPERVISION and in need of care, rehabilitation or supervision for the allegation of ___________________________________________________________________ ,Ala. Code 1975, Section ________________________ in that:

(If applicable) The child was taken into custody and placed into detention at _________________________________________________on _______________ at ___________.

I, being 18 years or older, swear or affirm that I have knowledge of the facts alleged or am informed of these facts and believe that they are true.Date: _________________________ Petitioner’s Signature: ___________________________________________

SWORN TO AND SUBSCRIBED BEFORE ME:Date: _____________________ Juvenile Court Intake Officer or Notary Public:__________________________________________

A PARENT, LEGAL GUARDIAN, OR LEGAL CUSTODIAN OF THE CHILD CAN BE MADE A PARTY TO THE DELINQUENCY OR CHILD IN NEEDOF SUPERVISION CASE PURSUANT TO ALA. CODE 1975, §12-15-113. A PERSON MADE A PARTY TO THIS CASE MAY BE REQUIRED TO PAY ATTORNEY FEES, TO PAY FOR EVALUATION AND TREATMENT, TO PAY FINES, COURT COSTS, AND RESTITIUTION, AND TO PAY FOR CARE, SUPPORT, AND SUPERVISION OF THE CHILD. A PERSON MADE A PARTY MAY BE SUBJECT TO OTHER ORDERS ALSO. FAILURE TO COMPLY WITH THE ORDERS OF THE COURT CAN RESULT IN CONTEMPT PROCEEDINGS, AND FAILURE TO MAKE PAYMENTS ORDERED CAN RESULT IN A CIVIL JUDGEMENT FOR THE COLLECTION OF THE PAYMENTS ORDERED.

I certify that I have been duly designated an Intake Officer of the Court according to Ala. Code 1975, § 12-15-102(11). Based on a verified complaint which was received ___________________, at ________ __.m., and alleged, contained legally sufficient information to establish subject-matter jurisdiction, venue and probable cause, I have determined that the filing of the petition is in the bests interests of the the public and/or the child.

Date: ______________________ Signature of the Juvenile Court Intake Officer: ________________________________Ala.Code 1975, §§ 12-15-120(a); 12-15-121; Rule 12, Ala.R.Juv.P.

COURT RECORD: (Original) PARENT/LEGAL GUARDIAN/LEGAL CUSTODIAN : (Copy) CHILD: (Copy)D.H.R. or D.A.: (Copy) G.A.L. or Attorney : (Copy)

Legal Custodian(s): ____________________________

(Name of County)