Fill and Sign the Deferred Prosecution Agreement 497431102 Form

State of Wisconsin Circuit Court 1. Intake Case No.       Deferred Prosecution Agreement 2. County       In the interest of: 3. Case Type Delinquency In Need of Protection/Services Ordinance/Civil Law 4. Name of Juvenile       5. Date of Birth       6. Juvenile's Address       7. Date Juvenile Referred       An inquiry has been conducted into this matter. It has been determined that at this time neither the interests of the juvenile named above nor of the public require filing of a petition for circumstances relating to §§938.12 to 938.14, Wisconsin Statutes. It is this intake worker's belief, however, that the facts are sufficient that court action could be sought, and this conclusion is undisputed by the juvenile and parents, guardian or legal custodian. 8. Summary of Undisputed Facts:       9. Obligations - Check all appropriate boxes for any combination of obligations A. Case held open for      months or until       . Date B. No new referrals to intake and/or violations of federal, state or local laws. C. Restitution: $       (under age 14, $250.00 limit), pay to:       Payment terms:       Make repairs or provide services agreeable to the victim (under age 14, 40 hour limit):       D. Community Service (under age 14, 40 hour limit) Amount:       hours Terms:       E. Counseling Child Parent/guardian Family Terms:       F. A.O.D.A. Assessment Terms:       G. Parent participation in parenting skills training H. Volunteers in Probation Program I. Teen Court Program J. Curfew:       K. Daily school attendance; no unexcused absences; obey school rules L. Avoid association with those who violate the law JD-1706, 05/00 Deferred Prosecution Agreement §938.245, Wisconsin Statutes . This form shall not be modified. It may be supplemented with additional material. Page 1 of 3 Deferred Prosecution Agreement Page 2 of 3 Case No. M. Other specific obligations/conditions:       The juvenile and the juvenile's parents, guardian and legal custodian are hereby notified of the right to object at any time to the facts or terms of the deferred prosecution agreement. If there are objections, the intake worker may alter the terms of the agreement or recommend that a petition be filed. This agreement may be terminated at any time upon the request of the juvenile, juvenile's parents, guardian or legal custodian. If the deferred prosecution agreement is terminated, the intake worker may recommend to the district attorney or corporation counsel that a petition be filed. If at any time during the period of this agreement the intake worker determines that the stated obligations are not being met, the intake worker may cancel this agreement and recommend that a petition be filed. The district attorney may file a delinquency petition within 20 days of receipt of this agreement. Filing of a petition will cancel this agreement. If a deferred prosecution agreement is canceled because the juvenile's parent, guardian or legal custodian is not meeting the obligations imposed under the agreement, a hearing may be held for the parent, guardian or legal custodian to show good cause for not meeting the obligations. If good cause is not shown, the court may impose a forfeiture not to exceed $1,000. Date Agreement is Effective       Date Agreement Terminates       Print or Type Names Signatures Date Signed Juvenile             Father/Guardian/Legal Custodian             Mother/Guardian/Legal Custodian             Intake Worker             JD-1706, 05/00 Deferred Prosecution Agreement §938.245, Wisconsin Statutes . This form shall not be modified. It may be supplemented with additional material. Page 2 of 3 JD-1706 , 05/00 Deferred Prosecution Agreement §938.245, Wisconsin Statutes . This form shall not be modified. It may be supplemented with additional material.