Fill and Sign the Ellis V State Department of Family Services 2019 Form

JC-1638 , 02/17 Order Concerning Termination of Parental Rights (Voluntary) §§48.426, 48.427 and 48.43, W isconsin Statutes This form shall not be modified. It may be supplemented with additional material. Page 1 of 2 STATE OF WISCONSIN, CIRCUIT COURT, COUNTY For Official Use IN THE INTEREST OF Name Order Concerning Termination of Parental Rights (Voluntary) Date of Birth Case No. This termination of parental rights hearing was held on [Date] , which is the effective date of this order. THE COURT FINDS: 1. Notice was given to all those entitled to notice. 2. The provisions of the Indian Child W elfare Act do not apply. An inquiry has been made on the record to each participant in this proceeding as to whether the participant knows or has reason to know th at the child is an Indian child. [For an Indian child, use the Indian Chi ld Welfare Act version (IW -1638 ) of this order.] 3. The parent(s) are A. Parent #1 ’s name: Date of birth: B. Parent #2 ’s name: Date of birth: C. Other possible parent (s): Name: Date of birth: Name: Date of birth: Name: Date of birth: 4. There was no declaration of paternal interest. 5. Testimony supporting the allegations in the petition was presented to the court and the allegations are true. Findings made on the record are incorporated. 6. The petition to terminate the parental r ights of the Parent #1 Parent # 2(s) is not contested, and the terminating parent(s) have freely, voluntarily and knowingly consented to a termination of their rights. 7. It is in the best interest of the child that the parental rights of the Parent #1 Parent # 2(s) be terminated after co nsidering the following fac tors :  The likelihood of the child’s adoption after termination.  The age and health of the child, both at the time of the disposition and, if applicable, at the time the child was removed from the home.  Whether the child has substantial relationships with the parent or other family members, and whether it would be harmful to the child to sever these relationships.  The wishes of the child.  The duration of the separation of the parent from the child.  Whether the child will be able to enter into a more stable and permanent family relationship as a result of the termination, taking into account the conditions of the child’s current placement, the likelihood of future placements and t he results of prior placements. Order Conce rning Termination of Parental Rights (Voluntary) Page 2 of 2 Case No. JC-1638 , 02/17 Order Concerning Termination of Parental Rights (Voluntary) §§48.426, 48.427 and 48.43, W isconsin Statutes This form shall not be modified. It may be supplemented with additional material. Page 2 of 2 8. Reasonable efforts to achieve the permanency goal of the permanency plan, including through an out -of- state placement if appropriate, were [Complete one of the following onl y if there is a permanency plan ] made by the department or agency responsible for providing services . not made by the department or agency responsible for providing services. 9. Any parent who appeared was informed of the provisions of §§48.4 32, 48.433 and 48.434, W is. Stat s. 10. Other: THE COURT ORDERS: 1.A. The parental rights of [Name of Parent(s) ] is/are terminated. Guardianship , placement and care responsibility, and custody of the child remain with the parent whose rights have not been terminated. are transferred pending adoption to Other: If guardianship or custody is transferr ed to an agency, th at agency shall be responsible for securing the adoption of the child or establishing the child in a permanent family setting. The child’s permanency plan was filed. is attached . will be filed within 60 days . The provisions of §§48.43 2, 48.433 and 48.434, W is. Stat s., are attached. 1.B. The petition to terminate parental rights of [Name ] is dismissed. 2. Other: THIS IS A FINAL ORDER FOR PURPOSES OF APPEAL. BY THE COURT: Circuit Court Judge Name Printed or Typed Date