Fill and Sign the Order Exemption Form

STATE OF WISCONSIN, CIRCUIT COURT,       COUNTY For Official Use State of Wisconsin, Plaintiff, -vs- Order for Exemption under §948.13(2m)       Defendant Case No.       THE COURT FINDS: 1. The petitioner was convicted of a crime under §948.025(1), Wisconsin Statutes. 2. The petitioner requested court approval to engage in an occupation or participate in a volunteer position that would require the petitioner to work or interact primarily and directly with children under 16 years of age. 3. The specific occupation or volunteer position in which the petitioner seeks to engage is:       4. A hearing was was not held on this matter. 5. The victim of the petitioner’s crime did did not make a statement to the court either orally or in writing concerning the petitioner’s request. 6. The court: did request the petitioner to submit to an examination by a physician, psychologist or other expert and a copy of that report has been reviewed by the court. did not request an examination. 7. At the time of the commission of the crime under §948.025(1), Wisconsin Statutes (all of the following must be true): a. The petitioner was age 18 or younger. The petitioner’s actual age on the date of the crime was       . b. The child with whom the petitioner had sexual contact or sexual intercourse was within 4 years of the petitioner’s age. c. The child with whom the petitioner had sexual contact or sexual intercourse was at least 13 years of age but not yet 16 years of age. The actual age of the child with whom the petitioner had sexual contact or sexual intercourse on the date of the crime was       . d. It is not necessary in the interest of public protection for the petitioner to comply with the legal prohibition to not engage in this type of occupational or volunteer position. 8. The court has considered, in addition to the factors in paragraph 7 above, a. The relationship between the petitioner and the victim. b. Whether the crime resulted in bodily harm to the victim. c. Whether the victim suffered from any mental illness or mental deficiency that affected the victim’s capacity to understand or evaluate the consequences of his or her actions. d. The probability that the petitioner will commit other serious child sex offenses. IT IS ORDERED that the petition is granted. Distribution: 1. Court - Original 2. District Attorney (who prosecuted the case) 3. Petitioner/Petitioner’s Attorney BY THE COURT: Circuit Court Judge       Name Printed or Typed       Date CR-232, 11/99 Order for Exemption Under §948.13(2m) §948.13(2m), Wisconsin Statutes This form shall not be modified. It may be supplemented with additional material.