Fill and Sign the Tribal and State Jurisdiction Administration for Children and Form

MT TO ASSUME JURISDICTION/ORDER (MT and ORAJ) - Page 1 of 2 WPF JU 13.0800 (9/2000) - RCW 28A.225.035(15) SUPERIOR COURT OF WASHINGTON COUNTY OF _______________________ JUVENILE COURT (School District) Petitioner vs. Respondent(s) Parent Student Student’s D.O.B. ___/___/___ NO: MOTION TO ASSUME JURISDICTION AND ORDER ASSUMING JURISDICTION (MT and ORAJ) [_________________________________] (Name of School) [Clerk’s action required] I. MOTION 1.1 Based upon the following declaration, the  school district  parent(s)/guardian(s) moves the court for an order assuming jurisdiction of the truancy case involving ______________________ student, cause number: in _________________________ County Juvenile Court. II. DECLARATION 2.1  I am the parent(s)/guardian(s) of the student. On ___________________________ (date), the student relocated to _______________________ County from __________________________ County. 2.2  I am an employee of the ______________________ School District. The school district’s records indicate that ____________________________________, the student, relocated to ______________________ County. I declare under penalty of perjury under the laws of the state of Washington that the forgoing is true and correct. SIGNED on: __________________________ at ______________________________, Washington. Signature Address Print name MT TO ASSUME JURISDICTION/ORDER (MT and ORAJ) - Page 2 of 2 WPF JU 13.0800 (9/2000) - RCW 28A.225.035(15) III. ORDER 3.1 THIS COURT assumes jurisdiction of the truancy case involving __________________________, the student, originally filed in the ____________________________________ County Juvenile Court, Cause Number: _____________________. 3.2 The court clerk of _____________________________ County is directed to transfer the file to the court clerk of ______________________________________ County. DATED: _____________________________________ JUDGE/COMMISSIONER