nd is now believed to be in your jurisdiction at: 

           

Juvenile’s physical description: Ht:   
Identifying marks or scars: 

           

  Wt:           Eyes:               Hair: 

              Race:                                                      Sex: 

           

. 

ttached(cid:3)(cid:76)(cid:86)(cid:3)(cid:68)(cid:3)certified(cid:3)true(cid:3)cop(cid:92)(cid:3)of(cid:3)the(cid:3)judgment,(cid:3)formal(cid:3)adjudication(cid:15)(cid:3)order(cid:3)of(cid:3)commitment,(cid:3)or(cid:3)petition(cid:3)alleging 

delinquency,(cid:3)verifying(cid:3)juvenile’s(cid:3)legal(cid:3)status. 

.  Particulars of adjudication or allegations of delinquency: 

    

     

 
            INTERSTATE COMPACT FOR JUVENILES 

 
FORM II 

                  
                  

 REQUISITION FOR ESCAPEE OR ABSCONDER 
 REQUISITION FOR ACCUSED DELINQUENT 

aid juvenile (check appropriate item): 
 was paroled to the custody of: 
 was placed on probation subject to the supervision of: 
   
 was committed to: 

           

    

           

OR 

 has fled to avoid prosecution and, despite applicable provisions of law, has: 
 escaped   

 absconded     

 fled 

(institution or custodial agency) 

 

DATE: 

           

orn on 

    

     

n accordance with the Interstate Compact for Juveniles, ICJ Rules Section 600, Return of Juveniles.   

requisition the return of 

    

     

  i

ROM: 

           

 (Name of Court or Agency) 
     

    

O: 

           

 (Court of Jurisdiction) 

      2.  Circumstances of breach of terms of probation, parole, escape from institution or fleeing to avoid prosecution: 

           

          Accordingly, the undersigned hereby requests the return of said juvenile as authorized by the Interstate Compact for Juveniles. 
          If Requisition is honored, please notify: 

           

                                                                                                              (Name,title, address, telephone no.) 

Signed:   
 

 

 

 

 

 

 

 

 

                              (Judge or Compact Official) 

 

 

 
    (Date)

 

 

 

Unless a Judge is the requisitioner, the requisition must be verified by affidavit, signed by requisitioner, and notarized.) 

_____________________________________________________ 

(Signature of Requisitioner) 

AFFIDAVIT OF VERIFICATION 

n this 

     

day of 

    

     

, 

    

     

,  personally appeared before me 

    

     

, 

proved to me on the basis of satisfactory evidence to be the person whose name is subscribed to this instrument and acknowledged  
that 

 he        she executed the same   

    
 . 

ubscribed and sworn to before me on this 

    

     

day of 

    

     

, 

    

     

. 

                                                                          _____________________________________________________________ 

 

 

 

 

 

NOTARY PUBLIC 

CJ FORM II | Rev. 02-01-16   

          

     

Residing at: 

 

My Commission expires: 

 

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