INTERSTATE COMPACT FOR JUVENILES
PETITION FOR REQUISITION TO
RETURN A RUNAWAY JUVENILE
FORM A
I, , being the
(Legal Guardian or Custodial Agency)
(Relationship)
of born on
(Name of Juvenile) (Date of Birth) (Race/Sex)
do hereby petition for the issuance of a requisition for the return of said
(Name of Court)
juvenile from or any other place in which he/she may be found.
(Location of juvenile, if known)
By reason of said juvenile’s age, such return is essential. (Attach additional information if necessary.) In support of this
petition and in order that the court may have necessary information, be it known that said juvenile should legally be in my
custody and control for the reasons set forth on the attached certified document(s). To the best of my knowledge, said
juvenile has not been adjudicated delinquent, but has run away under the following circumstances and/or for the following
reasons:
Attached hereto and in support hereof, I offer the following:
I have read the foregoing Petition and the contents of said Petition are true and correct to the best of my knowledge.
Signed:
(Legal Guardian or Custodial Agency)
(Date)
Address:
AFFIDAVIT OF VERIFICATION
On 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.
Subscribed and sworn to before me on this day of ,
NOTARY PUBLIC
Residing at:
My Commission expires:
ICJ FORM A | Rev. 02-01-16
It is essential that the above petition be verified by affidavit and be accompanied by a certified copy of supporting documents.
