Fillable Interstate Compact for Juveniles - Quarterly Progress, Violation, or Absconder Report

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Interstate Compact for Juveniles - Quarterly Progress, Violation, or Absconder Report

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ICJ QUARTERLY PROGRESS / VIOLATION / ABSCONDER REPORT | Rev. 02-01-16
INTERSTATE COMPACT FOR JUVENILES
Quarterly Progress, Violation, or Absconder Report
Quarterly Report Violation Report Absconder Report
FORM IX
Sending State:
Receiving State:
Case #
Case #
Juvenile’s Name:
DOB:
Address:
(Street address)
(City)
(State)
(Zip)
Primary Phone #
Supervision Level:
Exp. Date:
Juvenile’s Last Personal Contact with Supervising Agent:
Progress Topic
Rating
Adjustment in the home
Excellent
School/Education performance
Excellent
Compliance with orders
Excellent
Family and peer relationships
Excellent
Employment performance
Excellent
Treatment/Counseling
Excellent
General attitude
Excellent
SUMMARY OF PROGRESS SINCE LAST REPORT / DESCRIPTION OF CITATION OR VIOLATION / DETAILS OF
JUVENILE’S ABSCONDING:
COURT APPEARANCES? YES NO PENDING CHARGES IN THE RECEIVING STATE? YES NO
If YES, please provide certified court documents and a brief explanation of the current legal situation and/or a description
of charges below:
ICJ QUARTERLY PROGRESS / VIOLATION / ABSCONDER REPORT
ICJ QUARTERLY PROGRESS / VIOLATION / ABSCONDER REPORT | Rev. 02-01-16
EFFORTS OR INTERVENTIONS TO REDIRECT BEHAVIOR:
SANCTIONS, IF APPLICABLE:
Status/Disposition: Date of Citation or Violation:
RECOMMENDATION: Continue Supervision Request Discharge Request Revocation
(Juvenile Worker)
(Date)
(Supervisor)
(Date)
By checking this box, I confirm the validity of the
information contained within this Form.
By checking this box, I confirm the validity of the
information contained within this Form.
(Compact Administrator/Official)
(Date)
By checking this box, I confirm the validity of the
information contained within this Form.
For ICJ Official use only:
SENDING STATE RESPONSE TO DISCHARGE OR REVOCATION REQUEST:
Action To Be Taken: Date Action Will Occur:
(Compact Administrator/Official) (Date)
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Interstate Compact for Juveniles - Quarterly Progress, Violation, or Absconder Report

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Completed 13 May 2020

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