INTERSTATE COMPACT FOR JUVENILES
REQUISITION FOR ESCAPEE OR ABSCONDER
REQUISITION FOR ACCUSED DELINQUENT
FORM II
TO: DATE:
(Court of Jurisdiction)
FROM:
(Name of Court or Agency)
I, requisition the return of
born on
in accordance with the Interstate Compact for Juveniles, ICJ Rules Section 600, Return of Juveniles.
Said juvenile (check appropriate item):
was paroled to the custody of:
was placed on probation subject to the supervision of:
was committed to: (institution or custodial agency)
OR
has fled to avoid prosecution and, despite applicable provisions of law, has:
escaped absconded fled
and is now believed to be in your jurisdiction at: .
Juvenile’s physical description: Ht: Wt: Eyes: Hair: Race: Sex:
Identifying marks or scars:
AttachedLVDcertifiedtruecop\ofthejudgment,formaladjudicationorderofcommitment,orpetitionalleging
delinquency,verifyingjuvenile’slegalstatus.
1. Particulars of adjudication or allegations of delinquency:
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.)
AFFIDAVIT OF VERIFICATION
______________________________________________________
(Signature of Requisitioner)
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 II | Rev. 02-01-16
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