Appendix D Court Designated Worker Referral
Baldwin's Kentucky Revised Statutes Annotated6th Judicial District - Daviess District Court
KY RDDC App. D
Appendix D Court Designated Worker Referral
COMMONWEATLH1 OF KENTUCKY |
DAVIESS DISTRICT COURT |
DIVISION _____ |
CASE NO. _______________ |
IN RE: ______________________________ |
ORDER OF REFERRAL FOR SERVICES THROUGH THE OFFICE OF CDW |
This matter having come before the Court, the following individual is referred for services through the office of the CDW as set forth below: |
(Name) __________________________________, is a juvenile before the Court on a |
charge/charges of |
. |
The above juvenile resides with (parent, parents, guardian) |
____________________ at the following address |
__________________________________________________________________ and who |
may be contacted at the following telephone numbers (home) __________; (work) |
____________________; (cell) __________________; (other) ____________________. |
Services ordered: | _____ | Ankle Monitor ___ Hrs. of Community Service |
_____ | Tobacco Education Group | |
_____ | Summer Program (high school age) | |
_____ | Winter Camp (boys only, age 12 to 14) | |
_____ | Learning Project(s) relating to (circle) assault, bullying, shoplifting, truancy, other | |
_____ | Other: |
The above named child and/or parent/guardian shall contact the Office of the CDW (circle) IMMEDIATELY/ within __________ business days, or be subject to contempt or other consequences deemed appropriate by the Court. |
The Court shall be informed of noncompliance and both child and/or parent/guardian could be held in contempt and subject to the return of case to Court for additional penalties. |
Failure to keep the Office of the CDW informed of the address and whereabouts of the child and any change in contact information can be grounds for contempt as well. |
SO ORDERED this the _____ day of __________, _____. |
Judge | |
Juvenile | Parent(s)/Guardian |
County Attorney | Public Defender/Attorney for Child |
cc: Court, CDW, Juvenile, Parent/Guardian, Child's Attorney, County Attorney |
Credits
HISTORY: Adopted effective May 9, 2012.
Footnotes
So in original.
Daviess District Court App. D, KY R DAVIESS DIST CT App. D
Current with amendments received through November 15, 2023. Some rules may be more current, see credits for details.
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