Juvenile Delinquency Benchbook Forms

The following forms comply with provisions of HEA 1001, which requires that court orders include "language approved and recommended by the judicial conference of Indiana in relation to removal or detention."  Failure to adopt language from these forms, most significantly the federal IV-E language, may result in your county being liable for the costs of placement of a child.

Forms Last Updated or Newly Approved: July 28, 2017

The forms below are available in Microsoft Word format. To view and print Word documents, you must have Microsoft Word installed on your computer.

Access Probation Officers' Reports on the Probation Website

Chapter 1. Detention and Custody

Form # Form Title Date Approved Date Revised
D-1.02 Written Promise for Appearance of Juvenile 08.08.2008 08.08.2008
D-1.03 Notice of Detention of Child 08.08.2008 08.08.2008
D-1.04 Notice of Detention Hearing 08.08.2008 08.08.2008
D-1.05 Affidavit in Support of Probable Cause 08.08.2008 08.08.2008
D-1.06 Written Findings, Recommendations and 48 Hour Order Regarding Probable Cause 08.08.2008 02.09.2010
D-1.07 Order on Detention Hearing 08.08.2008 02.09.2010
D-1.08 Petition for Detention Hearing 08.08.2008 08.08.2008
D-1.09 Writ of Attachment for Failure to Appear 08.08.2008 08.08.2008
D-1.10 Detention Report to Court Delinquent Children 08.08.2008 08.08.2008

Chapter 3. Preliminary Inquiry

Form # Form Title Date Approved Date Revised
D-3.02 Intake Information for a Delinquent Child and Prosecutor's Request for Preliminary Inquiry 08.08.2008 08.08.2008
D-3.03 Intake Officer's Advice to a Delinquent Child and Parent, Guardian or Custodian 08.08.2008 08.08.2008
D-3.04 Consent to Background Investigation and Release 08.08.2008 08.08.2008

Chapter 4. Informal Adjustment

Form # Form Title Date Approved Date Revised
D-4. IA EXT Informal Adjustment Extension Request 08.08.2008 08.08.2008
D-4.03 Program of Informal Adjustment 08.08.2008 08.08.2008
D-4.04 Petition for Order of Compliance 08.08.2008 08.08.2008

Chapter 5. Delinquency Petition

Form # Form Title Date Approved Date Revised
D-5.02 Request for Custody Order 08.08.2008 08.08.2008
D-5.03 Order Approving Filing of Delinquency Petition Crime Delinquent 08.08.2008 11.03.2009
D-5.04 Order Approving Filing of Delinquency Petition Status Delinquent 08.08.2008 11.03.2009
D-5.05 Petition Alleging Delinquency 08.08.2008 08.08.2008
D-5.06 Order Setting Initial Hearing on Delinquency Petition and for Issuance of Summons 08.08.2008 02.09.2010
D-5.07 Summons 08.08.2008 08.08.2008

Chapter 6. Initial Hearing

Form # Form Title Date Approved Date Revised
D-6.00 C.R. 25: Waiver of Attorney 11.20.2014 03.16.2015
D-6.02 Order on Appointment of Attorney 08.08.2008 08.08.2008
D-6.03 Order on Initial Hearing on Delinquency Petition Crime Delinquent (No Waiver Requested) 08.08.2008 02.09.2010
D-6.04 Order on Initial Hearing on Delinquency Petition Crime Delinquent (Waiver Requested) 08.08.2008 02.09.2010
D-6.05 Order on Initial Hearing on Status Delinquency Petition 08.08.2008 02.09.2010
D-6.06 Order on Initial Hearing on Delinquency Petition (Denial or Delinquency) 08.08.2008 02.09.2010

Chapter 7. Waiver

Form # Form Title Date Approved Date Revised
D-7.02 Prosecutor's Motion for Waiver of Juvenile Jurisdiction (I.C. 31-30-3-2) 08.08.2008 01.30.2017
D-7.03 Waiver Order (I.C. 31-30-3-2) 08.08.2008 01.30.2017
D-7.04 Prosecutor's Motion for Waiver of Juvenile Jurisdiction on Controlled Substances Felony (I.C. 31-30-3-3) 08.08.2008 01.30.2017
D-7.05 Waiver Order (I.C. 31-30-3-3) 08.08.2008 01.30.2017
D-7.06 Prosecutor's Motion for Waiver of Juvenile Jurisdiction (I.C. 31-30-3-4) 08.08.2008 01.30.2017
D-7.07 Waiver Order (I.C. 31-30-3-4) 08.08.2008 01.30.2017
D-7.08 Prosecutor's Motion for Waiver of Juvenile Jurisdiction (I.C. 31-30-3-5) 08.08.2008 01.30.2017
D-7.09 Waiver Order (I.C. 31-30-3-5) 08.08.2008 01.30.2017
D-7.10 Prosecutor's Motion for Presumptive Waiver of Juvenile Jurisdiction Over Child Previously Convicted of Felony or Non-Traffic Misdemeanor 08.08.2008 08.08.2008
D-7.11 Waiver Order (I.C. 31-30-3-6) 08.08.2008 08.08.2008
D-7.12 Order Denying Waiver 08.08.2008 08.08.2008

Chapter 8. Dialogue for Detention / Initial Hearing

Form # Form Title Date Approved Date Revised
D-8.01 Dialogue for Detention Hearing (I.C. 31-37-6) 08.08.2008 03.16.2015
D-8.02 Dialogue for Initial Hearing (I.C. 31-37-12) 08.08.2008 08.08.2008
D-8.03 Dialogue for Combined Initial Hearing and Emergency Detention 03.16.2015  
D-DISPO ALT Dispositional Alternatives (I.C. 31-37-19-5 & 31-37-19-6) 08.08.2008 08.08.2008

Chapter 9. Fact Finding

Form # Form Title Date Approved Date Revised
D-9.02 Order of Fact-Finding Hearing on Delinquency Petition 08.08.2008 02.09.2010
D-9.03 Order on Fact-Finding Hearing on Delinquency Petition 08.08.2008 08.08.2008

Chapter 11. Dispositional Hearings

Form # Form Title Date Approved Date Revised
D-11.02 Sample Dialogue: Dispositional Hearing 08.08.2008 08.08.2008
D-11.03 Dispositional Order 08.08.2008 03.16.2015
D-11.04 Dispositional Order - Wardship Awarded to Dept. of Correction 08.08.2008 02.09.2010
D-11.05 Order to Reinstate Jurisdiction Over Child 08.08.2008 08.08.2008
D-11.08 Financial Obligation Order 08.08.2008 12.07.2009

Chapter 12. Parental Participation

Form # Form Title Date Approved Date Revised
D-12.02 Petition for Parental Participation 08.08.2008 08.08.2008
D-12.03 Order of Participation 08.08.2008 08.08.2008
D-12.04 Verified Information for Rule to Show Cause 08.08.2008 08.08.2008
D-12.05 Order to Show Cause 08.08.2008 08.08.2008
D-12.06 Motion for Termination of Probation and Reimbursement of Costs 08.08.2008 08.08.2008
D-12.07 Order on Motion for Termination of Probation and Reimbursement of Costs 08.08.2008 08.08.2008

Chapter 14. Modification

Form # Form Title Date Approved Date Revised
D-14.02 Verified Petition for Modification of Dispositional Decree 08.08.2008 08.08.2008
D-14.03 Notice of Hearing on Periodic Review of (or Petition to Modify) Dispositional Order 08.08.2008 08.08.2008
D-14.04 Order for Hearing and Notice on Modification Petition Including Temporary Order 08.08.2008 02.09.2010
D-14.05 Order on Periodic [Six (6) Month] Review Hearing (I.C. 31-37-20-2) 08.08.2008 02.09.2010
D-14.05a Order on Periodic Case Review - APPLA 05.10.2016  
D-14.06a Order Approving Permanency Plan - Non-APPLA 05.10.2016  
D-14.06b Order Approving Permanency Plan - APPLA 05.10.2016  
D-14.07 Order on Modification Hearing 08.08.2008 02.09.2010
D-14.08 Modified Dispositional Order (Secure Placement) 08.08.2008 02.09.2010
D-14.09 Notice of Detention Hearing 08.08.2008 08.08.2008

Chapter 15. Public Access

Form # Form Title Date Approved Date Revised
D-15.02 Order Closing Public Access to Juvenile Proceeding During Testimony of Child Witness / Victim 08.08.2008 08.08.2008
D-15.03 Order Granting Access to Certain Juvenile Records 08.08.2008 08.08.2008

Chapter 16. Miscellaneous Forms

Form # Form Title Date Approved Date Revised
D-16.01 Order of Pre-Adjudication Suspension of License (I.C. 31-37-5-7) 08.08.2008 08.08.2008
D-16.02 Order of Reinstatement of Driving Privileges (I.C. 31-37-5-7(b)) 08.08.2008 08.08.2008
D-16.03 Indiana Juvenile Detention Centers 08.08.2008 08.08.2008
D-16.04 Expungement Petition 02.25.2015 07.28.2017
D-16.05 Expungement Order 02.25.2015 07.28.2017
D-16.06 Dual Status Screening Tool Report 03.10.2016  
D-16.07 Referral to Dual Status Assessment Team 03.10.2016  
D.16.08 Recommendation of Dual Status Assessment Team 03.10.2016  
D.16.09 Order on Recommendation of Dual Status Assessment Team 03.10.2016  
D.16.10 Emancipation Order 03.10.2016  

Chapter 17: Indian Child Welfare Act

Form # Form Title Date Approved Date Revised
D-17.01 Indian Child Welfare Act Benchcard 05.01,2017