Permanency Hearing Order {IW-1791}

JD-1810, 11/15 Petition for Voluntary Transition to Independent Living Agreement 24724748.366 and 938.366, Wisconsin Statutes This form shall not be modified. It may be supplemented with additional material. Page 1 of 1 STATE OF WISCONSIN, CIRCUIT COURT, COUNTY IN THE INTEREST OF Name Date of Birth Petition for Voluntary T ransition to Independent Living Agreement Case No. I STATE ON INFORMATION AND BELIEF: 1. The person in the above captioned case is under a Voluntary Transition to Independent Living Agreement pursuant to 247247 48.366(3) or 938.366(3), Wis. Stats. 2. A copy of the Voluntary Transition to Independent Living Agreement is attached. 3. I am a representative of the agency primarily responsible for providing services under the agreement. 4. I am providing the following information for the parties entitled to notice: Name Address s Name (if any) Address Name Address 5. The placement is in the best interests of the person because: I am requesting that the court hold a hearing and grant an order determining that placement in out-of-home care under the Voluntary Transition to Independent Living Agreement is in the best interests of the person on or before [Date no later than 180 days after the agreement was entered] . DISTRIBUTION: 1. Court 2. Person 3. Guardian (if any) 4. Other: Signature Name Printed or Typed Date American LegalNet, Inc. www.FormsWorkFlow.com