Form CN-313 "Request for Review Hearing on Placement Denial" - Alaska

Form CN-313 is a Alaska Superior Court form also known as the "Request For Review Hearing On Placement Denial". The latest edition of the form was released in May 1, 2015 and is available for digital filing.

Download a PDF version of the Form CN-313 down below or find it on Alaska Superior Court Forms website.

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Download Form CN-313 "Request for Review Hearing on Placement Denial" - Alaska

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[Note to Court Clerk: Enter requestor as non-party participant in CV and route directly to judicial officer.]
IN THE SUPERIOR COURT FOR THE STATE OF ALASKA
AT
In the Matter of (use initials only):
)
)
)
)
CASE NO.
A minor under 18 years of age.
)
)
REQUEST FOR REVIEW HEARING
Date of birth:
)
ON PLACEMENT DENIAL
1.
I am an adult family member or adult family friend of the minor child(ren) named above.
2.
The Office of Children’s Services denied placement of the child(ren) with me because:
3.
I do not agree with the placement decision made by the Office of Children’s Services. I
believe that the child(ren) should be placed with me because:
4.
I request a hearing to review the placement decision. I understand that my
participation in this case is limited to participating in the hearing about denial of
placement with me.
Attached is a copy of the denial notice from the Office of Children’s Services.
Date
Signature
Type or Print Name
Mailing Address
City
State
ZIP
Daytime Phone Number
ORDER
IT IS ORDERED that the request for review hearing is GRANTED. A review hearing will be held
on
at
a.m./p.m., at
Date
Judge
(For Court Use Only)
Type or Print Name
I certify that on
s
I sent copies of this order to:
Clerk:
Irma E.
CN-313 (5/15)(cs)
AS 47.14.100(m);
, 312 P.3d 850;
REQUEST FOR REVIEW HEARING ON PLACEMENT DENIAL
CINA Rule 19.1(e)
[Note to Court Clerk: Enter requestor as non-party participant in CV and route directly to judicial officer.]
IN THE SUPERIOR COURT FOR THE STATE OF ALASKA
AT
In the Matter of (use initials only):
)
)
)
)
CASE NO.
A minor under 18 years of age.
)
)
REQUEST FOR REVIEW HEARING
Date of birth:
)
ON PLACEMENT DENIAL
1.
I am an adult family member or adult family friend of the minor child(ren) named above.
2.
The Office of Children’s Services denied placement of the child(ren) with me because:
3.
I do not agree with the placement decision made by the Office of Children’s Services. I
believe that the child(ren) should be placed with me because:
4.
I request a hearing to review the placement decision. I understand that my
participation in this case is limited to participating in the hearing about denial of
placement with me.
Attached is a copy of the denial notice from the Office of Children’s Services.
Date
Signature
Type or Print Name
Mailing Address
City
State
ZIP
Daytime Phone Number
ORDER
IT IS ORDERED that the request for review hearing is GRANTED. A review hearing will be held
on
at
a.m./p.m., at
Date
Judge
(For Court Use Only)
Type or Print Name
I certify that on
s
I sent copies of this order to:
Clerk:
Irma E.
CN-313 (5/15)(cs)
AS 47.14.100(m);
, 312 P.3d 850;
REQUEST FOR REVIEW HEARING ON PLACEMENT DENIAL
CINA Rule 19.1(e)
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