Form KDOC-0093 "Affidavit" - Kansas

What Is Form KDOC-0093?

This is a legal form that was released by the Kansas Department of Corrections - a government authority operating within Kansas. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on April 1, 2008;
  • The latest edition provided by the Kansas Department of Corrections;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form KDOC-0093 by clicking the link below or browse more documents and templates provided by the Kansas Department of Corrections.

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Download Form KDOC-0093 "Affidavit" - Kansas

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IN THE DISTRICT COURT OF
COUNTY, KANSAS
In the Matter of:
, Respondent
Case No.:
DOB:
A
male
female
Under the age of 18 years.
AFFIDAVIT
STATE OF KANSAS
)
) ss:
COUNTY OF
)
I,
, being of lawful age and first being duly sworn
upon my oath, state:
1.
I am the Community Supervision Officer for the above-named respondent.
2.
I have conducted and completed an assessment of the respondent and it is my
Opinion and belief:
(Please check one.)
That reasonable efforts have been made but have failed to maintain the family and prevent
the unnecessary removal of the juvenile from the juvenile’s home as follows:
or
That an emergency exists which threatens the safety of the juvenile and it is reasonable to
make no effort to maintain the juvenile in the home because:
State of Kansas
Kansas Department of Corrections
Form KDOC-0093
Rev. April 2008
Page 1 of 2
IN THE DISTRICT COURT OF
COUNTY, KANSAS
In the Matter of:
, Respondent
Case No.:
DOB:
A
male
female
Under the age of 18 years.
AFFIDAVIT
STATE OF KANSAS
)
) ss:
COUNTY OF
)
I,
, being of lawful age and first being duly sworn
upon my oath, state:
1.
I am the Community Supervision Officer for the above-named respondent.
2.
I have conducted and completed an assessment of the respondent and it is my
Opinion and belief:
(Please check one.)
That reasonable efforts have been made but have failed to maintain the family and prevent
the unnecessary removal of the juvenile from the juvenile’s home as follows:
or
That an emergency exists which threatens the safety of the juvenile and it is reasonable to
make no effort to maintain the juvenile in the home because:
State of Kansas
Kansas Department of Corrections
Form KDOC-0093
Rev. April 2008
Page 1 of 2
or
That reasonable efforts are not required because the parent has been found to have (1)
committed murder in the first degree, K.S.A. 21-3401, and amendments thereto, murder in
the second degree, K.S.A. 21-3402, and amendments thereto, capital murder, K.S.A. 21-
3429, and amendments thereto, or violated a law of another state which prohibits such
murder or manslaughter of a child; or, (2) parent aided or abetted, attempted, conspired or
solicited to commit such murder or voluntary manslaughter of a child as provided in
subsection (1); or, (3) parent committed a felony battery that resulted in bodily injury to the
child or another child; or, (4) parent has subjected the child or another child to aggravated
circumstances as defined in K.S.A. 38-2202, and amendments thereto; or, (5) parental rights
of the parent to another child have been terminated involuntarily. (Set out specifically the
facts relied upon):
and
That remaining in the home would be contrary to the welfare of the juvenile and immediate
placement is in the best interest of the juvenile, specifically:
Wherefore, affiant sayeth naught:
Signature
Community Supervision Officer
SUBSCRIBED AND SWORN to before me this
day of
, 20__.
Notary Public
My Appointment Expires:
State of Kansas
Kansas Department of Corrections
Form KDOC-0093
Rev. April 2008
Page 2 of 2
Page of 2