Form CHP904 "Child Age 10 or Older Request for Lawyer or Waiver of Court-Appointed Lawyer" - Minnesota

What Is Form CHP904?

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

Form Details:

  • Released on October 1, 2019;
  • The latest edition provided by the Minnesota District Courts;
  • 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 printable version of Form CHP904 by clicking the link below or browse more documents and templates provided by the Minnesota District Courts.

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Download Form CHP904 "Child Age 10 or Older Request for Lawyer or Waiver of Court-Appointed Lawyer" - Minnesota

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STATE OF MINNESOTA
DISTRICT COURT
JUDICIAL DISTRICT
COUNTY OF
CASE TYPE: JUVENILE
PROTECTION
COURT FILE NUMBER:
In the Matter of the Welfare of the
CHILD AGE 10 OR OLDER
Child(ren) of:
REQUEST FOR LAWYER OR
____________________ , Mother, and,
WAIVER OF COURT-APPOINTED
____________________ [Father]
LAWYER
[Adjudicated Father]
This form is accessible to the public, unless it contains the signature of a child that is
confidential under
Juv. Prot. Rule 8.04, subd.
2(n). If a confidential signature is included,
then this form is confidential and must be accompanied by a
Confidential Document
Cover Sheet Form
11.3. The Confidential Coversheet shall be accessible to the public,
but the document referenced in the Cover Sheet shall not be accessible to the public
except by court order.
Child’s Name
____________________ and Date of Birth ___________________
Child’s Acknowledgment
1. The social worker gave me a paper telling me I can have a lawyer if I want one. The
paper also told me I can ask to go to court.
2. I have talked with a lawyer about whether I want a court-appointed lawyer and
whether I want to go to court.
3. After talking with a social worker and lawyer, I have decided:
I want a lawyer. I will talk with my lawyer about whether I do or do not want to go
to court.
Right now, I do not want a lawyer and I do not want to go to court, but I know I
can change my mind.
I do not want a lawyer, but I do want to attend some or all court hearings.
Signature of child: ___________________________________ Date: ______________
Consulting Attorney’s Acknowledgement
By signing below, I am telling the judge that I talked with the child about the child’s right
to a lawyer and right to go to court.
Name of attorney who consulted with child (print): _____________________________
Signature of attorney: _____________________________ Date: ______________
CHP904
State ENG
10/19
www.mncourts.gov/forms
Page 1 of 1
STATE OF MINNESOTA
DISTRICT COURT
JUDICIAL DISTRICT
COUNTY OF
CASE TYPE: JUVENILE
PROTECTION
COURT FILE NUMBER:
In the Matter of the Welfare of the
CHILD AGE 10 OR OLDER
Child(ren) of:
REQUEST FOR LAWYER OR
____________________ , Mother, and,
WAIVER OF COURT-APPOINTED
____________________ [Father]
LAWYER
[Adjudicated Father]
This form is accessible to the public, unless it contains the signature of a child that is
confidential under
Juv. Prot. Rule 8.04, subd.
2(n). If a confidential signature is included,
then this form is confidential and must be accompanied by a
Confidential Document
Cover Sheet Form
11.3. The Confidential Coversheet shall be accessible to the public,
but the document referenced in the Cover Sheet shall not be accessible to the public
except by court order.
Child’s Name
____________________ and Date of Birth ___________________
Child’s Acknowledgment
1. The social worker gave me a paper telling me I can have a lawyer if I want one. The
paper also told me I can ask to go to court.
2. I have talked with a lawyer about whether I want a court-appointed lawyer and
whether I want to go to court.
3. After talking with a social worker and lawyer, I have decided:
I want a lawyer. I will talk with my lawyer about whether I do or do not want to go
to court.
Right now, I do not want a lawyer and I do not want to go to court, but I know I
can change my mind.
I do not want a lawyer, but I do want to attend some or all court hearings.
Signature of child: ___________________________________ Date: ______________
Consulting Attorney’s Acknowledgement
By signing below, I am telling the judge that I talked with the child about the child’s right
to a lawyer and right to go to court.
Name of attorney who consulted with child (print): _____________________________
Signature of attorney: _____________________________ Date: ______________
CHP904
State ENG
10/19
www.mncourts.gov/forms
Page 1 of 1