Form IW-1711 "Order for Temporary Physical Custody (Secure/Nonsecure) - Indian Child Welfare Act" - Wisconsin

What Is Form IW-1711?

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

Form Details:

  • Released on August 1, 2021;
  • The latest edition provided by the Wisconsin Circuit Court;
  • Easy to use and ready to print;
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  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of Form IW-1711 by clicking the link below or browse more documents and templates provided by the Wisconsin Circuit Court.

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Download Form IW-1711 "Order for Temporary Physical Custody (Secure/Nonsecure) - Indian Child Welfare Act" - Wisconsin

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STATE OF WISCONSIN, CIRCUIT COURT,
COUNTY
IN THE INTEREST OF
Order for Temporary Physical Custody
Secure
Nonsecure
Name
Indian Child Welfare Act
Date of Birth
Case No.
A hearing for temporary physical custody was held on
, which is the effective date of this Order.
[Date]
THE COURT FINDS:
1.
The child/juvenile is in the jurisdiction of this court under
JIPS (under §938.13 (4), (6), (6m), or (7
Wis. Stats.)
:
or
),
[Statutes]
CHIPS
:
.
[Statutes]
2.
Probable cause exists to believe that the
A. Child/Juvenile will commit injury to person or property of others.
B. Child/Juvenile will
cause injury to self.
be subject to injury by others.
C. Parent, guardian, legal custodian or other responsible adult is
neglecting
refusing
unable
unavailable
to provide adequate supervision and care.
D. Child/Juvenile will run away or be taken away, making the child/juvenile unavailable for further court
proceedings.
E. Parent(s) has relinquished custody of the child/juvenile.
3.
Child/Juvenile is subject to the federal Indian Child Welfare Act. (If the child/juvenile is placed in-home and
therefore not subject to the Indian Child Welfare Act, use form JD-1711 instead of this order.)
4.
Emergency removal and placement outside of the home
is
is not
necessary to prevent imminent
physical damage or harm to the Indian child/juvenile.
For secure custody, the court further finds that probable cause exists to believe:
1.
A protective order was issued and the child/juvenile consents in writing to the custody.
2.
The child/juvenile ran away or committed a delinquent act while in nonsecure custody.
For secure custody in a jail, the court further finds:
1.
No other juvenile detention facility approved by DOC or the county is available.
2.
The child/juvenile presents a substantial risk of physical harm to others in the juvenile detention facility.
IW-1711, 08/21 Order for Temporary Physical Custody (Secure/Nonsecure) - Indian Child Welfare Act
§§48.19(1), 48.21, 48.205, 48.415(1m), 48.355(2d), 938.19(1), 938.21, 938.205, and 938.355(2d), Wis. Statutes; 25 U.S.C. §1912.
This form shall not be modified. It may be supplemented with additional material.
Page 1 of 3
STATE OF WISCONSIN, CIRCUIT COURT,
COUNTY
IN THE INTEREST OF
Order for Temporary Physical Custody
Secure
Nonsecure
Name
Indian Child Welfare Act
Date of Birth
Case No.
A hearing for temporary physical custody was held on
, which is the effective date of this Order.
[Date]
THE COURT FINDS:
1.
The child/juvenile is in the jurisdiction of this court under
JIPS (under §938.13 (4), (6), (6m), or (7
Wis. Stats.)
:
or
),
[Statutes]
CHIPS
:
.
[Statutes]
2.
Probable cause exists to believe that the
A. Child/Juvenile will commit injury to person or property of others.
B. Child/Juvenile will
cause injury to self.
be subject to injury by others.
C. Parent, guardian, legal custodian or other responsible adult is
neglecting
refusing
unable
unavailable
to provide adequate supervision and care.
D. Child/Juvenile will run away or be taken away, making the child/juvenile unavailable for further court
proceedings.
E. Parent(s) has relinquished custody of the child/juvenile.
3.
Child/Juvenile is subject to the federal Indian Child Welfare Act. (If the child/juvenile is placed in-home and
therefore not subject to the Indian Child Welfare Act, use form JD-1711 instead of this order.)
4.
Emergency removal and placement outside of the home
is
is not
necessary to prevent imminent
physical damage or harm to the Indian child/juvenile.
For secure custody, the court further finds that probable cause exists to believe:
1.
A protective order was issued and the child/juvenile consents in writing to the custody.
2.
The child/juvenile ran away or committed a delinquent act while in nonsecure custody.
For secure custody in a jail, the court further finds:
1.
No other juvenile detention facility approved by DOC or the county is available.
2.
The child/juvenile presents a substantial risk of physical harm to others in the juvenile detention facility.
IW-1711, 08/21 Order for Temporary Physical Custody (Secure/Nonsecure) - Indian Child Welfare Act
§§48.19(1), 48.21, 48.205, 48.415(1m), 48.355(2d), 938.19(1), 938.21, 938.205, and 938.355(2d), Wis. Statutes; 25 U.S.C. §1912.
This form shall not be modified. It may be supplemented with additional material.
Page 1 of 3
For all custody outside of the home, the court further finds:
1.
Continued custody of the child/juvenile by the parent or Indian custodian
is
is not
likely to result in
serious emotional or physical damage to the child/juvenile, based on the testimony of one or more qualified
expert witnesses.
(This finding is optional at this hearing.)
2. Active efforts
were
were not
made to provide remedial services and rehabilitation programs designed
to prevent the breakup of the Indian family.
(This finding is optional at this hearing.)
See attached Statement of Active Efforts (IW-1609)
is not contrary to the child’s/juvenile’s welfare.
3.
Continuation of residence in the home at this time
is
4.
Reasonable efforts to prevent removal and return child/juvenile safely home were
[Complete one of the following.]
made by the department or agency responsible for providing services as follows:
made by the department or agency responsible for providing services, although an emergency situation
resulted in immediate removal of the child/juvenile from the home as follows:
not required under §§48.355(2d) and 938.355(2d), Wis. Stats.
required, but good cause has been shown why sufficient information is not available to enable the court to
make the necessary findings. This hearing is continued until
:
.
[Date
]
(Not to exceed 5 days)
required, but the department or agency responsible for providing services failed to make reasonable efforts.
5.
Reasonable efforts to place the child/juvenile in a placement that enables the sibling group to remain together were
 made.
not required because the child/juvenile does not have siblings in out-of-home care.
not required because it would be contrary to the safety or well being of the child/juvenile or any of the siblings.
6.
Emergency removal and placement outside of the home
is
is not
necessary to prevent imminent
physical damage or harm to the Indian child/juvenile.
7. The placement is certified as a Qualified Residential Treatment Program.
A. The standardized assessment and recommendation by a qualified individual have been submitted.
1. The needs of the child/juvenile
can
cannot
be met through placement in a foster home.
2. The placement
does
does not
provide the most effective and appropriate level of care for
the child/juvenile in the least restrictive environment.
3. The placement
is
is not consistent with the short-term and long-term goals for the
child/juvenile, as identified in the permanency plan.
4. The placement is
approved
disapproved.
OR
B. The agency primarily responsible for providing services will submit the standardized assessment and
recommendation by a qualified individual by:
.
[No later than 30 days from date of placement]
8.
As to the department or agency recommendation:
A. The placement location recommended by the department or agency is adopted.
OR
B. After giving bona fide consideration to the recommendations of the department or agency and all parties,
the placement location recommended is not adopted.
IW-1711, 08/21 Order for Temporary Physical Custody (Secure/Nonsecure) - Indian Child Welfare Act
§§48.19(1), 48.21, 48.205, 48.415(1m), 48.355(2d), 938.19(1), 938.21, 938.205, and 938.355(2d), Wis. Statutes; 25 U.S.C. §1912.
This form shall not be modified. It may be supplemented with additional material.
Page 2 of 3
9.
The
mother
father
was present and was asked to provide the names and other identifying information
of three adult relatives of the child/juvenile or other adult individuals whose home the parent requests the court to
consider as placements for the child/juvenile.
THE COURT ORDERS:
1.
The child/juvenile is held in custody out-of-home at
and into the placement and care responsibility of the department in the county where this order is issued, or the
Division of Milwaukee Child Protective Services if this order is issued in Milwaukee County under Ch. 48, which
has primary responsibility for providing services.
2.
The child/juvenile has one or more siblings in out-of-home care and the child/juvenile is not placed with all those
siblings.
The department or agency shall make reasonable efforts to provide frequent visitation or other ongoing
interaction between the child/juvenile and any siblings.
The department or agency is not required to provide for frequent visitation or other ongoing interaction
because it would be contrary to the safety or well being of the child/juvenile or any siblings.
3.
The department or agency shall conduct a diligent search in order to locate and provide notice as required by
§48.21(5)(e)2. or §938.21(5)(e)2., Wis. Stats., to all adult relatives of the child/juvenile, including the three adult
relatives provided by the parents under §48.21(3)(f) or §938.21(3)(f), Wis. Stats., no later than 30 days from the
date of the child’s/juvenile’s removal from the home, unless the search was previously conducted and notice
provided.
4.
While in a nonsecure placement above, the child/juvenile shall also be monitored by an electronic monitoring
system.
5.
Other conditions of custody:
6.
The parent(s)/guardian shall contribute toward the expenses of custody/services in the amount of
$
.
to be determined by
.
[Agency]
7.
Transportation to the placement and any return to court shall be provided by
.
8.
The next hearing is
at
a.m.
p.m.
[Date]
[Time]
9.
The request for temporary physical custody is denied.
10.
Other:
Name and Address of Placement:
DISTRIBUTION:
1. Court
2. Placement Facility
3. Child/Juvenile/Parents/Indian Custodian/Attorneys
4. District Attorney/Corporation Counsel
5. Case Worker/Intake Worker
6. Tribe
IW-1711, 08/21 Order for Temporary Physical Custody (Secure/Nonsecure) - Indian Child Welfare Act
§§48.19(1), 48.21, 48.205, 48.415(1m), 48.355(2d), 938.19(1), 938.21, 938.205, and 938.355(2d), Wis. Statutes; 25 U.S.C. §1912.
This form shall not be modified. It may be supplemented with additional material.
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