For Official Use state of wisconsin, circuit court




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For Official Use





STATE OF WISCONSIN, CIRCUIT COURT,       COUNTY

IN THE INTEREST OF


     

Name




Petition for Judgment Against

Juvenile/Parent

for Unpaid Restitution

     

Date of Birth



Case No.      

Under oath to tell the truth I state:


1. I am:  the victim in this matter

 the victim’s insurer (name of company):      

 a representative of the public’s interest under §938.09, Wisconsin Statutes:

 District attorney (for §§938.12, 938.125, 938.13, Wisconsin Statutes)

 Corporation counsel (for §§938.125, 938.13, Wisconsin Statutes)

 City/Village/Town attorney (for §938.125, Wisconsin Statutes)

 Person designated by county board (for §938.125, Wisconsin Statutes)

 a representative of the agency supervising the juvenile.


2. The amount of restitution that was to be paid was $       , and

 the court ordered the juvenile to pay restitution to the victim or victim’s insurer in this matter.

 the court ordered the custodial parent to pay the restitution to the victim or victim’s insurer in this matter.

 the juvenile agreed to pay restitution in a deferred prosecution agreement.


3. The amount of restitution still owing is $       , and

 the juvenile has failed to pay the restitution.

 the custodial parent has failed to pay the restitution.



or

 it appears likely that the juvenile will not pay restitution.

 it appears likely that the custodial parent will not pay the restitution.
4. The deferred prosecution agreement, consent decree, dispositional order or sentence that created the obligation of the juvenile dated on       , expired or will expire on       .
5. This petition is brought not later than one year after the expiration or any extension of the deferred prosecution agreement, consent decree, dispositional order or sentence.
I am requesting that the court conduct a hearing and enter judgment for the amount of unpaid restitution in favor of the victim of the victim’s insurer, or both, and against:

 the juvenile.

 the custodial parent of the juvenile.


Subscribed and sworn to before me

on      


Notary Public, State of Wisconsin

My commission expires:      
Distribution:

1. Original – Court; 2. Juvenile; 3. Juvenile’s Custodial Parent




Signature of Petitioner



     

Name Printed or Typed



     

Company/Agency






JD-1759, 11/99 Petition for Judgment Against Juvenile/Parent for Restitution §895.035 (2m), Wisconsin Statutes

This form shall not be modified. It may be supplemented with additional material.


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