IN THE DISTRICT COURT OF IOWA, IN AND FOR ____________ COUNTY
(JUVENILE DIVISION)
IN THE INTEREST OF )
) Juvenile No. _____
__________________, )
) ORDER SETTING HEARING ON
) PETITION ALLEGING
A Child. ) CHILD IN NEED OF ASSISTANCE
__________________________________________________
NOW, on this October 21, 2011, the Court is presented with a Petition alleging that the child
in interest is a child in need of assistance under Iowa Code Chapter 232. The Court finds that the
allegations contained in the Petition, if unexplained, would allow a finding that the child in interest is
a child in need of assistance under Iowa Code Chapter 232 and that an adjudicatory hearing should
be held.
IT IS THEREFORE ORDERED that the State file the above-entitled Petition, which is
hereby approved.
IT IS FURTHER ORDERED that an adjudicatory hearing determine whether the child in
interest is a child in need of assistance as alleged in the Petition under Iowa Code Section 232.96
shall be held at ___:___ o'clock __.M. on the ____ day of ________________, 200__, in the
designated Juvenile Courtroom of the _______________ County Courthouse in _______________,
Iowa.
IT IS FURTHER ORDERED that __________________________, Attorney at Law, of
____________________, Iowa, is hereby appointed to represent the child in interest as both attorney
and guardian ad litem at public expense. If it is later determined by the Court that the child's
parent(s) are not indigent and have the ability to pay all or portion of said fees, an order requiring the
parent(s) to reimburse the State will be entered. In the event the child's parents desire to privately
retain counsel to represent the child, they should contact said private counsel immediately
concerning the case and hearing and also notify the attorney appointed by the Court that his or her
services will not be needed.
IT IS FURTHER ORDERED, in the event representation for the child is sought at public
expense, _______________________________ [child's custodial parent] shall submit to the Clerk of
this Court the attached Application for Appointment of Counsel and Financial Statement by the time
of the adjudicatory hearing. Persons who fail to file said application shall be responsible to pay the
entire cost of the attorney appointed for the child and will be ordered to do so.
IT IS FURTHER ORDERED, in the event representation for the child's parent(s) is sought
at public expense, the parent(s) seeking counsel shall submit to the Clerk of this Court the attached
Application for Appointment of Counsel and Financial Statement by the time of the adjudicatory
hearing noting on the application that representation is requested for the parent.
IT IS FURTHER ORDERED that the child, child's parent(s), and the child's guardian ad
litem personally served a copy of the petition, this order, and summons for and/or notice of the
adjudicatory hearing, except that any non-custodial parent who resides outside the State of Iowa shall
be served by certified mail, said notice being served no less than five (5) days prior to the hearing.
The Clerk shall also provide a copy of the same by ordinary mail or personal delivery to the Assistant
County Attorney, the Iowa Department of Human Services, the child's attorney, foster parent or
foster care provider, and case scheduler unless personally served as above, by ordinary mail or
personal delivery.
If you require the assistance of auxiliary aids or services to participate in court because
of a disability, immediately call your district ADA coordinator at (563) 589-4448. (If you are
hearing impaired, call Relay Iowa TTY at 1-800-735-2942.)
SO ORDERED this October 21, 2011.
BY THE COURT:
_________________________________
ASSOCIATE/JUVENILE COURT JUDGE
FIRST JUDICIAL DISTRICT OF IOWA
FORM - CH151 Revised 11/03