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I. Introduction PRS Litigation Manual A. Legal Authority and Responsibilities of DYFS Under New Jersey law, the Division of Youth and Family Services is the state agency mandated to receive and investigate reports of alleged child abuse and neglect. The law also gives the Division authority to seek court relief in those cases where the child's parent or guardian refuses to cooperate with the Division's investigation or service plan where the child requires protection. The Division may petition the court on behalf of a child under two different titles of the New Jersey statutes: N.J.S.A. 30:4C-1 et seq. and N.J.S.A. 9:6-1 et seq. B. N.J.S.A. 30:4C-1 et seq. This title of the law outlines the Division's major responsibilities in the areas of investigation, supervision, foster care, maintenance arrangements, etc. The portions of the law which pertain to court intervention are included in sections 4C-12 and 4C-15. Under these provisions, the Division may apply to the Juvenile and Domestic Relations Court for four types of orders: 1. Order to Investigate, 2. Order to Supervise, 3. Order for Temporary Custody, and 4. Order of Guardianship. C. N.J.S.A. 9:6-1 et seq. This title of the law specifically addresses children who are abandoned, abused or neglected. It includes, among other things, provisions defining child abuse and neglect, establishing the Central Registry, outlining reporting requirements, authorizing physicians and hospitals to hold children for three (3 court days and establishing court procedures. Unlike Title 30, this title of the law

also authorizes persons other than Division personnel to remove a child from his home and to petition the court. The Division is directed to assist any such person by providing placement for the child and in causing a complaint to be filed with the court. Under Title 9, the Division may seek several types of relief, including temporary custody, preliminary order for medical treatment, supervision or order of protection. However, the most frequent use of Title 9 will be to seek an Order for Temporary Custody which may occur in 3 different situations: 1. Removal with Parental Consent (9:6-8.27 If any person removes a child from his home with parental consent, a complaint must be filed with court within 3 days if the child is not returned in that time. Note: If DYFS removes upon written voluntary agreement from the parent, a complaint need not be filed, but may be. 2. Preliminary Order for Removal Without Parental Consent (9:6-8.28 This order may be sought prior to a preliminary hearing when: a. the parent is absent or refuses to consent to removal after having been advised of the Division's intention to seek a court order; b. removal is necessary to avoid imminent danger to the child's life or health; and c. there is insufficient time to hold a preliminary hearing. In this case, a complaint, Appendix V, must accompany the order at the time of filing. An Order to Show Cause with Preliminary Removal may be found in Appendix VII, Chapter 209 Laws of New Jersey, 1977. 3. Removal Without Consent or Court Order (9:6-8.29 DYFS, a probation officer, a physician

II. or the police may remove a child under this section if the child's life or health is in imminent danger. The removing authority is required to immediately notify DYFS of the action taken. The removing authority or DYFS must make every reasonable effort to inform the parent or guardian of the removal and the facility to which the child was taken. A complaint must be filed by DYFS in Superior Court, Chancery Division, Family Part, and a hearing must be held on the next court day. Note: Whether or not DYFS returns the child or obtains a written placement agreement before the next court day, the complaint MUST be filed and the hearing must be held in court the next court day. D. When to use Title 9 or Title 30 The decision of which section of the law to file under rests with the Deputy Attorney General. However, there are some situations in which one title of the law is preferable or must be used: 1. Title 9 must be used when removal is made without consent or court order (9:6-8.29. 2. Title 9 may also be used when the Division seeks specified relief in the form of an order which will direct certain action by the parent, i.e., to stay away from the home, to accept therapeutic services, to be placed under probation supervision, etc. (9:6-8.55, 8.56 and 8.58. 3. Title 30 should be used to obtain authority for investigation and must be used when seeking guardianship (30:4C-12 and 4C-15. General Procedures The Office of the Attorney General represents DYFS in all legal matters except ACI's. A list of all DAG's assigned to the Division may be found in Appendix XIV. No court action may be initiated without the review and consent of the Deputy

Attorney General. The general rules of this manual are subject to the specific directions of the attorney handling the case. The responsibilities of the designed litigation specialist include: 1. reviewing materials on all cases being prepared for court; 2. providing assistance to DO staff in the preparation of complaints and in preparing for the court hearing; 3. discussing all cases with the DAG; 4. forwarding all materials to the DAG; 5. handling all calls from the DAG, other attorneys or the court; 6. keeping a record of all cases pending court action. These duties may be modified at the discretion of the DO Supervisor and the DO staff. Except in those cases described in Section 4 below, the following general rules will apply in all cases: 1. Complaints and application to any court on behalf of DYFS will be filed by the Deputy Attorney General. 2. When a decision has been made to initiate court action, the proposed initiating document (complaint, etc. will be forwarded to the DAG assigned to that office. Other materials to be forwarded to the DAG include: a. a copy of the entire case record; b. information on all prior court action taken by DYFS in this case; c. supporting affidavit by the caseworker (Appendix X; d. other supporting affidavits where necessary, e.g., medical affidavit or reports from other agencies or persons; e. a copy of the order when it has been prepared by the DO;

f. cover sheet, Appendix XII; g. covering memorandum to the DAG, Appendix XIII; 3. Upon reviewing the petition and related papers, the DAG assigned to the case will prepare the appropriate order. In the event that additional information is needed from the caseworker, the DAG will so advise. When the papers are in order, the DAG will file in the county Juvenile and Domestic Relations Court. 4. In emergency situations, when there is insufficient time to forward the complaint to the DAG, the complaint and other supporting documents may be read to the DAG over the telephone If the DAG approves, the complaint may be signed by the District Office Supervisor, or his designee, and filed with the court. In this case, the district office will prepare the order for the Judge's signature. The DAG should be advised by telephone of the hearing date set by the court. All materials should then be forwarded to the DAG immediately. 5. All specific, case-related questions of a nonemergency nature should be directed in writing to the DAG. Replies by the DAG will also be in writing where warranted. 6. Telephone calls to the DAG from the district office should be made through the litigation specialist or other designated person. 7. Upon receipt of any motion papers or legal papers from an attorney other than the DAG, immediately notify the DAG by telephone and send such papers to the Deputy for appropriate action. Retain a copy for the DO file. 8. When an order has been issued by the court, the Division is required to comply with all provisions of the order. If any action is proposed or taken which does not comply with the order (e.g., returning the child to his parent prior to the expiration of an Order of Custody both the court and the DAG must be notified in writing. Such notification must cite justifying facts upon which the

III. determination has been made. 9. Prior to the expiration of any court order, appropriate DO staff must decide whether or not an extension of the order is needed. If an extension is sought, notify the DAG in writing. The DAG will prepare an application to the court to have the order extended. To prepare the application, the DAG must have the following materials supplied by the DO: a. New affidavit or affidavits outlining the facts which form the basis for seeking the extenstion. Such facts will relate only those incidents or circumstances occurring subsequent to the issuance of the previous court order. The primary affidavit, prepared by the caseworker, should begin by stating the child's name and current address. This should be followed by statements identifying the caseworker, his position and length of involvement with the case, the date of the last court hearing and relief given and a chronological listing of all facts and occurrences since the last court hearing. b. Any reports or materials which have been received by the DO since the original order was issued. Note: If the decision is not to apply for an extension, the DAG must be notified in writing. This notification must include a statement of the facts justifying this determination. See sample letter to the DAG in Appendix XI. Types of Court Action Which May Be Taken A. Complaint to Compel Investigation, 30:4C-12, Appendices I and Ia. 1. To be sought when a referral has been received and an investigation has been attempted but the parent has refused to cooperate with the DYFS investigation. 2. In preparing such a complaint, allege facts sufficient to show:

a. that you have reason to believe that investigation is required; b. that the parent or guardian has refused to cooperate. 3. Necessary documents are (original and 4 copies: a. complaint signed by DAG; b. verifying affidavit by caseworker; c. other supporting documents; i.e., medical affidavit, or reports of other agencies or persons; d. Order, Appendices II and IIa. B. Complaint to Authorize Protective Services, 30:4C-12, Appendices III and IIIa. 1. To be sought when the child or family requires services but refuses to cooperate with DYFS. 2. Complaint must allege facts sufficient to show: a. that the child requires supervision, i.e., protection, medical needs, emotional disturbance, family disruption, education, etc.; b. that parent refused to cooperate with DYFS or accept services required. 3. Necessary documents (original and 4 copies: a. complaint signed by DAG; b. verifying affidavit; c. supporting affidavits and reports; d. Order, Appendices IV and IVa. C. Complaint to Obtain Temporary Custody, 30:4C-12, Sample Appendices III and IIIa - same as used for complaint to authorize protective services. 1. Under the law, the Division has the authority to

seek such relief only when it appears, based on available evidence, that the parent, guardian or other person having custody and control of the child is grossly unfit or is failing to provide proper protection, maintenance and education so that the welfare of the child is endangered. When the Division determines that such a situation exists and that removal of the child is necessary for his protection, an Order of Temporary Custody may be sought. 2. Complaint must allege facts sufficient to show: a. that the child should be removed from his home for protection, maintenance, etc., b. that the parent refused to sign a voluntary agreement or rescinded pre-existing placement agreement. 3. Necessary documents (original and 4 copies: a. complaint signed by DAG; b. verifying affidavit; c. supporting affidavits and reports; d. Order, Appendices IV and IVa. 4. This kind of order may be sought in two ways: a. Show Cause Order, Appendices IV and IVa, prepared by the DAG. This order compels the parent to show cause why DYFS should not take custody of the child. When this is signed by the Judge and the order so specifies, the child may be removed immediately, prior to the hearing. This is the course of action most often used. b. The complaint may be filed and a hearing held before an order is issued. In this case the child may not be removed prior to the hearing and issuance of the order.

IV. D. Complaint to Obtain Temporary Custody (9:6-8.21 et seq. 1. To be sought pursuant to Title 9 (Dodd law when a child is, or has been, removed because of imminent danger to his life or health and the parent is absent or refuses to consent. 2. Complaint must allege facts sufficient to show: a. that the child has been abused or neglected; b. that immediate removal is, or was, necessary to protect the child; c. that the parent is absent or refused to consent. 3. Necessary documents (original and 4 copies: a. complaint; b. verifying affidavit; c. supporting affidavits and reports; d. Interim Order of Continued Removal and Custody, Appendices VI and VIa. E. Complaint to Obtain Permanent Guardianship (30:4C-15a-d. 1. To be sought only after complete investigation and a determination that parental rights should be served. 2. For specific requirements and procedures see II M 2125-Preparing the Complaint for Guardianship. Preparation of Materials A. Complaints The complaint is a legal document in which specific allegations or charges are made against a party. Except when a child is removed without court order or parental consent under N.J.S.A. 9:6-8.29, the complaint must be prepared and filed with the court before a hearing can be

held or an order issued. In the exception noted above, the complaint will be filed after the initial action has been taken. The following guidelines are to be followed in preparing a complaint: 1. Gather all relevant facts and arrange them in chronological order. 2. Begin with identifying information (i.e., child's name, age (birthdate, if known and place of residence. Follow with name of parent or guardian, relationship to the child and address. Follow with allegations of facts in chronological order. 3. Each fact should be included as a separate allegation in single numbered paragraphs. This does not mean that the paragraphs should be limited to one sentence, but rather that each paragraph relates to one narrow subject. 4. No allegation should be included unless it can be supported by an affidavit, formal report or testimony. 5. Be as specific and accurate as possible. Give dates (on January 15, 1976 or on or about January 15, 1976 and specific observations. 6. Make no judgmental, opinion or conclusionary statements in the complaint. (Do not say Mrs. Smith is an alcoholic. Say intead, the caseworker saw Mrs. Smith consume a six-pack of beer on January 15, 1976 or the caseworker smelled liquor on Mrs. Smith's breath on January 15, 1976. 7. In general, abbreviations should not be used in the complaint. For example, the day 1/15/76 should be written as January 15, 1976. However, some abbreviations may be used after the abbreviated phrase or words have been written in full at the beginning of the complaint. Example: Division of

Youth and Family Services, hereinafter referred to as DYFS. After this initial statement, subsequent references to the Division may be written in the abbreviated form. 8. A complaint is never written in the first person. 9. More than one child may be included in the complaint. 10. When two parents are living separately, but there has been no court order determining legal custody, both parents should be named as defendants in the complaint. 11. The complaint should contain a WHEREFORE clause indicating what relief is sought (see example, Appendix III. 12. The complaint must be signed by the DAG or, in emergencies by the DO Supervisor after approval by the DAG. The complaint is not notarized. 13. The complaint must be dated at the time it is signed. 14. Prepare an original and 4 copies for: B. Affidavits a. Court b. DAG c. Client (for client's attorney Note: An extra copy must be prepared when both parents are named in the action but are living separately from each other. d. Law guardian e. Case record The affidavit is a legal document, signed under oath and notarized, setting forth the true facts as the person has witnessed them.

The following guidelines should be followed in preparing an affidavit: 1. Must be made by a person with firsthand knowledge and signed by him. 2. Must be written in the first person. 3. Must be notarized. Note: When a notary is not readily available, the court rules permit the inclusion of a certification in lieu of an oath. The certification must immediately precede the signature of the person making the affidavit and must be dated. The certification must read exactly as follows: I certify that the foregoing statements made by me are true. I am aware that if any of the foregoing statements made by me are willfully false I am subject to punishment. 4. Prepare an original and 4 copies. 5. There is an example of an affidavit in Appendix X. C. Orders An order is issued by the court stating the disposition of the court and indicating what relief is given. The following guidelines pertain to orders: 1. Prepared by the DAG or DO staff in emergencies. 2. Not notarized. 3. Signed by the Judge. No other signature is required. 4. Prepare an original and 4 copies. 5. See sample Show Cause Orders in Appendices II, IV and VII. Verbal Orders In certain emergent situations, when there is insufficient time to prepare and file a complaint and when it is

desirable to have the authority of an order rather than to remove without an order, a verbal order may be sought. Through a verbal order, the Judge may authorize the Division to remove a child from his home, or institute any other action necessary for the protection of the child. With the provisions of Title 9, under which DYFS may remove without consent or court order (9:6-8.29 or apply for a preliminary order prior to a hearing being held (9:6-8.28, the need to seek a verbal order should be minimized. However, in the event that a verbal order is necessary, the following procedures should be used: 1. The caseworker should, if possible, contact his supervisor or the DO litigation specialist to relate the facts of the case and obtain authorization for action to be taken. 2. Every attempt must be made to consult with the DAG before proceeding. When possible, the DAG should contact the Judge. 3. The Judge may be contacted by telephone at the court during working hours or at his home at night or on weekends. The number at which the judge may be reached should be provided to the DO through the DAG, who should consult with the Judge regarding the conditions under which he is willing to be contacted. Such consultation should occur prior to calling the Judge so that procedures for handling emergent situations may be established. 4. Upon contacting the Judge, all relevant facts should be related as completely and concisely as possible so that he may make an appropriate determination on the case. 5. The complaint and other related papers must be filed with the court on the next court day. 6. Under no circumstances should a verbal order be sought when other appropriate courses of action are available.

V. Filing and Service Note: In any situation involving the court, individual Judges may determine the procedures to be followed in their courts. It is the responsibility of the DAG to consult with the Judge regarding procedural matters and to inform the DO staff. Any disagreements or problems with the court should be referred to the DAG. A. Procedures Follow the advice of the DAG assigned to your district office with regard to the procedures for filing and service. In most cases, the caseworker will file the appropriate materials with the court. The Court Rules (R.1:4-5 require that all documents filed with the court be dated. The date may be entered next to the signature on the document. The only exception is the order on which the date is entered by the court. After filing, the court then directs the sheriff's department to serve the papers on the defendant. Service may be effected by the Division if the order so specifies. In this case, an Affidavit of Service (Appendix VIII must be completed and forwarded to the court and the DAG. B. What Should Be Filed Materials to be filed with the court include: 1. Complaint 2. Verifying affidavits 3. All other affidavits or formal reports, i.e., medical, psychiatric, police, etc. 4. Order - to be signed by the Judge C. Who Should Be Served All moving papers and papers which will come to the attention of the court must be served on the parties themselves. Everything included in the materials which are presented to the court, including the complaint, affidavits and other reports, which form the basis upon which the order is being sought must be served on the

VI. parents. If there is information included in these materials which you feel should not be conveyed to the parent, you may exclude it only upon authorization from the court. D. Subpoenas A subpoena is a legal document compelling a witness to appear in court. The witness may also be compelled to bring certain documents to court if the subpoena so specifies. If necessary, subpoenas will be supplied by the DAG. Subpoenas must be personally served (usually by the caseworker by delivering the original to the person named in the subpoena and giving the person served a witness fee of $2.00 to be paid from "petty cash." If the hearing is outside the witness' home county, the witness receives $2.00 additional for every 30 miles of travel, unless the witness is being paid for expert testimony. After serving the original, fill out proof of service on copy provided and retain in the file. An additional copy, photocopy is sufficient, must be fowarded to the DAG as proof of service. Release of Information and Case Records A. The originals of the complete case record, including all reports, information, etc., must be brought to court in all hearings. B. The release of DYFS records of child abuse reports and information collected in the investigation of such report is strictly limited by N.J.S.A. 9:6-8.10a. None of this material, except that which is included in the documents filed with the court, may be released to law guardians or other attorneys except on court order. The DAG should be contacted concerning requests for discovery in litigated cases. See Attorney General Opinions, M75-1994 and M75-1994 (supplementary Appendix XV. Appendices The following forms are suggested for uniform use in seeking court relief in a variety of situations. Immediately preceeding each form is

a brief explanation of the conditions under which the form should be used and how it should be used. In most cases there are two copies of the form (i.e., Appendix II and Appendix IIa. The first form is annotated with explanations and directions. The second is the basic form as it should be used for court. Appendices I, II and IIa An Order to Investigate should be sought when: 1. a referral alleging abuse or neglect has been received; 2. the parents have refused to allow DYFS to conduct an investigation; and 3. there is reason to believe an investigation is needed. The annotated Complaint for Investigation, Appendix I, indicates that additional relief may be sought where immediate investigation or other emergent relief is necessary. An example of a situation in which continued placement would be sought in conjunction with an Order to Investigate might occur where the Division has custody of the child on a voluntary agreement and the parent demands the child's return, but the Division has not completed its investigation. Continued placement could be sought to protect the child while the Division concludes the investigation provided for in the court order. The supporting affidavit which must accompany the complaint must state facts sufficient to warrant the relief sought. The Order to Show Cause to Investigate, Appendices II and IIa, must be filed with the complaint in all cases. The prepared order should include paragraphs authorizing all the relief sought. The Judge may sign it as prepared or may add or delete any provisions he feels are appropriate. Appendix I FORM: Verified Complaint for Investigation to be used in accord with N.J.S.A. 30:4C-12 and requires supporting affidavit. If emergent ex parte relief is not sought, the affidavit may rely on receipt of a referral or application for care. Where emergent relief (continued placement, immediate investigation is sought prior to hearing, affidavit must state facts sufficient to warrant such relief. JOHN J. DEGNAN

ATTORNEY GENERAL OF NEW JERSEY BY: JUVENILE & DOMESTIC RELATIONS COURT COUNTY OF DOCKET NO. Civil Action NEW JERSEY DIVISION OF YOUTH & FAMILY SERVICES, Plaintiff, VERIFIED COMPLAINT FOR INVESTIGATION vs. Defendant, [FOR IMMEDIATE INVESTIGATION] [WITH OTHER EMERGENT RELIEF] IN THE MATTER OF: The New Jersey Division of Youth and Family Services, by way of complaint, does say: 1. The instant action is brought by the new Jersey Division of Youth and Family Services (hereafter Division with offices at in accord with the provisions of N.J.S.A. 30:4C-12 and R. 5:7A et seq, and R. 4:67-1 et seq. seeking an order to investigate the circumstances of the following child(ren: Appendix I Name Age Address 2. The parent(s or guardian(s of the aforesaid child(ren are residing at 3. A referral has been made to the Division regarding the welfare of the aforesaid child(ren. 4. The Division is attempting to investigate the allegations made in the referral but has been impeded in the conduct of that investigation by the parent(s, guardian(s, or other person having custody and control of the child. 5. Further investigation is necessary in the best interests of the child. Appendix I Wherefore the Division requests an order directing the parent(s or

guardian(s to assist and cooperate with the Division in the conduct of its investigation. [Where additional specific relief (right to entry, police assistance, parental release of records, etc. is sought, include it in Wherefore clause] Appendix II FORM: To be used with Complaint for Investigation and authorizes immediate investigation or other emergent relief only when so specified JOHN J. DEGNAN ATTORNEY GENERAL OF NEW JERSEY BY: JUVENILE & DOMESTIC RELATIONS COURT COUNTY OF DOCKET NO. Civil Action NEW JERSEY DIVISION OF Child Abuse-Neglect YOUTH & FAMILY SERVICES, Plaintiff, ORDER TO SHOW CAUSE TO INVESTIGATE vs. Defendant, [WITH IMMEDIATE INVESTIGATION] [WITH OTHER EMERGENCY RELIEF] IN THE MATTER OF: This matter having been opened to the court by the New Jersey Division of Youth and Family Services (hereafter Division on the verified complaint for investigation pursuant to N.J.S.A. 30:4C-12 and R. 5:7A-1 et seq. and R. 4:67-1 et seq. and it appearing therefrom 1/4 and the affidavits and other supporting documents annexed thereto 1/2 that the best interests of the above-named child(ren require(s entry of this order and other good cause existing therefore, IT IS on this day of 19 ORDERED that [Name of defendant(s] Appendix II

show casue before this court on theday of19 at o'clock why an order should not be entered authorizing the Division to investigate the circumstances of and directing the to assist and cooperate with the Division in the conduct of its investigation. It is further Ordered that a true copy of this Order, Complaint and all supporting documents be served upon the parent(s and/or guardian(s by the Sheriff or a designee of the Division within days of entry of this Order in accord with R. 4:4-4. All parties having an interest in this matter may move for dissolution or modification of this Order upon days' notice to all parties. [Include provision for any specific relief merited in a particular case, i.e., medical evaluation, lie detector test, police assistance, etc.]. J.J.D.R.C. Appendix II *Add this paragraph where immediate, continued placement is sought: It is further Ordered that the Division shall have temporary custody and control of (name of child(ren [including authorization to order and consent to medical treatment] pending completion of its investigation or the return date of this order whichever shall sooner occur. *Add this paragraph were circumstances warrant immediate investigation prior to the return date: It is further Ordered that the Division proceed with its investigation forthwith and (name of parent(s or guardian(s are hereby ordered to assist and cooperate with the Division pending completion of its investigation or the return date of this order, whichever shall sooner occur. - - - - *Where unusual or very specific investigative assistance is needed, the Order should include such relief, i.e., medical or psychological testing, releases, consents for access to confidential records, police assistance, etc. Appendix IIa JOHN J. DEGNAN ATTORNEY GENERAL OF NEW JERSEY BY:

JUVENILE & DOMESTIC RELATIONS COURT COUNTY OF DOCKET NO. Civil Action NEW JERSEY DIVISION OF Child Abuse-Neglect YOUTH & FAMILY SERVICES, Plaintiff, ORDER TO SHOW CAUSE TO INVESTIGATE vs. Defendant, IN THE MATTER OF: This matter having been opened to the court by the New Jersey Division of Youth & Family Services (hereafter Division on the verified complaint for investigation pursuant to N.J.S.A. 30:4C-12 and R. 5:7A-1 et seq. and R. 4:67-1 et seq. and it appearing therefrom [and the affidavits and other supporting documents annexed thereto] that the best interests of the above-named child(ren require(s entry of this order and other good cause existing therefore, IT IS on this day of19 ORDERED that show cause before this court on theday of19 at o'clock Appendix IIa why an order should not be entered authorizing the Division to investigate the circumstances of and directing the to assist and cooperate with the Division in the conduct of its investigation. It is further Ordered that a true copy of this Order, Complaint and all supporting documents be served upon the parent(s and/or guardian(s by the Sheriff or a designee of the Division within days of entry of this Order in accord with R. 4:4-4. All parties having an interest in this matter may move for dissolution or

modification of this Order upon days' notice to all parties. J.J.D.R.C. Appendices III, IIIa, IV and IVa An Order for Protective Services should be sought when: 1. investigation of a child abuse neglect referral indicates a need for the Division to supervise and offer services to a child in his own home; 2. the parent has refused to voluntarily accept the necessary services; and 3. investigation indicates that the child should be temporarily removed from his home, but is not removed under a Title 9 procedure, i.e., removal without a court order or with a Preliminary Order. This action is intended to be used primarily in cases where supervision of the child in his own home is sought. However, if the facts are sufficient, temporary removal may also be sought. See Appendix III. The Order to show cause for Protective Services, Appendices IV and IVa, must be filed in all cases and should specify the relief sought. Appendix III FORM: Verified Complaint for Protective Services [with Temporary Removal] to be used for protective services in accord with N.J.S.A. 30:4C-12 and must be verified (supported by affidavit. Where emergent relief (removal is sought, affidavit must state facts to sustain removal prior to a hearing. JOHN J. DEGNAN ATTORNEY GENERAL OF NEW JERSEY BY: JUVENILE & DOMESTIC RELATIONS COURT COUNTY OF DOCKET NO. Civil Action NEW JERSEY DIVISION OF Child Abuse-Neglect YOUTH & FAMILY SERVICES, Plaintiff, VERIFIED COMPLAINT FOR PROTECTIVE SERVICES vs.

Defendant, [WITH TEMPORARY REMOVAL] IN THE MATTER OF: The New Jersey Division of Youth & Family Services by way of complaint does say: 1. The instant action is brought by the New Jersey Division of Youth & Family Services (hereafter Division with offices at in accord with the provisions of N.J.S.A. 30:4C-12 and R. 5:7A-1 et seq. and R. 4:67-1 et seq. seeking (care and supervision and/or (temporary custody (specify relief sought. Appendix III [Identify child(ren and parent(s or guardian(s by name and address and allege facts for which relief is sought.] #. The best interest of the child(ren require(s placement in the care and supervision and/or temporary custody of the Division. Wherefore the Division seeks an order placing the child(ren in the care (supervision and/or custody of the Division in accord with N.J.S.A. 30:4C-12 and such other relief as may be warranted. (Specify and include other relief sought. JOHN J. DEGAN ATTORNEY GENERAL OF NEW JERSEY Attorney for Division of youth and Family Services (When Deputy available By (Name (Deputy Attorney General Date: JOHN J. DEGNAN ATTORNEY GENERAL OF NEW JERSEY Attorney for Division of Youth and Family Services BERNICE L. MANSHEL (On Emergency Division of Youth and Family Services

By (Name District Office Supervisor (or Acting District Office Supervisor Date: Appendix IIIa JOHN J. DEGNAN ATTORNEY GENERAL OF NEW JERSEY BY: JUVENILE & DOMESTIC RELATIONS COURT COUNTY OF DOCKET NO. Civil Action NEW JERSEY DIVISION OF Child Abuse-Neglect YOUTH & FAMILY SERVICES, Plaintiff, VERIFIED COMPLAINT FOR PROTECTIVE SERVICES vs. Defendant, IN THE MATTER OF: The New Jersey Division of Youth & Family Services by way of complaint does say: 1. The instant action is brought by the New Jersey Division of Youth & Family Services (hereafter Division with offices at in accord with the provisions of N.J.S.A. 30:4C-12 and R. 5:7A-1 et seq. and R. 4:67-1 et seq. seeking Appendix IV FORM: To be used with Protective Services Complaint and authorizes temporary pre-hearing removal only when so specifying. JOHN J. DEGNAN

ATTORNEY GENERAL OF NEW JERSEY BY: JUVENILE & DOMESTIC RELATIONS COURT COUNTY OF DOCKET NO. Civil Action NEW JERSEY DIVISION OF Child Abuse-Neglect YOUTH & FAMILY SERVICES, Plaintiff, ORDER TO SHOW CAUSE FOR PROTECTIVE SERVICES vs. Defendant, [WITH TEMPORARY REMOVAL] IN THE MATTER OF: This matter having been opened to the court of the New Jersey Division of Youth & Family Services upon a Verified Complaint for Protective Services and it appearing therefrom and the affidavits and/or other supporting documents that the best interests of the child(ren require(s entry of this order and other good cause existing therefore, IT IS on this day of 19 ORDERED that within captioned child(ren hereby is placed in the care and supervision of the New Jersey Division of Youth & Family Services as provided by N.J.S.A. 30:4C-12. [Where immediate custody is sought, add:] Appendix IV Ordered that the child(ren hereby is (are made a ward of this court and placed in the immediate custody of the Division with authorization in the Division to consent to emergency medical treatment in accord with N.J.S.A. 30:4C-12 and R. 5:7A-1(b. It is further Ordered that (name of parent(s or guardian(s show cause before this court (name and address of court on the day of 19 at o'clock in the noon why an order placing the child(ren in the care, supervision and/or custody of the Division for a period not to exceed six months shall not be granted by this

court. It is further Ordered that a true copy of this Order, Complaint and all supporting documents be served upon the parent(s or guardian(s by the Sheriff or a designee of the Division within days of entry of this Order in accord with R. 4:4-4. All parties having an interest in this matter may move for dissolution or modification of this Order upondays' notice to all parties. [Include provision for any specific relief merited in a particular case i.e., medical evaluation, lie detector test, police assistance, etc.]. J.J.D.R.C. Appendix IVa JOHN J. DEGNAN ATTORNEY GENERAL OF NEW JERSEY BY: JUVENILE & DOMESTIC RELATIONS COURT COUNTY OF DOCKET NO. Civil Action NEW JERSEY DIVISION OF Child Abuse-Neglect YOUTH & FAMILY SERVICES, Plaintiff, ORDER TO SHOW CAUSE FOR PROTECTIVE SERVICES vs. Defendant, IN THE MATTER OF: This matter having been opened to the court of the New Jersey Division of Youth & Family Services upon a Verified Complaint for Protective Services and it appearing there from and the affidavits and/or other supporting documents that the best interests of the child(ren require(s entry of this order and other good cause

existing therefor, IT IS on thisday of 19 ORDERED that the within captioned child(ren hereby is placed in the care and supervision of the New Jersey Division of Youth & Family Services as provided by N.J.S.A. 30:4C-12. Appendices V, Va and Vb The Verified Complaint is to be used in accordance with the provisions of the Dodd Law (N.J.S.A. 9:6-8.27, 8.28 and 8.29 when: 1. the child has been removed from his home by someone other than DYFS personnel with the consent of the parent (N.J.S.A. 9:6-8.27 requires that a complaint be filed within 3 working days unless the child is returned; 2. the child is removed on a Preliminary Order; and 3. the child is removed without parental consent or court order (N.J.S.A. 9:6-8.30 requires filing by the next court day unless the child is returned. This form is set up so that the appropriate statutory definition of abuse which is being alleged may be checked off, with the specific facts of the case to follow. In emergent situations, where there is little time for preparation, the form, Appendix Va, may be xeroxed and used as a check-off form with the specific facts of the case added. When time allows, the form should be retyped in full retaining only those allegations which pertain to the specific case at hand. Appendix Vb includes facts from a sample case as they might be set out. The Verified Complaint must be accompanied by a supporting affidavit and any other documents (i.e., medical reports which allege facts sufficient to obtain the relief sought. Appendix V FORM: For use in abuse-neglect complaints in accord with N.J.S.A. 9:6-8.27, 8.28 and 8.29. JOHN J. DEGNAN ATTORNEY GENERAL OF NEW JERSEY BY: (DAG Name ( Address ( Telephone JUVENILE & DOMESTIC RELATIONS COURT COUNTY OF DOCKET NO. Child Abuse-Neglect

NEW JERSEY DIVISION OF Civil Action YOUTH & FAMILY SERVICES, Plaintiff, VERIFIED COMPLAINT (Annotated vs. Defendant, IN THE MATTER OF: (Name of Child (Children The New Jersey Division of Youth & Family Services, by way of complaint, does say: 1. The New Jersey Division of Youth & Family Services (Division, with offices at: is a Division of the Department of Human Services of the State of New Jersey. 2. The instant action is brought by the Division pursuant to Appendix V N.J.S.A. 9:6-8.21 et seq. and N.J.S.A. 30:4C-12 and R. 5:7A-1 et seq. for the protection and best interests of the following child(ren: Name Age Address 3. residing at is(are the parent(s or guardian(s of the aforesaid child(ren. 4. At present, the child(ren is(are in the temporary custody of 5. While in the care and custody of his(her (their parent(s or guardian(s, the aforesaid child(ren was(were abused and/or neglected in that: (check applicable paragraphs and delete portions not relevant ( Parent(s or guardian(s inflicted or allowed to be inflicted by (name of person where abuser is upon the child(ren injury by other (person other than parent or guardian than accidental means which caused or created a substantial risk of death, or serious or protracted disfigurement or protracted impairment of physical or emotional health or protracted loss or impairment of the function of any bodily

organ. Appendix V ( Parent(s or guardian(s created and/or allowed to be created by (name of person where abuser is person a substantial or ongoing risk of other than parent or guardian physical injury to the child(ren by other than accidental means which would be likely to cause death or serious or protracted disfigurement or protracted loss or impairment of the function of any bodily organ. ( Parent(s or guardian(s committed or allowed to be committed by an act of sexual abuse against the child(ren. ( Parent(s or guardian(s has(have failed to exercise a minimum degree of care a in supplying the child(ren with adequate food, clothing, shelter, education, medical or surgical care through financially able to do so or through offered financial or other reasonable means to do so; or b in providing child(ren with proper supervision or guardianship by unreasonable inflicting or allowing to be inflicted harm or substantial risk thereof, including infliction of excessive corporal punishment or by any other acts of a similarly serious nature requiring the aid of the court resulting in such child(ren's physical, mental or emotional condition becoming impaired or in imminent danger of becoming impaired. ( Parent(s or guardian(s has(have willfully abandoned the child(ren. Appendix V 6. The facts upon which this complaint is based [as verified by the accompanying documents and affidavits] are as follows: a b c Appendix V 7. For the reasons indicated above, the child(ren require(s the protection, care and supervision of the Division which the parent(s or guardian(s have been offered on behalf of the said child(ren, but which have been refused by the parent(s or guardian(s. Wherefore, the Division requests an order granting and/or continuing custody of the child(ren in the Division and/or such other relief as is provided by law, specifically N.J.S.A. 9:6-8.21 et seq. and N.J.S.A. 30:4C-12, and as is in the

best interests of the child(ren. JOHN J. DEGNAN ATTORNEY GENERAL OF NEW JERSEY Attorney for Division of Youth and Family Services (When Deputy available By (Name Deputy Attorney General Date: JOHN J. DEGNAN ATTORNEY GENERAL OF NEW JERSEY Attorney for Division of Youth and Family Services (On Emergency BERNICE L. MANSHEL Division of Youth and Family Services By (Name District Office Supervisor (or Acting District Office Supervisor Date: Appendix Va JOHN J. DEGNAN ATTORNEY GENERAL OF NEW JERSEY BY: JUVENILE & DOMESTIC RELATIONS COURT COUNTY OF DOCKET NO. Civil Action NEW JERSEY DIVISION OF Child Abuse-Neglect YOUTH & FAMILY SERVICES,

Plaintiff, vs. Defendant, VERIFIED COMPLAINT IN THE MATTER OF: The New Jersey Division of Youth & Family Services, by way of complaint, does say: 1. The New Jersey Division of Youth & Family Services with offices at is a Division of the Department of Human Services of the State of New Jersey. 2. The instant action is brought by the Division pursuant to N.J.S.A. 9:6-8.21 et seq. and N.J.S.A. 30:4C-12 and R. 5:7A-1 et seq. for the protection and best interests of the following child(ren: Appendix Va Name Age Address 3. residing at is(are the parent(s or guardian(s of the aforesaid child(ren. 4. At present, the child(ren is(are in the temporary custody of 5. While in the care and custody of his(her (their parent(s or guardian(s, the aforesaid child(ren was(were abused and/or neglected in that: ( Parent(s or guardian(s inflicted or allowed to be inflicted by upon the child(ren injury by other accidental means which caused or created a substantial risk of death, or serious or protracted disfigurement or protracted impairment of physical or emotional health or protracted loss or impairment of the function of any bodily organ. ( Parent(s or guardian(s created and/or allowed to be created by a substantial or ongoing risk of physical injury to the child(ren by other than accidental means which would be likely to cause death or serious or protracted disfigurement or protracted loss of impairment of the function of any bodily organ. Appendix Va ( Parent(s or guardian(s committed or allowed to be committed by an act of sexual abuse against the child(ren. ( Parent(s or guardian(s has(have failed to exercise minimum

degree of care a in supplying the child(ren with adequate food, clothing, shelter, education, medical or surgical care though financially able to do so or though offered financial or other reasonable means to do so; or b in providing child(ren with proper supervision or guardianship by unreasonable inflicting or allowing to be inflicted harm or substantial risk thereof, including infliction of excessive corporal punishment or by any other acts of a similarly serious nature requiring the aid of the court resulting in such child(ren's physical, mental or emotional condition becoming impaired or in imminent danger of becoming impaired. ( Parent(s or guardian(s has(have willfully abandoned the child(ren. 6. The facts upon which this complaint is based as verified by the accompanying affidavits and documents are as follows: Appendix Va 7. For the reasons indicated above, the child(ren require(s the protection, care and supervision of the Division which the parent(s or guardian(s have been offered on behalf of the said child(ren, but which have been refused by the parent(s or guardian(s. Wherefore, the Division requests an order granting and/or continuing custody of the child(ren in the Division and/or such other relief as is provided by law, specifically N.J.S.A. 9:6-8.21 et seq. and N.J.S.A. 30:4C-12, and as is in the best interests of the child(ren. Appendix Vb Sampled Verified Complaint JOHN J. DEGNAN ATTORNEY GENERAL OF NEW JERSEY BY: (Name of DAG (Address (Telephone JUVENILE & DOMESTIC RELATIONS COURT COUNTY OF DOCKET NO. Civil Action NEW JERSEY DIVISION OF Child Abuse-Neglect

YOUTH & FAMILY SERVICES, Plaintiff, vs. Jane Smith Defendant, VERIFIED COMPLAINT IN THE MATTER OF: Mary Smith, an infant The New Jersey Division of Youth and Family Services, by way of complaint, does say: 1. The New Jersey Division of Youth & Family Services with offices at 78 Carroll Place, New Brunswick, New Jersey is a Division of the Department of Human Services of the State of New Jersey. Appendix Vb 2. The instant action is brought by the Division pursuant to N.J.S.A. 9:6-8.21 et seq. and N.J.S.A. 30:4C-12 and R. 5:7A-1 et seq. for the protection and best interests of the following child: Name Age Address Mary Smith 2 years (d.o.b. 6-28-74 10 Green Street Edison, New Jersey 3. Miss Jane Smith, residing at 10 Green Street, Edison, New Jersey is the mother of the aforesaid child. 4. At present, the child is in the temporary custody of the Division of Youth and Family Services and is placed at the Middlesex General Hospital in New Brunswick, New Jersey. 5. While in the care and custody of her mother, Jane Smith, the aforesaid child was abused in that: Jane Smith inflicted or allowed to be inflicted by Thomas Jones upon the child injury by other than accidental means which caused or created a substantial risk of death, or serious or protracted disfigurement or protracted impairment of physical or emotional health or protracted loss or impairment of the function of any

bodily organ. 6. The facts upon which this complaint is based as verified by the accompanying affidavits and documents are as follows: a. On June 30, 1976, Mrs. Jane Adams of 12 Green Street, Edison, New Jersey, called the Division of Youth & Family Services' Office of Child Abuse Control at 8:30 p.m., and reported possible child abuse of Mary Appendix Vb Smith. Mrs. Adams stated that she had not seen the aforementioned child for two days but had heard continual crying of a child coming from the residence at 10 Green Street, Edison, New Jersey. Mrs. Adams further stated that she had observed Jane Smith hitting Mary Smith on several previous occasions. b. On the evening of June 30, 1976, Sue Brown, a caseworker with the Division went to 10 Green Street, Edison, New Jersey, and saw Mary Smith and spoke with Jane Smith. c. At that time, the caseworker observed that Mary Smith was crying and had numerous bruises on her legs, arms and face. The caseworker further observed that the left arm of the aforementioned child was hanging in a distorted fashion. d. Upon questioning by the caseworker, Jane Smith stated that Mary Smith had received the bruises from continual falling down. Jane Smith further stated that Mary Smith always cries even when there is no reason. e. Upon further questioning, Jane Smith stated that her boy-friend, Thomas Jones, had beaten the child on June 28, 1976, for wetting her pants. f. Jane Smith stated that she had not taken Mary Smith to a doctor, and refused to do so, because she didn't want to get Thomas Jones in trouble. g. At approximately 10:00 p.m., June 30, 1976, Jane Smith ordered the caseworker to leave the house and not return. h. At 10:45 p.m., the caseworker returned to 10 Green Street, Edison, New Jersey, with Sgt. James Green and Plt. Mike Morris of the Edison Police Department. Appendix Vb i. Jane Smith again refused to take Mary Smith to the hospital for examination. j. At 11:15 p.m., June 30, 1976, the caseworker, with police assistance, removed Mary Smith from her home and transported her to Middlesex General Hospital. k. Mary Smith was examined in the emergency room by Dr. James Howard and was admitted for treatment at 12:45 a.m., July 1, 1976.

l. Examination by Dr. Howard revealed that the child had sustained a broken left clavicle (collar bone as well as multiple abrasions over her entire body. m. On July 1, 1976, radiological examination of Mary Smith revealed fractures in various stages of healing in her upper left arm, lower right arm, and right leg. 7. For the reasons indicated above, the child requires the protection, care and supervision of the Division which the parent, Jane Smith, has been offered on behalf of said child, but which have been refused by the parent. WHEREFORE, the Division requests an order continuing custody of the in the child in the Division for a period not to exceed 18 months child in the Division for a period not to exceed 18 months and/or such other relief as Appendix Vb is provided by law, specifically N.J.S.A. 9:6-8.21 et seq. and N.J.S.A. 30:4C-12, and as is in the best interests of the child. JOHN J. DEGNAN ATTORNEY GENERAL OF NEW JERSEY Attorney for the Division of Youth and Family Services BERNICE L. MANSHEL Division of Youth and Family Services By District Office Supervisor Middlesex County District Office Date: Appendices VI and VIa The Interim Order of Continued Removal and Custody must be filed with the Verified Complaint in all cases where a child was removed prior to the filing of a complaint (N.J.S.A. 9:6-8.29. It should include provisions requesting all the relief sought. This Order serves to authorize the Division to retain custody of the child during the period between the preliminary hearing and the final disposition of the court which will occur at a later hearing. Appendix VI FORM: For use in accord with N.J.S.A. 9:6-8.29 upon filing of complaint where child was removed prior to filing of complaint.