IN THE SUPERIOR COURT FOR THE STATE OF ALASKA

In the Matter of:	)

)

)

A minor under 18 years of age	)	CASE NO.

)

Date of birth:	)	ADJUDICATION UPON ADMISSION

A petition was filed on	alleging that the minor is delinquent.

An admission hearing was held on

Present:

Allegation	Offense Date	Admit	Dismiss Discuss	Dismiss Outright
Allegation 1: Amended to:
Allegation 2: Amended to:
Allegation 3: Amended to:
Allegation 4: Amended to:
Allegation 5: Amended to:
Allegation 6: Amended to:

[Attach extra pages if necessary]

Findings

The court finds that the minor knowingly and voluntarily admitted the allegations noted above. The State agreed to dismiss all other allegations, as noted above.

Order

IT IS ORDERED that:

The minor is adjudged delinquent.

Adjudication stands without further proceedings.

Adjudication is deferred and this matter is held in abeyance until	[may not exceed two years], under the written conditions that appear on a separate document filed in this case.

Recommended on	Effective Date:

Superior Court Master	Date	Superior Court Judge	Date

Print or Type Name	Print or Type Name

I certify that on	a copy of this order was distributed to:

DJJ DA Minor/Attorney Parent/Guardian GAL

Clerk: