IN THE SUPERIOR COURT FOR THE STATE OF ALASKA

AT

In the Matter of:	)

)

)

)	CASE NO.

A minor under 18 years of age.	)

)	ORDER AMENDING

Date of birth:	)	DISPOSITION ORDER

IT IS ORDERED that the disposition order entered on	is amended as follows:

Probation is TERMINATED.

Probation is EXTENDED until	.

Institutional placement period is TERMINATED.

Institutional placement period is extended until	.

All other terms and conditions of the disposition order remain in full force and effect.

Recommended on	Effective Date:

Date

Superior Court Master	Superior Court Judge

Type or Print Name	Type or Print Name

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

DJJ	DA	Minor/Attorney

Parent/Guardian	GAL

Clerk: