IN THE SUPERIOR COURT FOR THE STATE OF ALASKA

AT

In the Matter of:	)

)

)	CASE NO.

)

Date of birth:	)	RESTITUTION JUDGMENT

IT IS ORDERED THAT:

The above-named minor and the minor’s parents [list full names]:

jointly and severally owe restitution to the recipients listed below for the amounts shown:

Restitution Recipients	Amount
A.	$
B.	$
C.	$
Others listed on attached Addendum.	TOTAL AMOUNT DUE: $

2.	Find payment instructions at ak-courts.info/payments or contact your local court clerk.

3.	Restitution is due immediately. A payment schedule is attached may be established by the probation officer. If any required payment is missed, the total unpaid amount becomes immediately due and civil execution may begin.

Interest will accrue on the principal amount due at the rate as specified in AS 09.30.070(a) from

date of loss:	date of this order.

5.	The above restitution amount is owed jointly and severally with the following persons [list initials/names and case numbers]:

The restitution amount is owed only by this minor and parents, if listed. In addition, the following persons have been ordered to pay restitution to the recipient(s) [list initials/names and case numbers]:

6.	The parents must apply for an Alaska Permanent Fund Dividend for the minor and for themselves every year that the minor is eligible for a dividend until the restitution is paid in full. This restitution judgment will continue to be civilly enforceable after probation expires and after any suspended entry of judgment in this case. (AS 12.55.045(l))

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	restitution@akcourts.us (Fiscal Operations)

Clerk: