JFS 01645 - Part I: Agreement for Temp. Custody of Child (Initial Voluntary Agreement for Care)

Case Number

Select the appropriate case number for the person you're working with. SACWIS will populate some fields with data from the selected case. This is a required field. (When entered from a case screen, this field defaults to that case's ID  number and is a display-only field.)

(Parent/Guardian/Custodian) Available

Select each parent, guardian, or custodian and click Add to move the name to the Selected field.

(Parent/Guardian/Custodian) Selected

This field must contain one or two parents, guardians, or custodians selected from the Available field. This is a required field.

Role

Select the role that best describes the relationship of the selected individuals to the child or children being put into temporary custody. This is a required field.

(Case Participants) Available

Select each child  who is being put into temporary custody and click Add to move the name to the Selected field.

(Case Participants) Selected

This  field must contain at least one child selected from the Available field.

Effective From

Enter the date  temporary custody begins.

Effective To

Enter the date  temporary custody ends.

Reason for Temporary Custody

Explain the reasons for putting the children in temporary custody.

Financial Responsibility Agreement Details

Enter the financial responsibilities of the parent(s), guardian(s), or custodian(s) for the children while they are in temporary custody.

Visitation Agreement Details

Enter the visitation agreement (frequency and duration of visits, location, etc.).