JFS 01645 - Part II: Agreement for Temp. Custody of Child
(1st and 2nd Extension 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.)

Type of Extension

Select the type of extension.  This is a required 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. This is a required field.

Effective From

Enter the date  temporary custody begins. This is a required field.

Effective To

Enter the date  temporary custody ends. This is a required field.

Reason for Temporary Custody

Explain the reasons for putting the children in temporary custody. This is a required field.

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. This is a required field.

Visitation Agreement Details

Enter the visitation agreement (frequency and duration of visits, location, etc.). This is a required field.