(SDCL 26-7A-43 )
STATE OF SOUTH DAKOTA IN CIRCUIT COURT
SS.
COUNTY OF __________ ________ JUDICIAL CIRCUIT
THE PEOPLE OF THE STATE OF SOUTH (Case No. JUV. ________)
DAKOTA, EX REL. SOUTH DAKOTA
DEPARTMENT OF SOCIAL SERVICES,
IN THE INTERESTS OF PETITION
_____________________________________ [Alleged Abused Or
MINOR CHILD(REN), AND CONCERNING Neglected Child(ren)]
____________________________________
RESPONDENTS.
TO: Judge of the Circuit Court, _____ Judicial Circuit, State of South Dakota, in and for _____ County, South Dakota.
Petitioner alleges as follows:
Name Date of Birth Residence
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Name Residence
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
WHEREFORE, Petitioner requests the Court to issue Summons requiring the appropriate parties to appear and answer to the Petition, to schedule hearing on this Petition and to conduct adjudication and dispositional proceedings according to law.
SDCL tit. 26, ch. 7A, APPENDIX OF FORMS, form 3