Truancy Petition

STATE OF MINNESOTA
COUNTY OF BLUE EARTH
IN DISTRICT COURT
FIFTH JUDICIAL DISTRICT JUVENILE DIVISION
In the Matter of the Welfare of the Child(ren) of
PETITION -- CHILD IN NEED OF
PROTECTION OR SERVICES
(TRUANCY)
TO THE DISTRICT COURT, JUVENILE DIVISION:
Petitioner (Name, Title, School Name),
, alleges that:

The child's name, date of birth, residence, and post office address are as follows:
Child's Name
Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
2. The child is in need of protection or services within the meaning of Minnesota Statutes, Chapter 260:
In that the child has been habitually truant from school (260C.007, Subd. 19

3. The applicable law is:
Minnesota Statutes 260C.007, Subd. 6(14) and Subd. 19 -- Habitual Truant.

4. The facts upon which Petitioner relies for the assertion that the child is habitually truant are as follows:
That during the
school year, the above-named juvenile in the above-named county was
While being a student at
Other school
School in the City of
, Blue Earth County, Minnesota.
5. The names, residence, county of residence, and post office address of the child's parents, guardian, custodian, spouse, and nearest known relative other than parents are:
Mother
Mother's Address

Address Line 1

Address Line 2

CityState / Province

Postal / Zip Code
Mother's County of Residence
Mother's Email
Mother's Phone
Father
Father's Address

Address Line 1

Address Line 2

CityState / Province

Postal / Zip Code
Father's County of Residence
Father's Email
Father's Phone
Other
Other's Address
Other's County of Residence
Other's Email
Other's Phone
WHEREFORE, Petitioner prays that the child be brought before the district court and that the child's alleged habitual truancy be dealt with according to law.

I declare under penalty of perjury under the laws of the State of Minnesota that the foregoing is true and correct.
Executed on

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
in the County of Blue Earth in the State of Minnesota.
Petitioner
Being duly authorized to prosecute the offense(s) charged, I hereby approve this Petition.
Assistant County Attorney
Attorney License No.
Dated

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
401 Carver Road
P.O. Box 3129
Mankato, MN 56002-3129
Telephone: (507) 304-4600