MINNESOTA COURT RULES

JUVENILE COURT

Minnesota Rules of Juvenile Delinquency Procedure

Forms provided here are for reference purposes. To download forms to fill out please visit the Minnesota Courts website.

Form 4. Summons

STATE OF MINNESOTA	DISTRICT COURT - JUVENILE DIVISION
COUNTY OF _______________	_ JUDICIAL DISTRICT

In the Matter of the Welfare of:	SUMMONS
_
Child	Court File No. __________

TO: The above-named child and to the child's parent(s), legal guardian(s), legal custodian(s) or person having custody and control of child:

ADDRESS:

PLEASE take notice that a petition has been filed with this Court alleging that the child is a:

□ juvenile traffic offender

□ juvenile petty offender

□ juvenile delinquent

and the Court has directed that a hearing be held in this matter at the _______ Courthouse, Courtroom _______, in _______, Minnesota on _______ at _______ before a District Court Judge or Referee.

Attached is a copy of the:

□ charging document	□ affidavit
□ court order	□ other _
□ motion

ALSO attached is a statement describing the purpose of the hearing, the possible consequences of the hearing and an explanation of the child's basic rights, including the right of the child's parent(s), legal guardian(s), or legal custodian(s) to participate. PLEASE READ ATTACHED ITEMS CAREFULLY.

TAKE NOTICE THAT if you fail to appear in response to this Summons, the Court may: (1) issue a warrant for your arrest; and (2) conduct a hearing without your presence and grant appropriate relief. Further information concerning the date and consequences of later hearings, if any, may be obtained for the Court by a request in writing.

DATE:	BY THE COURT:
BY: ____________________	_
Deputy	Court Administrator

□ Served by Certified Mail
□ Served Personally
DATE: _	BY: _

(11/02)