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ICJ Referral Packet

by Cheryl Cadue last modified Mar 08, 2018 01:50 PM

Required Documents

The following documents are required in order to forward an ICJ packet to the receiving state: 

1. Cover Letter

    • Describes why the ICJ Referral to receiving state is being done and explains why it is a good case decision.

2. ICJ Form IV

    • Must be filled out completely and must be legible.

3. ICJ Form IA/VI

    • Must be signed by the Judge for Probation & Custody cases.

4. ICJ Travel Permit

    • A copy must be given to and kept in the juvenile's possession. (Not required until juvenile is moving out of state.)

5. ICJ Form V

    • Must instruct the juvenile to report back to sending officer until ICJ supervision begins in the receiving state. (Not required until juvenile is moving out of state.)

6. Complaint

7. Journal Entry of Adjudication

8. Journal Entry of Disposition

9. Conditions of Supervision

10. Any additional documents that will assist with successful supervision:

    • Required Sex Offender Registration and Treatment
    • Pre-disposition or Pre-sentence Investigation
    • Program progress reports from facilities, placements or providers
    • Kansas Standard Arrest Report


Please e-mail the completed ICJ Referal Packet to for processing and forwarding to the receiving state.

ICJ Main Page  ICJ Forms  |  Kansas Council for Interstate Juvenile Supervision (KCIJS)  |  Interstate Commission for Juveniles  |  ICJ Contacts

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