FORM XI
[Rule 27(19)]
ORDER OF RESTORATION OF A CHILD TO AN INSTITUTION
To
The Officer-in-Charge
Whereas on the
____________________ day of ____________________20 ______ (name of
the child)
______________________________, son/daughter of _______________________
aged _____ residing at
________________________________________________________
being in care and protection
under section 33(4) of the Juvenile Justice (Care and Protection) Act
2000 is ordered by the Child
Welfare Committee _________________________, to be kept in
The Children’s Home/Shelter Home __________________________________________________for
a period of ________________.
This is to authorize and require you to receive the said
child in your charge, and to kept him/her
in the Children’s Home/ Shelter Home
___________________________ for the aforesaid order
to be carried into execution according to law.
Given
under my hand and the seal of Child Welfare Committee.
This __________________________
day of _________________________ 20.
(Signature)
Chairperson/ Member
Child Welfare Committee
Encl:
Copy of the orders, particulars
of home and previous record, case history and individual care
plan, whichever is applicable:
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