STATE OF NORTH CAROLINA County Name And Address Of Juvenile File No. In The General Court Of Justice District Court Division IN THE MATTER OF: (ABUSE/NEGLECT/DEPENDENCY) G.S. 7B-406, -407, -504, -506 Date Of Birth Age Date Last Summons Issued JUVENILE SUMMONS AND NOTICE OF HEARING Alias and Pluries Summons Name And Address Name And Address To Each Of The Person(s) Named Below: Parent Other (specify) Parent Other (specify) A petition has been filed alleging that the juvenile named above is: abused. neglected. dependent. NOTICE TO PARENT(S) ABOUT THE PARENT'S RIGHT TO A LAWYER You have a right to be represented by a lawyer at all stages of the proceeding. If you want a lawyer and cannot afford to hire one, the Court will appoint a lawyer to represent you. You may hire a lawyer of your choice at any time, or you may waive the right to a lawyer and represent yourself. You may contact the Clerk of Superior Court immediately to ask for a court-appointed lawyer. If you want a court-appointed lawyer, you are encouraged to contact immediately the following lawyer who has been temporarily assigned to represent you. At the first hearing, the Court will determine whether you qualify for a court-appointed lawyer. If you do not qualify, the lawyer named below will be released. Name And Address of Mother's Lawyer Name And Address of Father's Lawyer Telephone Number Of Attorney Telephone Number Of Attorney NOTICE OF PREHEARING CONFERENCE A nonsecure custody order has been entered and the juvenile has been placed in the temporary custody of the Department of Social Services (DSS). You are notified to appear on the date, and at the time and place set forth below for a conference to review the need for continued custody, placement options, visitation, available services, and other issues. Date Of Conference Time Place AM PM NOTICE OF HEARING ON NEED FOR CONTINUED NONSECURE CUSTODY A nonsecure custody order has been entered and the juvenile has been placed in the temporary custody of the Department of Social Services (DSS). Unless changed at the Prehearing Conference, you are notified to appear on the date, time and place set forth below for a hearing to determine the need for continued custody. Date Of Hearing On Continued Custody Time Place AM PM A juvenile petition has been filed in this matter. You are notified to appear on the date, time, and place set forth below for a pre-adjudication hearing. Date Of Pre-Adjudication Hearing Time Place NOTICE OF PRE-ADJUDICATION HEARING AM PM AOC-J-142, Rev. 10/13 (Replaces J-301) © 2013 Administrative Office of the Courts Original-File Copy-Parent Copy-DSS Attorney Copy-GAL Copy-Parents Attorney Copy-Attorney Advocate (Over) American LegalNet, Inc. www.FormsWorkFlow.com You are SUMMONED to appear on the date and at the time and place set forth below for a hearing on the attached petition. Date Of Hearing On Petition Date Issued Time Place SUMMONS AND NOTICE OF HEARING ON PETITION AM Signature Date Of Endorsement Signature Deputy CSC PM Deputy CSC Time Assistant CSC Clerk Of Superior Court This Summons was originally issued on the date indicated above and returned not served. At the request of the petitioner, the time within which this Summons must be served is extended sixty (60) days. NOTE: See Important Notices below. ENDORSEMENT AM PM Assistant CSC Clerk Of Superior Court IMPORTANT NOTICES If the Court determines at the hearing on the petition that the allegations of abuse, neglect or dependency are true, the Court will conduct a dispositional hearing to consider the needs of the juvenile and enter an order designed to meet those needs and the objectives of the State. The dispositional order, or a subsequent order, may: 1. remove the juvenile from the custody of a parent, guardian, custodian, stepparent, adult member of the juvenile's household, or adult relative entrusted with the juvenile's care; 2. order the parent to pay child support if custody of the juvenile is placed with someone other than the parent; 3. place legal or physical custody of the juvenile with the parent, stepparent, adult member of the juvenile's household, or adult relative entrusted with the juvenile's care on the condition that that individual undergo medical, psychiatric, psychological, or other treatment; 4. require that the juvenile receive medical, psychiatric, psychological, or other treatment and that the parent, guardian, custodian, stepparent, adult member of the juvenile's household, or adult relative entrusted with the juvenile's care participate in the treatment; 5. require the parent, stepparent, adult member of the juvenile's household, or adult relative entrusted with the juvenile's care to undergo psychiatric, psychological, or other treatment or counseling; 6. order the parent, stepparent, adult member of the juvenile's household, or adult relative entrusted with the juvenile's care to pay for treatment that is ordered for the juvenile or that individual; 7. upon proper notice and hearing and a finding based on the criteria set out in G.S. 7B-1111, terminate the parental rights of the respondent parent . RETURN OF SERVICE INSTRUCTIONS TO SHERIFF: This Summons, with a copy of the Petition, any Order For Nonsecure Custody (AOC-J-150) and an Affidavit As To Status Of Minor Child (AOC-CV-609) attached, shall be served immediately upon each of the persons named above, by personally delivering copies to that person. I certify that this Summons, a copy of the petition, any attached Order For Nonsecure Custody and an Affidavit As To Status Of Minor Child were received and served by personally delivering to each person named below a copy of the same. Date Served Date Served Date Served Name Of Person Personally Served Name Of Person Personally Served Name Of Person Personally Served I certify that the person(s) named below cannot be found by a diligent effort: (state reason not found) Date Received Date Of Return Signature Of Deputy Sheriff Making Return Name Of Deputy Sheriff Making Return (Type Or Print) County Of Deputy Sheriff Making Return NOTICE TO PARENT, GUARDIAN, CUSTODIAN, OR CARETAKER: You may be held in contempt of court if, without reasonable cause, you fail to (1) appear at a hearing and (2) bring the juvenile before the Court if the juvenile resides with you. In addition, upon service of this summons on you, the Court obtains jurisdiction over you, and your failure to comply with any order of the Court pursuant to G.S. 7B-904 may cause the Court to issue