State of Alabama Unified Judicial System Form JU- 7 Case Number CUSTODY ORDER FOR VIOLATION OF APPEARANCE AGREEMENT Rev. 06/11 IN THE JUVENILE COURT OF ___________________________________________________________ COUNTY, ALABAMA (Name of County) In the Matter of ___________________________________________________________________________________, a child Part I TO ANY LAW ENFORCEMENT OFFICER OF THE STATE OF ALABAMA OR ANY AUTHORIZED OFFICIAL: It appearing to the court that the parent, legal guardian or other legal custodian, after request, has failed to bring the child before the court in compliance with an appearance agreement executed under the authority of Ala. Code 1975, §12-15-127(a)(2), it is ordered that the child be taken into immediate custody and delivered to: ____________________________________________ Name of Detention/Shelter Care/Other Facility ___________________________________ Date TTTTT Part II ______________________________________________________ Judge p TO PARENT/LEGAL GUARDIAN/LEGAL CUSTODIAN: To question this Custody Order, you must appear at the hearing to be held at ______________________________________ __________________________________ on (date) __________________ at _______________ time and date to be determined later. (You will be notified ) DESCRIPTION OF CHILD Part III Sex ______________ Height _____________ DOB ________________ Eyes __________ Race _____________ Weight _____________ Hair _________________ Marks ___________ Address _________________________________________________________________________________________________ _________________________________________________________________________________________________ PERSON TAKING CHILD INTO CUSTODY Part IV I certify that I have executed this Order by placing the above- named child in custody as ordered, and that I have delivered the above named child to _________________________________________________and that I have delivered a copy of this Order to same. (Name of Detention, Shelter or other Care Facility) ______________________________________ Date Part V ______________________________________________________ Signature CUSTODY RECEIPT I certify that I have received custody of the above- named child. ________________________________ Date ______________________________________________________ Signature of Person Receiving Custody Ala. Code 1975, §12-15-125(a)(1) COURT RECORD: (Original) PARENT/LEGAL GUARDIAN/LEGAL CUSTODIAN: (Copy) FACILITY: (Copy) American LegalNet, Inc. www.FormsWorkFlow.com