PETITION (DELINQUENT/UNRULY) IN THE JUVENILE COURT OF __________________________COUNTY, GEORGIA In the interest of CASE NUMBER ________________________ ____________________________________ SEX __________________________________ A Child DOB ___________________ AGE__________ TO THE JUVENILE COURT OF _______________________COUNTY, GEORGIA: 1. Your petitioner alleges the child named above to be of the sex and age and to have the name there setforth; that the father of said child is ________________________, who resides at ________________ ____________________________________________; the mother is____________________________, who resides at _______________________________________________________; said child resides at ____________________________________________________________________________________ (Address) in said county and state, and is in the custody and control of____________________________________, (Name) who resides at said place; that the said child is subject to the jurisdiction of this Court. 2. That the within petition is filed in the best interest of the public and the within named child. 3. That said child has violated the section of the code cited below and is a delinquent/unruly child by reason of the facts set forth below: A. 4. That said child is in need of supervision, treatment or rehabilitation. That said child is/is not currently in detention in the _______________________________________ Center, having been placed there at ________________________________ on __________________________________ 20 _____. Petitioner prays that process issue, directed to the parties hereto, requiring them to show cause why saidchild should not be dealt with according to law. ___________________________________ (Petitioner) Subsribed and sworn to before me, on information and belief, this _______________________ day of ___________________________________, 20 ______. ___________________________________ (Attesting Officer) The above petition is approved to be filed in the best interest of the public and the named child. This ______ day of ___________________________, 20______. _____________________________ (Court Designee) Rev. 01/2001 JUV-3>>>> 2 ORDER OF DISMISSAL The foregoing petition having come before me for consideration, and is hereby dismissed for the following reason(s): This ______ day of ____________________________, 20______. ___________________________________ Judge/Associate Judge of ________________________County Juvenile Court ORDER OF WITHDRAWAL The foregoing petition having come before me for consideration, it is hereby found that withdrawal of the petition is in the best interest of the public and the child and the petition is withdrawn. This ______ day of ___________________________, 20______. ___________________________________ Judge/Associate Judge of _______________________County Juvenile Court Rev. 01/2001 JUV-3>>>> 3 ADMISSION/DENIAL After having been fully advised of my rights to remain silent, to a hearing before the Judge and my rightto have legal counsel, I, _______________________________, understand the nature of the charges against me and hereby admit/deny the following allegations contained in this petition: I do further assert that I have not been promised anything or been threatened or forced to enter this admission and that this admission is entered freely and voluntarily. This ______ day of ___________________________, 20______. _________________________________ ____________________________________ (Attorneys Signature) (Childs Signature) ____________________________________ (Parent or Guardians Signature) ORDER OF ADJUDICATION The foregoing petition having come on before me for hearing and consideration, it is hereby found that the allegations of the petition are true (as admitted), that the acts attributed to or admitted by the child were, in fact, committed by said child, and that such acts constitute acts of delinquency (felony/misd.) / unruliness within the meaning of the law. It is further found that the childs admission was entered knowingly, freely and voluntarily. It is further found upon hearing the evidence that said child is in need of treatment or rehabilitation (and/or supervision) as a delinquent/unruly child. Said child is hereby ordered released into the custody of ________________________________/ detained or held in custody until further order of this court. This ______ day of ____________________________, 20______. __________________________________________ Judge/Associate Judge of ________________________County Juvenile Court Rev. 01/2001 JUV-3