ORDER OF COMMITMENT IN THE JUVENILE COURT OF __________________________ COUNTY, GEORGIA In the interest of: CASE NUMBER ____________________ SEX ______________________________ DOB _______________ AGE __________ _________________________________, A Child Petition(s) having been filed in this court and after hearing evidence in this court, this courthas determined that the above-named child is subject to the jurisdiction and protection of this court asprovided by law; and After hearing evidence or upon the recommendation of the associate judge, no appeal having been timely filed, the court finds that the child committed the act(s) alleged in said petition(s), to wit:_________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ and that said child is hereby found to be in a state of: (Place an "X" in appropriate space). ____ delinquency and in need of treatment or rehabilitation. ____ unruliness and in need of treatment, rehabilitation, or supervision. The court also finds that the child is not amenable to treatment or rehabilitation pursuant to O.C.G.A. 15-11-66(a)(1)-(3). The court further finds that reasonable efforts have been made to prevent the unnecessary removal of the child from the childs home, and that removal is in the best interest of the child at thistime. It is further ordered that said child be and hereby is committed to the Department of JuvenileJustice, for care, supervision and planning as provided in O.C.G.A. 49-4A-8. The undersigned judge hereby recommends that the child be: _____________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ The said Department of Juvenile Justice is authorized to provide such medical treatment, hospitalization and/or surgery as is considered necessary by competent medical authorities for said child. It is further ordered that said child be released into the custody of ____________/detained inthe ________________________ pending placement by the Department of Juvenile Justice. Considered, Ordered, and Adjudged This ____________ day of ________________________, 20______. __________________________________________________ Judge/Associate Judge of ________________________________ County Juvenile Court Rev. 10/2001 JUV-15