JUVENILE DOCKET JUVENILE COURT OF ___________________ COUNTY Case Number:______________________________ Name: Address: Race: ( ) White ( ) Black ( ) Am. Indian ( ) Hispanic ( ) Asian ( ) OtherAge: DOB: / / Sex: ( ) Male ( ) Female Complaint: ( ) Delinquency _____ Fel. _____ Misd. ( ) Deprivation ( ) Termination of Parental Rights ( ) Unruly ( ) Traffic ( ) Special Proceedings Referral Source: Attorney Type: ( ) Pub. Defender ( ) Private Appointed ( ) PrivateRetained ( ) County Attorney ( ) None / / Date of Bond Type: Amount: $ / / Date Complaint Received / / Date Child Taken Into Custody / / Date Detained or Placed ( ) RYDC ( ) Attention Home ( ) FosterCare / / Detention Hearing Date ( ) Shelter ( ) Other Released To: / / Date Petition Filed / / Date of Arraignment, if held / / Dismissed or Withdrawn Prior to Adjudication / / Date Continuation of Adjudicatory Hearing is Granted / / Adjudicatory Hearing Date: Rev. 01/2001 JUV-16>>>> 2 OFFENSE DISPOSITION ( ) Adjudicated ( ) Amended/Reduced ( ) Dismissed( ) Transferred to Another Juvenile Court ( ) Transferred to Superior Court ( ) Informal Adjustment ( ) Order Entered ( ) Granted( ) Denied CASE DISPOSITION / / Date of Disposition ( ) Informal Adjustment ( ) Probation/Supervision ( ) Probation - Detention under OCGA 15-11-66(b) ( ) Detention under OCGA 15-11-66(b) ( ) Committed to DJJ ( ) Committed - Designated Felony Restrictive Custody for: Months ( ) Committed - Detention under OCGA 15-11-66(b) ( ) Committed - DHR ( ) Traffic Fine ( ) Dismissed ( ) Custody Other Name/Relationship: ( ) Custody to DFCS ( ) Transferred to Other Juvenile Court ( ) Transferred to Superior Court ( ) Granted ( ) Denied ( ) Review Order Entered Disposition by: ( ) Judge, Name: ( ) Associate Judge, Name: ( ) Officer of the Court, Name: Appealed ( ) Yes ( ) No Date of Notice: / /Date of Remittitur: / / Findings: Motions, Remarks: Rev. 01/2001 JUV-16