File No. STATE OF NORTH CAROLINA In the General Court Of Justice Superior Court Division County STATE VERSUS Name And Address Of Juvenile/Defendant RELEASE ORDER FOR JUVENILE TRANSFERRED TO SUPERIOR COURT FOR TRIAL G.S. 7B-2204,15A-533, 15A-534 Date Of Birth Age Amount Of Bond $ Offenses And Additional File Numbers See Attachment Location Of Court Date Court Time AM PM Superior To The Juvenile/Defendant Named Above: You are ORDERED to appear before the Court as provided above and at all subsequent continued dates. If you fail to appear, you will be arrested and you may be charged with the crime of willful failure to appear. The juvenile/defendant has been advised of the charge(s) against him/her and his/her right to communicate with counsel and friends. Your release to WRITTEN PROMISE to appear CUSTODY RELEASE ELECTRONIC HOUSE ARREST administered by (agency) You may leave your residence for the purpose(s) of employment is authorized upon execution of your: UNSECURED BOND in the amount shown above SECURED BOND in the amount shown above and the SECURED BOND above. counseling course of study vocational training You will be arrested if you violate the following restrictions: Your release is not authorized. The juvenile/defendant is required to provide fingerprints under G.S. 7B-2201 and G.S. 15A-502(a1). Prior to release, the juvenile/defendant shall provide fingerprints. The juvenile/defendant is required to provide a DNA sample under G.S. 7B-2201 and G.S. 15A-266.3A. Prior to release, the juvenile/defendant shall provide a DNA sample. The juvenile/defendant was arrested or surrendered after failing to appear as required under a prior release order. two or more times in this case. Your release is subject to the conditions shown on the attached AOC-CR-630. AOC-CR-631. Other: . Date Name Of Judicial Official (Type Or Print) Magistrate Deputy CSC Signature Of Judicial Official Assistant CSC Clerk Of Superior Court District Court Judge Superior Court Judge ORDER OF COMMITMENT To The Custodian Of The Juvenile Detention Facility Named Below: You are ORDERED to receive in your custody the juvenile/defendant named above who may be released if authorized above, or to the sheriff as provided below. To the Sheriff of County: You are ORDERED to transport the juvenile/defendant above to an approved juvenile detention facility to be held until such time as released. If not released, you are ORDERED to produce the juvenile/defendant in court as required and provide transportation to and from the juvenile detention facility. Name Of Juvenile Detention Facility Date Signature Of Judicial Official WRITTEN PROMISE TO APPEAR OR CUSTODY RELEASE I, the undersigned juvenile/defendant, promise to appear at all hearings, trials or otherwise as the Court may require and to abide by any restrictions set out above. I understand and agree that this promise is effective until the entry of judgment in Superior Court. If I am released to the custody of another person, I agree to be placed in that person's custody, and that person agrees by his/her signature to supervise me. Date Signature Of Juvenile/Defendant Signature Of Person Agreeing To Supervise Juvenile/Defendant Name Of Person Agreeing To Supervise Juvenile/Defendant (Type Or Print) Address Of Person Agreeing To Supervise Juvenile/Defendant JUVENILE/DEFENDANT RELEASED ON BAIL Date Time AOC-CR-922M, Rev. 2/11 © 2011 Administrative Office of the Courts AM PM Name Of Juvenile Detention Facility Official (Type Or Print) Signature Of Juvenile Detention Facility Official ORIGINAL (Over) American LegalNet, Inc. www.FormsWorkFlow.com CONDITIONS OF RELEASE MODIFICATIONS The Conditions of Release on the reverse are modified as follows: Modification Date Signature Of Judge SUPPLEMENTAL ORDERS FOR COMMITMENT The juvenile/defendant is next Ordered produced in Court as follows: Date Time Place Purpose Signature Of Judge JUVENILE/DEFENDANT RECEIVED BY JUVENILE DETENTION FACILITY Time Date Signature Of Juvenile Detention Facility Official JUVENILE/DEFENDANT RELEASED FOR COURT APPEARANCE Date Time Signature Of Juvenile Detention Facility Official NOTE TO CUSTODIAN: This form shall accompany the juvenile/defendant to court for all appearances. AOC-CR-922M, Side Two, Rev. 2/11 © 2011 Administrative Office of the Courts American LegalNet, Inc. www.FormsWorkFlow.com