STATE OF NORTH CAROLINA County Name And Address Of Juvenile/Defendant File No. In the General Court Of Justice Superior Court Division STATE VERSUS RELEASE ORDER FOR JUVENILE TRANSFERRED TO SUPERIOR COURT FOR TRIAL Amount Of Bond Date Of Birth Offenses And Additional File Numbers Age G.S. 7B-2204, 15A-533, 15A-534 $ See Attachment Location Of Court Court Date Time 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. You also may be arrested without a warrant if you violate any condition of release in this Order or in any document incorporated by reference. The juvenile/defendant has been advised of the charge(s) against him/her and his/her right to communicate with counsel and friends. AM PM Your release to is authorized upon execution of your: UNSECURED BOND in the amount shown above WRITTEN PROMISE to appear SECURED BOND in the amount shown above CUSTODY RELEASE HOUSE ARREST with ELECTRONIC MONITORING administered by(agency) and the SECURED BOND above. You may leave your residence for the purpose(s) of employment counseling course of study vocational training 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. This Order is entered upon the juvenile/defendant's warrantless arrest for violation of conditions of release entered previously for the above-captioned . case in the Order dated The juvenile/defendant was arrested or surrendered after failing to appear as required under a prior release order. This was the juvenile/defendant's second or subsequent failure to appear in this case. Your release is subject to the conditions shown on the attached AOC-CR-630. Date Magistrate Name Of Judicial Official (Type Or Print) Deputy CSC Assistant CSC Clerk Of Superior Court AOC-CR-631. Other: . Signature Of Judicial Official 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 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 Address Of Person Agreeing To Supervise Juvenile/Defendant WRITTEN PROMISE TO APPEAR OR CUSTODY RELEASE Name Of Person Agreeing To Supervise Juvenile/Defendant (Type Or Print) Date Time JUVENILE/DEFENDANT RELEASED ON BAIL AM PM Name Of Juvenile Detention Facility Official (Type Or Print) Signature Of Juvenile Detention Facility Official ORIGINAL (Over) AOC-CR-922, Rev. 12/12 � 2012 Administrative Office of the Courts American LegalNet, Inc. www.FormsWorkFlow.com The Conditions of Release on the reverse are modified as follows: Modification CONDITIONS OF RELEASE MODIFICATIONS 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 Date JUVENILE/DEFENDANT RECEIVED BY JUVENILE DETENTION FACILITY Time 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-922, Side Two, Rev. 12/12 � 2012 Administrative Office of the Courts American LegalNet, Inc. www.FormsWorkFlow.com