COURT COUNTY . . . . . . . . . . . .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . : STATE OF NORTH CAROLINA : County IN THE MATTER OF: -against- : : : Juvenile's Date Of Birth Age Calendar The General Court Of Justice In No. District Court Division Plaintiff(s) Name And Address Of Juvenile File IndexNo. No. Date Of Hearing JUDICIAL SUBPOENA JUVENILE DISPOSITION ORDER (ABUSE/NEGLECT/DEPENDENCY) : G.S. 7B-101, -905 Defendant(s) This case came on for disposition, the above named juvenile having been found within the juvenile jurisdiction of the : . as: ...... ........ ....... Court . . . . . . . . . Abused. . . . . . . . . . . Neglected . . . . . . . . . . . . Dependent The following persons were present at the hearing: NAME RELATIONSHIP/TITLE NAME RELATIONSHIP/TITLE THE PEOPLE OF THE STATE OF NEW YORK TO FINDINGS GREETINGS: NOTE: If the Order places or continues placement of the juvenile in the custody of a county department of social services, it must contain the findings required by G.S. 7B-507. WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before Afterthe Honorable evidence, the court makes the following findings of fact: (Attach additional facts, if necessary.) considering the at the Court located at County of in room , on the day of , 20 , at o'clock in the noon, and at any recessed or adjourned date, to testify and give evidence as a witness in this action on the part of the Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a result of your failure to comply. Witness, Honorable Court in County, , one of the Justices of the day of , 20 DSS has made the following efforts to prevent or eliminate the need (Attorneyjuvenile'sabove and type name below) for the must sign placement: Attorney(s) for Office and P.O. Address AOC-J-154, Rev. 4/06 © 2006 Administrative Office of the Courts (Over) Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.FormsWorkflow.com , COURT COUNTY . . . . . . . . . . . .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . : CONCLUSIONS OF LAW Index No. The Court concludes as a matter of law that: : 1. the efforts made by DSS to prevent or eliminate the need for the juvenile'sCalendar No. are placement are not reasonable pursuant to G.S. 7B-507(a), and : 2. the best interests of the juvenile would be served by the following disposition. JUDICIAL SUBPOENA Plaintiff(s) -against- : ORDER It is therefore ORDERED that: : : Defendant(s) : ...................................................... THE PEOPLE OF THE STATE OF NEW YORK TO GREETINGS: WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before , the Honorable at the Court located at County of in room , on the day of , 20 , at o'clock in the noon, and at any recessed or adjourned date, to testify and give evidence as a witness in this action on the part of the Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a result of your failure to comply. Witness, Honorable Court in County, , one of the Justices of the day of , 20 (Attorney must sign above and type name below) Attorney(s) for Office and P.O. Address The next hearing date is scheduled for Date Name Of Presiding Judge (Type Or Print) AOC-J-154, Side Two, Rev. 4/06 © 2006 Administrative Office of the Courts . Signature No.: Telephone Of Presiding Judge Facsimile No.: E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.FormsWorkflow.com