COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : File No. Index No. STATE OF NORTH CAROLINA : Calendar The General Court Of Justice In No. : JUDICIAL SUBPOENA County Plaintiff(s) IN THE MATTER OF: Name And Address Of Juvenile -against- District Court Division : JUVENILE LEVEL 1 AND 2 DISPOSITION ORDER : (DELINQUENT) Juvenile's Date Of Birth Age Date Of Hearing : G.S. 7B-2500, -2501, -2502, -2506 through -2510, -2512 Defendant(s) : ...................................................... The following persons were present at the hearing: Name Relationship/Title Name Relationship/Title THE PEOPLE OF THE STATE OF NEW YORK TO FINDINGS The most serious offense before the Court today, which provides the basis for disposition, is: Adjudication Date Offense (with statute number) F/M Class GREETINGS: Based on the evidence presented, the Courtthat all business and excuses being WE COMMAND YOU, makes the following Findings of Fact: 1.the Honorable delinquency history level is The juvenile's low. at the laid aside, you and each of you attend before medium. Court high. , The Court predisposition report risk assessment needs assessment 2.County of received and considered located at and risk assessment needs assessment recessed in room incorporates on the , the contents of theof predisposition report at day , 20 , o'clock in the noon, and at any by reference. (If the report and give evidence as a report MUST be attached on the part or adjourned date, to testifyis incorporated, a copy of the witness in this actionto the order) of the 3. Other Findings: (continue on attached page(s) if necessary) NOTE: State any findings regarding the seriousness of the offense(s); the need to hold the juvenile accountable; the importance of protecting the public; the degree of the juvenile's culpability; the juvenile's rehabilitative and treatment needs; and available and appropriate resources. Also use this space for any to comply are requiredsubpoenaais punishable as a contempt of court and will maketo pay liable Your failure findings that with this to support particular disposition, such as a finding of the juvenile's ability you if the court is ordering restitution. 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. Court in Witness, Honorable 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 AOC-J-461, 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. Based on the foregoing findings of fact, the Court concludes as a matter of law that: : (check only one block) Calendar No. 1. 2. 3. 4. The Court is required to order a Level 1 disposition. : The Court is required to order a Level 2 disposition (and also may order any Level JUDICIAL SUBPOENA 1 disposition). Plaintiff(s) The Court is required to order either a Level 1 disposition or a Level 2 disposition, or both. -against: Because of the juvenile's extraordinary needs, the Court is authorized to order a Level 2 disposition rather than a Level 3 disposition, which otherwise would be required in this case. 5. The disposition ordered below is authorized by law and is an appropriate plan to meet the needs of the juvenile and to achieve : the objective of the State in exercising jurisdiction. ORDER It is ORDERED that: (Select and check appropriate disposition(s). : If necessary, attach additional page and reference appropriate paragraph(s).) Defendant(s) : . . . . . . . . . . . . . . . . . . . . . . . . . . LEVEL . . .INTERMEDIATE. DISPOSITIONS . . . . . . 2. . . . . . . . . . . . . . . . . . . 1. Wilderness Program [G.S. 7B-2506(13)]. The juvenile cooperate with placement in a wilderness program. NOTE: This is both a Level 1 and a Level 2 disposition. 2. Cooperate With Placement In Specified Program [G.S. 7B-2506(14)]. The juvenile cooperate with placement in: THE PEOPLE OF THE STATE OF NEW YORK a. a residential treatment facility b. an intensive nonresidential treatment program TO c. an intensive substance abuse program d. a group home other than a multipurpose group home operated by a State agency . . . . 3. Intensive Probation [G.S. 7B-2506(15)]. The juvenile be placed on intensive probation under the supervision of a court counselor under GREETINGS: the conditions on the attached probation form. 4. Supervised Day Program [G.S. 7B-2506(16)]. The juvenile cooperate with a supervised day program. WE Training Program [G.S. 7B-2506(17)]. and excuses being laid aside, you and each of you as follows: 5. RegimentedCOMMAND YOU, that all businessThe juvenile participate in a regimented training program,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 6. House Arrest [G.S. 7B-2506(18)]. The juvenile submit to house arrest, as follows: part of the or adjourned date, to testify and give evidence as a witness in this action on the Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to a result of your failure to comply. 7. Intermittent Confinement this subpoena was The juvenile a maximumon an intermittent basisall an approved detentionas the party on whose behalf [G.S. 7B-2506(20)]. issued for be confined penalty of $50 and in damages sustained facility, as follows: (specify timing, not more than fourteen 24-hour periods) Witness, Honorable one of the a multipurpose 8. Placement In State Multipurpose Group Home [G.S. 7B-2506(21)]. The juvenile, be placed inJustices of the group home operated Court in by a State agency. County, day of , 20 9. Restitution [G.S. 7B-2506(22)]. (Over $500) The juvenile pay restitution in the amount of (specify amount which must be more , into the office of the Clerk of Superior Court for the than $500. If less than $500, use No. 17 in Level 1.) $ benefit of (name payee) , within (specify time, not to exceed twelve months) , according to the following terms and conditions: (Attorney must sign above and type name below) hours (not to exceed 200) of community 10. Community Service [G.S. 7B-2506(23)]. The juvenile perform Attorney(s) for service, as follows: (specify nature of work and length of obligation, not to exceed twelve months) Office and P.O. Address 11. Suspension Of More Severe Disposition [G.S. 7B-2506(19)]. The disposition(s) listed in paragraph(s) # be suspended on condition that the juvenile meet the following condition(s), to which the juvenile has agreed: AOC-J-461, Side Two, Rev. 4/06 © 2006 Administrative Office of the Courts Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.FormsWorkflow.com COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. :File No. Index No. IN THE MATTER OF: Name Of Juvenile : Calendar No. LEVEL 1. COMMUNITY DISPOSITIONS : JUDICIAL SUBPOENA Plaintiff(s) 12. Probation [G.S. 7B-2506(8)]. The juvenile be placed on probation, under the supervision of a court counselor, for , under the conditions listed on the attached (period of time, not to exceed one year) -against: "Supplemental Order Conditions Of Probation (Delinquent)" (AOC-J-464). 13. In-Home Supervision With Conditions [G.S. 7B-2506(1)a]. The juvenile remain at home and be supervised by : , subject to the following conditions applicable to the parent, guardian, custodian, and/or the juvenile, as specified: : Defendant(s) : ...................................................... 14. Custody [G.S. 7B-2506(1)b]. The juvenile is hereby placed in the custody of: a. The juvenile's parents b. The juvenile's mother c. The juvenile's father d. Other: (specify person or agency and relationship to juvenile, if any) THE PEOPLE OF THE STATE OF NEW YORK TO e. The County Department of Social services, as the Court finds that the juvenile's continuation in the juvenile's home could be contrary to the juvenile's best interest, as evidenced by . This placement shall be reviewed in accordance with G.S. 7B-906. Reasonable efforts to prevent the removal of the juvenile were precluded by the need for the disposition ordered for the health and safety of the juvenile. 15. Excuse From School Attendance [G.S. 7B-2506(2)]. The juvenile is excused from compliance with the compulsory school attendance law GREETINGS: and shall comply instead with the following plan: 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 , The , at o'clock the following (specify time, notrecessed noon, and at any to 16. Cooperate With Specified Program [G.S. 7B-2506(3)].20 juvenile cooperate within the or exceed one date, to testify and give evidence as a witness in this action on the part of the adjourned year) : a. b. c. d. community-based program intensive substance abuse treatment program residential treatment program Your failure to comply with this subpoena nonresidential treatment program . . . to . is punishable as a contempt of court and will make you liable the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a 17. Restitution [G.S. 7B-2506(4)]. (up to $500) The juvenile pay restitution in the amount of (specify amount, not to exceed $500. If result of your failure to comply. more than $500, use No. 9 in Level 2.) $ benefit of (name payee) Witness, exceed 12 months) Honorable Court in County, , into the office of the Clerk of Superior Court for the , payable within (specify time, not to , according to the following terms , one of the Justices of the and conditions: day of , 20 (Attorney must sign above and type name below) 18. Payment Of Fine [G.S. 7B-2506(5)]. The juvenile pay a fine in the amount of (specify amount that does not exceed maximum fine for adult for same offense) $ into the office of the Clerk of Superior Court. 19. Community Service [G.S. 7B-2506(6)]. The juvenile perform hours (not to exceed 100) of community service, as follows: (specify nature of work and length of obligation, not toAttorney(s) for exceed 12 months) Office and victim-offender 20. Victim-Offender Reconciliation [G.S. 7B-2506(7)]. The juvenile participate in aP.O. Address reconciliation program. 21. No Drivers License [G.S. 7B-2506(9)]. The juvenile not be licensed to operate a motor vehicle in this state: , a. for (specify period of time) b. for as long as the Court retains jurisdiction, Telephone No.: and that the Clerk notify the Division of Motor Vehicles of this Order. Facsimile No.: NOTE TO CLERK: Give notice as required above. AOC-J-461, Page Two, Rev. 4/06 © 2006 Administrative Office of the Courts (Over) E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.FormsWorkflow.com COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : 22. Curfew [G.S. 7B-2506(10)]. The juvenile comply with the following curfew: : Index No. Calendar No. : 23. Not Associate With Specified Persons [G.S. 7B-2506(11)]. The juvenile not JUDICIAL (specify person(s)) associate with: SUBPOENA Plaintiff(s) -against- : : 24. Not Be In Specified Places [G.S. 7B-2506(11)]. The juvenile not be in the following place(s): : Defendant(s) : ...................................................... 25. Intermittent Confinement [G.S. 7B-2506(12)]. The juvenile be confined on an intermittent basis in an approved detention facility, as follows: (specify timing, not more than five 24-hour periods) THE PEOPLE OF THE STATE OF NEW YORK TO 26. Wilderness Program [G.S. 7B-2506(13)]. The juvenile cooperate with placement in a wilderness program. NOTE: This is both a Level 1 and a Level 2 disposition. OTHER 27. Continuance For Family To Implement Approved Plan [G.S. 7B-2501(d)]. The case be continued for (specify time, not to GREETINGS: to allow the juvenile's family an opportunity to meet the juvenile's needs exceed six months) through the following plan, which the Court approves: 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 by (specify the part of of expert) 28. Examination By Expert [G.S. 7B-2502(a)]. The juvenile be examined action on name or type the , to assist the Court in determining the juvenile's needs, and that a hearing , to determine whether the juvenile is in need of evaluation or be held on (specify date) treatment and, if so, who should pay the cost; further, that the Clerk send notice of that hearing to the county manager or other person designated comply with thisboard of county commissioners of the county namedand will make you liable to Your failure to by the chair of the subpoena is punishable as a contempt of court above. NOTE on whose Mail notice as provided above. the partyTO CLERK: behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a result of your failure to comply. 29. Interdisciplinary Evaluation [G.S. 7B-2502(c)]. The area mental health, developmental disabilities, and substance abuse services director arrange an interdisciplinary evaluation of the juvenile, mobilize resources, and take other appropriate action to meet the juvenile's needs, and report to the Court; further, that the Clerk mail a copy of this Order to the area mental health , one of the Justices of the director. Witness, Honorable copy of order as provided above. NOTE TO CLERK: Mail Court in County, day of , 20 30. Testing for Use Of Controlled Substances [G.S. 7B-2502(a)]. The juvenile be tested for the use of controlled substances, and that the results of this initial test be used for evaluation and treatment purposes only. 31. Testing for Use Of Alcohol [G.S. 7B-2502(a)]. The juvenile be tested for the use of alcohol, and that the results of this initial test be used for evaluation and treatment purposes only. (Attorney must sign above and type name below) 32. Requirements For Parent, Guardian, Custodian [G.S. 7B-2700 through -2704]. The juvenile's mother father guardian custodian comply with the "Supplemental Order To Parent, Guardian Or Custodian Of Undisciplined Or Delinquent Juvenile" (AOC-J-463) directed to that person, which is attached and incorporated by reference. Attorney(s) for 33. Next Hearing This case be brought back before the Court for review on (specify date or time period) . 34. Other (attach additional sheet if necessary): Office and P.O. Address Date Name Of District Court Judge (Type Or Print) AOC-J-461, Page Two, Side Two, Rev. 4/06 © 2006 Administrative Office of the Courts Telephone No.: Signature No.: Facsimile Of District Court Judge E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.FormsWorkflow.com