File No. STATE OF NORTH CAROLINA In The General Court Of Justice District Court Division County IN THE MATTER OF: Name Of Respondent ORDER INVOLUNTARY COMMITMENT PROCEEDINGS SUBSTANCE ABUSER G.S. 122C-287 FINDINGS The Court finds that: 1. The State 2. The respondent 3. The 24-hour facility was was was was not represented by counsel. was not represented by counsel. was not represented by counsel. Based on the evidence presented, the Court 4. by clear, cogent and convincing evidence finds as facts all matters set out in the physician's/eligible psychologist's/qualified professional's report, specified below, and the report is incorporated by reference as findings. Date Of Last Examiner's Report Name Of Examiner 5. by clear, cogent and convincing evidence finds these other facts: 6. finds that the respondent does not meet the criteria for commitment. CONCLUSIONS Based on the above findings, the Court concludes that the respondent: 1. is a substance abuser. 2. is not a substance abuser. 3. is dangerous to self. others. 4. is not dangerous to self or others. NOTE TO CLERK: If the respondent is involuntarily committed, send a DL-24 to the Division of Motor Vehicles. AOC-SP-306, Rev. 7/11 © 2011 Administrative Office of the Courts (See ORDER on reverse) American LegalNet, Inc. www.FormsWorkFlow.com ORDER It is ORDERED that: 1. the respondent be committed/recommitted to the area authority/physician named below for the period specified. The respondent is now being held at the 24-hour facility listed below and the respondent is ordered returned to that facility to be held until the area authority/physician to whom the respondent is committed authorizes release. and that venue be transferred to County. 2. the respondent be discharged and this matter dismissed. Committed/recommitted to the area authority/physician for a period not to exceed days. 180 days. Name And Address Of Area Authority/Physician Name And Address Of 24-Hour Facility 1 year. Date Signature Of District Court Judge Name Of District Court Judge (Type Or Print) AOC-SP-306, Side Two, Rev. 7/11 © 2011 Administrative Office of the Courts American LegalNet, Inc. www.FormsWorkFlow.com