Fill and Sign the Allege that Form

File No. Name And Address Of Juvenile Name Of Petitioner Offense Code Offense In Violation Of G.S. Physical Address Of Offense, If Applicable Date Of OffenseTime Of Offense Juvenile’s Date Of Birth Age Race Sex G.S. 7B-1501(7), -1801, -1802 I have suf�cient knowledge or information to believe that a case has arisen that invokes the juvenile jurisdiction of the court, and therefore allege that: 1. The juvenile named above is under the age of eighteen (18) and committed a delinquent act in this district while under the age of sixteen (16). ( NOTE: Iftherespondentiseighteenorolderandisallegedtohavecommittedafelonywhileagethirteen,fourteen,or�fteen,thisallegationshouldbe modi�edaccordingly.SeeG.S.7B-1601. ) 2. The names, addresses, and telephone numbers of the juvenile’s parents, guardian, or custodian are as follows: STATE OF NORTH CAROLINA County In The General Court Of Justice District Court Division IN THE MATTER OF (Over) AM PM JUVENILE PETITION (DELINQUENT) I. LARCENY II. POSSESSION 3. I. LARCENY [G.S. 14-72(a)] Felony Misdemeanor The juvenile is a delinquent juvenile as de�ned by G.S. 7B-1501(7) in that on or about the date of offense shown above and in the county named above, the juvenile did unlawfully, willfully and feloniously steal, take and carry away: (describe property) ___________________________________________________________________________________________________ ___________________________________________________________________________________________________ ___________________________________________________________________________________________________ the personal property of ________________________________________________________________________________ having a value of $ . II . POSSESSION [G.S. 14-71.1] ( NOTE: This offense is a felony if Count I is a felony. This offense is a misdemeanor if Count I is a misdemeanor. ) And on or about the date of offense shown above and in the county named above, the juvenile did unlawfully, willfully and feloniously possess the personal property described in Count I above, which property was stolen property, being the personal property of the person, corporation, and other legal entity described in Count I above, and having the value described in Count I above, knowing and having reasonable grounds to believe the property to have been feloniously stolen and taken. NC-JOINNo. Name Address Relationship/Title Telephone No. Category Of Offense Felony, Class Misdemeanor, Class AOC-J-319, Rev. 12/17 © 2017 Administrative Of�ce of the Courts I request the Court to hear the case to determine whether the allegations are true and whether the juvenile is within the jurisdiction of the Court as a delinquent juvenile. VERIFICATION Being �rst duly sworn, I say that I have read the allegations in the petition and that the same are true to my own knowledge, except as to those matters alleged upon information and belief, and as to those, I believe them to be true. Date My Commission Expires County Where NotarizedSignature Of Petitioner Date City, State, Zip Address Agency (if applicable) Title Or Relationship To Juvenile Telephone No. Signature Of Person Authorized To Administer Oaths Notary SWORN/AFFIRMED AND SUBSCRIBED TO BEFORE ME SEAL Deputy CSC Assistant CSC Clerk Of Superior Court Magistrate Date Complaint Received By Juvenile Justice Section Of The Division Of Adult Correction And Juvenile Justice Pursuant to G.S. 7B-1703, at the discretion of the undersigned chief court counselor, the time to �le a petition in the above captioned case is extended 15 days. 15-DAY EXTENSION OF TIME TO FILE PETITION Date Name Of Chief Court Counselor Signature Of Chief Court Counselor Post-Diversion Approval For Filing Of Petition Signature Of Court Counselor Date Date Time Name Of Court Counselor Giving Telephonic Approval Name And Title Of Person Receiving Telephonic Approval Signature Of Person Receiving Telephonic Approval 1. Approved for Filing 2. Not Approved for Filing a. Closed b. Diverted and Retained AM PM Signature Of Court Counselor Date Approved for Filing DECISION OF COURT COUNSELOR REGARDING THE FILING OF THE PETITION WITNESS(ES) Name Address Telephone No. AOC-J-319, Side Two, Rev. 12/17 © 2017 Administrative Of�ce of the Courts