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File No. Name And Address Of Juvenile ORDER FOR NONSECURE CUSTODY (UNDISCIPLINED/DELINQUENT) STATE OF NORTH CAROLINA County In The General Court Of Justice District Court Division IN THE MATTER OF Name And Address Name And Address Juvenile’s Date Of Birth AgeRace Sex G.S. 7B-1902, -1903, -1904, -1905, -1907 TO ANY LAW ENFORCEMENT OFFICER OR OTHER AUTHORIZED PERSON YOU ARE ORDERED to assume custody of the above-named juvenile for placem\ ent in nonsecure custody and to make due return on this Order. You are also ordered to give a copy of this order to the juv\ enile’s parent, guardian, or custodian named above. The juvenile shall be placed in nonsecure custody with: 1. (designate person) . 2. the Department of Social Services of the county named above, for tempora\ ry residential placement in a licensed foster home, a home otherwise authorized by law to provide such care, a facility operat\ ed by a department of social services, or the following relative’s home, or other home or facility, which the court hereby ap\ proves: . The department of social services is authorized to arrange for and conse\ nt to only the following types of evaluation and/or treatment, after first attempting to obtain consent from the juvenile’s parent, guardian, custodian, or caretaker: . As grounds for the issuance of this Order, the Court finds that there is a reasonable factual basis to believe the matters alleged in the petition are true, and that: 1. the juvenile is a runaway and consents to nonsecure custody. 2. the juvenile meets one or more of the criteria in G.S. 7B-1903(b) for \ secure custody, but it is in the juvenile’s best interest to be placed in a nonsecure placement. In addition, if the juvenile is placed in the custody of DSS, the court finds: a. the juvenile’s continuation in or return to the juvenile’s own hom\ e would be contrary to the juvenile’s best interest. b. DSS made reasonable efforts to prevent or eliminate the need for placeme\ nt, as follows (or attached) : . c. Efforts to prevent the need for the juvenile’s placement were preclud\ ed by an immediate threat of harm to the juvenile, and placement of the juvenile in the absence of such efforts was reasonable.\ (Describe immediate threat of harm) : . d. DSS did not make reasonable efforts to prevent or eliminate the need for\ placement, and efforts were not precluded by an immediate threat of harm to the juvenile. (Over) If the person above gives telephonic approval: Name Of Judge/Judge’s Designee (type or print) Maximum Duration Of Custody Judge Judge’s Designee Date Signature Of Judge/Judge’s Designee Name And Title Of Person Receiving Telephonic ApprovalSignature Of Person Receiving Telephonic Approval Time AM PM Custodian Guardian Parent Custodian Guardian Parent NC-JOIN No. AOC-, 5ev. ,