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File No. Name And Address Of Juvenile (Petitioner) Date And File No. Of Juvenile Petition To Be Expunged Name And Address Of Chief Court Counselor Name And Address Of Law Enforcement Agency PETITION/ORDER/NOTICE EXPUNCTION OF JUVENILE RECORDS UPON DISMISSAL (UNDISCIPLINED/DELINQUENT) STATE OF NORTH CAROLINA County In The General Court Of Justice District Court Division IN THE MATTER OF Date Of Birth G.S. 7B-3200(h) The above petition under G.S. 7B-3200 was served on the chief court counselor for this district as shown in the certificate of service above, and: ten (10) days have passed since that service and no written objection has been filed. a hearing was held before the judge named below upon the written objecti\ on of the chief court counselor. The Court finds that the petitioner satisfied the conditions of G.S. 7B-3200(h) and ORDERS that: 1. The Clerk of Superior Court and any law enforcement agency named above s\ hall expunge all their records relating to the Juvenile Petition filed on the date shown above, including all references to arrests, complaints, referral, juvenile petitions and others. 2. The Clerk of Superior Court shall forward a certified copy of this Order to the law enforcement agency and the chief court counselor named above, and shall send to the petitioner the notice requi\ red by G.S. 7B-3202. The Court finds that the petitioner does not satisfy the conditions of G.S. 7B-3200 and ORDERS that this Petition be denied. I petition the Court for expunction of the juvenile records of my having been alleged to be delinquent or undisciplined as specified above, and in support of this Petition I state: 1. I was alleged to be delinquent or undisciplined in a petition filed on the date and in the case shown above. 2. The Court dismissed the juvenile petition without an adjudication that I\ was delinquent or undisciplined. I request that an order be entered pursuant to G.S. 7B-3200 to expunge a\ ll records of the delinquent or undisciplined acts alleged in that Petition. I certify that a copy of this petition was served by: delivering a copy personally to the chief court counselor. depositing a copy enclosed in a postpaid properly addressed envelope in a post office or official depository under the exclusive care and custody of the U.S. Postal Service directed to the chief court couns\ elor. leaving a copy at the office of the chief court counselor with an associate or employee. CERTIFICATE OF SERVICE PETITION Juvenile Parent Attorney Date Name (type or print) Signature ORDER Date Name Of Presiding Judge (type or print) Signature Of Presiding Judge (NOTE: See Side Two for Notice To Petitioner And Certification By Clerk .) (Over) NC-JOIN No. AOC-J-909, Rev. 12/17