Fill and Sign the Shoplifting 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 AgeRace Sex JUVENILE PETITION CONCEALMENT OF MERCHANDISE (SHOPLIFTING) (DELINQUENT) G.S. 7B-1501(7), -1801, -1802 I have sufficient 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). 2. The names, addresses, and telephone numbers of the juvenile’s parents, guardian, or custodian are as follows: 3. CONCEALMENT OF MERCHANDISE (SHOPLIFTING) [G.S. 14-72.1] The juvenile is a delinquent juvenile as defined 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 without authority conceal: (describe items) ________________________________________________________________________\ __________________________________ ________________________________________________________________________\ __________________________________ ________________________________________________________________________\ __________________________________ ________________________________________________________________________\ __________________________________ ________________________________________________________________________\ __________________________________ ________________________________________________________________________\ __________________________________ ________________________________________________________________________\ __________________________________ ________________________________________________________________________\ __________________________________ ________________________________________________________________________\ __________________________________ ________________________________________________________________________\ __________________________________ the goods and merchandise of a store (name store) __________________________________________________________________, while still upon the premises of the store and not having theretofore purchased the goods and merchandise. STATE OF NORTH CAROLINA County In The General Court Of Justice District Court Division IN THE MATTER OF (Over) AM PM 14-72.1 NC-JOIN No. Category Of Offense Misdemeanor, Class Name Address Relationship/Title Telephone No. AOC-J-315, Rev. 12/17