IN THE JUVENILE COURT OF __________________________ COUNTY, GEORGIA
IN THE INTEREST OF: ______________________________, An Unemancipated Minor
CASE NUMBER _____________________ SEX _______________________________ DOB _______________ AGE___________
CERTIFICATE I hereby certify that according to the record in this case, a hearing was scheduled to be heard on the ______ day of _______________________, 20_____, at ____ o'clock ____.m. The court did not conduct the hearing, and more than twenty-four (24) hours have elapsed since the time of the scheduled hearing. This ____ day of ________________________, 20_____, at __________, o'clock ____.m.
______________________________ Clerk or Designated Deputy (Seal of Court)
Rev. 01/2001
JUV-28