Fill and Sign the 9a114 113 Form

FELONIOUS FINANCIAL TRANSACTION CARD THEFT [G.S. 14-113.9(a)(1)] The jurors for the State upon their oath present that on or about the date of offense shown and in the county named above the defendant named above unlawfully, willfully and feloniously did take, obtain and withhold a financialtransaction card, from the person, possession, custody and control of The taking, obtaining and withholding was done without the consent of the cardholder, to use the financial transaction card described above. (Charge only if Count I is charged) FINANCIAL TRANSACTION CARD FRAUD [G.S. 14-113.13(a)(1)] And the jurors for the State upon their oath present that on or about the date of offense shown and in the county named above the defendant named above unlawfully, willfully and feloniously did with the intent to defraud use the financial transaction card described in Count I above for the purpose of obtaining the following goods, services, and other things of value described as follows: The financial transaction card was obtained and retained by financial transaction card theft under G.S. 14-113.9. The value of the goods, services, and other things of value that were obtained by this violation during a six-month period was I. II. STATE OF NORTH CAROLINA County STATE VERSUS Offense In Violation Of G.S. INDICTMENT Signature Of Grand Jury Foreman NOTE: File No. In The General Court Of Justice Superior Court Division FINANCIAL TRANSACTION CARD THEFT (2612 ) FINANCIAL TRANSACTION CARD FRAUD (2616) I . II. Signature Of Prosecutor The charge in Count II is a felony if the value of the goods, services, etc. obtained during a six-month period exceeds $500.00. The charge is a misdemeanor if the goods, services, etc. obtained during a six-month period is $500.00 or less. WITNESSES A TRUE BILL by twelve or more grand jurors, and I the undersigned Foreman of the Grand Jury, attest the concurrence of twelve or more grand jurors in this Bill of Indictment. NOT A TRUE BILL. The Witnesses marked "X" were sworn by the undersigned Foreman of the Grand Jury and, after hearing testimony, this Bill was found to be: . , and with the intent 14-113.9(a)(1),14-113.13(a)(1) . Date Of Offense Name Of Defendant AOC-CR-152, Rev. 10/961997 Administrative Office of the Courts Date