Fill and Sign the Bill of Costs District Courtunited States Courts Form

File No. Name Of Defendant Costs Assessed In Each Of The Following Cases SFF 22500 CPD 235 Other 2 5 Cost Waived $ CRIMINAL BILL OF COSTS STATE VERSUS STATE OF NORTH CAROLINA County In The General Court Of Justice Superior Court Division NOTE: This bill of costs does not reflect amounts you may owe outside the criminal judgment, such as a civil revocation fee or an administrative fee owed to another agency. 24325 24326 24202 24330 24335 21820 21821 21830 21835 21560 21565 District 21211 Superior 21111 District 21213 Superior 21113 21810 State 24320 County 22915 City 23915 State 24324 County 22917 City 23917 State 24321 County 22916 City 23916 21583 21584 PROCESS FEE DUE COUNTY Co. Co. # SERVED AMOUNT $ $ 22500 295 22600 296 22620 297 23500 2350 2360 236 2362 22610 Waived Waived Waived Waived Waived Waived Waived # SERVED AMOUNT $ $ # DAYS AMOUNT $ $ AMOUNT $ # DAYS AMOUNT $ $ # DAYS AMOUNT $ $ # DAYS AMOUNT $ JAIL FEE DUE COUNTY Co. Co. JAIL FEE DUE COUNTY (Post-Trial) Co. Co. PROCESS FEE DUE CITY JAIL FEE DUE CITY PRE-TRIAL RELEASE FEE DUE THIS COUNTY JAIL FEE DUE CITY (Post-Trial) COSTS DUE STATE EHA Fee $ EHA Daily Fee $ Community Service Fee $ SBM Sex Offender Fee $ Limited Driving Privilege Fee $ Chapter 20 Violation $ Chapter 20 Violation (CRDA) $ Impaired Driving Fee $ Impaired Driving Fee (CRDA) $ Improper Equipment Fee $ Improper Equipment Fee (CRDA) $ Failure To Appear Fee $ Failure To Comply Fee $ Installment Plan Set-up Fee $ DNA, Bodily Fluid, Cont. Sub. Analysis $ Digital Forensic Analysis $ Lab Analyst Expert Witness $ Private Hosp. Toxicological Testing $ Private Hosp. Expert Witness $ Date Name Of Clerk By Date: FULL PAYMENT PARTIAL PAYMENT PROBATION SUPERVISION B - Supervised U - Unsupervised N - Not Collecting Fee SURRENDER LICENSE ASSESSMENT TOTAL DUE $ Recovery of Blood Test Payment: $ Recovery of Expert Witness Fee: $ Pre-Trial Release to County $ Other: $ Other: $ REIMBURSE ATTORNEY FEES ATTORNEY APPT. FEES Fee Assessed OTHER MISC. COSTS FINES DUE THE COUNTY RESTITUTION SEE ATTACHED WORKSHEET SEE SIDE TWO Restitution Jointly & Severally Due with Co-Defendants Listed on Reverse\ TOTAL RESTITUTION DUE TOTAL COST DUE $ $ 22700 24610 55.00 - 24612 / 5.00 - 24615 24630 2464 295 $ $ $ Deputy CSC Assistant CSC Clerk Of Superior Court $2&&5 6uSerior, 5ev. ,