Fill and Sign the For Temporary Custody Form

Assistant District Attorney Ot her S heri ff Of This County Ot her To The Custodian Of The Institution Named Above: The defendant named above is confined in your institution and his presence is required for the trial of the charge referred to abo ve. The undersigned prosecutor requests that you temporarily release the defendant to the custody of the law en for ceme nt agency named below so that the agency may produce the defendant for trial at the date, time and place sho wn below. Under G.S. 15A-711(a) the request of the prosecutor is sufficient authorization for the release and must be honore d. PROSE CUTOR'S REQUEST FOR TEMPORARY CUSTODY OF DEFENDANT FOR TRIAL G.S. 15A-711(a) Law Enforcement Agency To Receive Temporary Custody: Signa ture Of Prosecutor Di strict Attorney I certify that this Prosecutor’s Request was received and served as follows: S igna ture Of Person Making Return Of Service Depu ty Sheriff NOTE TO PROSECUTOR: Give original and two copies to law enforcement agency. File third copy with the Clerk. If the defendant is confined awaiting trial on charges pending in another prosecutorial district, give notice of this request to the defendant and to the prosecutor for that prosecutorial district. NOTE TO LAW ENFORCEMENT OFFICER: Deliver the original to the custodian and first copy to the defendant. Take defendant into temporary custody, produce him for trial and after trial return him to custodian unless court directs otherwise. Complete Return of S ervice on second copy and file with the Clerk. Make a copy for your records. File No. Offense( s ) CHAR GES PENDING FOR TRIAL Location Of Court Court Da te Na me Of Prosecutor (Type Or Print) Date Of Return Of Service Date Request Served On Custodian Na me Of Person Served Date Def. Received From Custodian Cou nty STATE OF NORTH CAROLINA In T he General Cour t Of Justice Di stric t Superior Court Division File No. STATE VERSUS Race Offender ID (if any) Name Of Defendant County Where Notarized Deputy CSC Assistant CSC Clerk Of Superior Court Magistrate Notary SEAL SWO RN/AFFIRMED AND S UBSCR IBED T O BEFORE ME Date Si gnature Of Person Authorized To Administer Oaths Date My Co mmission Expires Cour t Time Date Of Request AM PM RETURN OF SERVICE Da te Request Received Date Def. Returned To Custodian AOC-CR-900, Rev. 6/12 © 2012 Administrative Office o f the Courts Name Of Agency In Whose Custody Defendant Confined Or Co mmitted N.C. DAC Sheriff of County Division Of Juven ile Justice Sex Date Of Birth