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STATE OF NORTH CAROLINA(Over) Date Of Arrest & Check Digit No. (As Shown On Fingerprint Card) File No. POSSESSION WITH INTENT TO MANUFACTURE, SELL, AND DELIVER WARRANT FOR ARREST This act(s) was in violation of the law(s) referred to in this Warrant. This Warran t is issued upon information furnished under oath by the complainant listed. You are DIRECTED to arrest the defendant and bring the defendant before a judicial official without unnecessary delay to answer the charge(s) above. Signature AM PM I. II. SALE AND DELIVERY III. MANUFACTURE THE STATE OR NORTH CAROLINA VS. Magistrate Assistant CSC Deputy CSC Clerk Of Superior Court (Identify Substance) AOC-CR-111, Rev. 2/03 (Structured Sentencing) 2003 Administrative Office of the Courts Name And Address Of Defendant County Of Residence Race Sex Date Of Birth Social Security No. Offense Code(s) Offense In Violation Of G.S. Complainant (Name, Address Or Department) Names & Addresses Of Witnesses (Including Counties & Telephone Nos.) Date Issued County Of Residence Telephone No. Location Of Court Court Date Court Time II. SALE AND DELIVERY I, the undersigned, find that there is probable cause to believe that on or about the date of offense shown and in the county named above the defendant named above unlawfully, willfully and feloniously did sell and deliver the controlled substance identified in Count I to: Name Of Person Substance Sold And Delivered To I. POSSESSION WITH INTENT TO MANUFACTURE, SELL, AND DEL IVER I, the undersigned, find that there is probable cause to believe that on or about the date of offense shown and in the county named above the defendant named above unlawfully, willfully and feloniously did possess with intent to manufacture, sell, and deliver a controlled substance as follows: Schedule Of The N. C. Controlled Substances Act Specify Amount Of Substance Identify Substance III. MANUFACTURE I, the undersigned, find that there is probable cause to believe that on or about the date of offense shown and in the county named above the defendant named above unlawfully, willfully and feloniously did manufacture the controlled substance identified in Count I by: (describe act of manufacturing) In The General Court Of Justice District Court Division County To any officer with authority and jurisdiction to execute a warrant for a rrest for the offense(s) charged below: (Always charge Count I . If appropriate, charge Count II or III , or II and III .) Telephone No. Age Drivers License No. & State Name Of Defendant's Employer 90-95(a)(1) Date Of Offense Law Enforcement Case No. FBI No. LID No. SID No. No./Level: shorter period of probation, than that which is specified in G.S. 15A-1343.2(d), is necessary. JUDGMENT: The defendant appeared in open court and freely, voluntarily and understandingly entered the above plea; on the above verdict it is ORDERED that the defendant: RETURN OF SERVICE REDELIVERY WAIVER OF PROBABLE CAUSE HEARING pay costs and a fine of $ PRIOR CONVICTIONS: 0 Appointed Retained Waived COMMITMENT: It is ORDERED that the Clerk deliver two certified copies of this Judgment and Commitment to the sheriff and that the sheriff cause the defendant to be retained in custody to serve the sentence imposed or until the defendant shall have com plied with the conditions of release pending appeal. CSC If this Warrant For Arrest is not served within one hundred and eighty (180) days, it must be returned to the Clerk of Court in the county in which it was issued with the reason for the failure of service noted thereon. The officer must state all steps taken by the department in attempting to execute the Warrant and any information obtained about the whereabouts of the defendant. I certify that this Warrant was received and served as follows: Signature Dep. CSC Assist. CSC CSC RETURN FOLLOWING REDELIVERY I certify that this Warrant was received and served as follows: By arresting the defendant and bringing the defendant before: This Warrant WAS NOT served for the following reason: Signature Of Officer Making Return APPEAL ENTRIES The defendant, in open court, gives notice of appeal to the Superior Court. The current pretrial release order is modified as follows: Signature Of District Court Judge The undersigned defendant, with the consent of his/her attorney, waives the right to a probable cause hearing. Signature Of Defendant Signature Of Attorney By arresting the defendant and bringing the defendant before: This Warrant WAS NOT served for the following reason: Signature Of Officer Making Return I (0) II (1-4) III (5+) no contest no contest PLEA: guilty guilty not guilty VERDICT: guilty guilty not guilty MISD. CLASS: MISD. CLASS: Signature Deputy CSC Assist. CSC be imprisoned for a term of days in the custody of the sheriff. DOC. Pretrial Credit days served. Work release is recommended. is not recommended. [ is ordered. (use form AOC-CR-602) ] The Court finds that a longer With defendant's consent, execution of the sentence is suspended and the defendant is placed on unsupervised probation for months, subject to the following conditions: (1) commit no criminal offense in any jurisdiction. (2) possess no firearm, explosive or other deadly weapon listed in G.S. 14-269. (3) remain gainfully and suitably employed or faithfully pursue a course of study or of vocational training, that will equip the defendant for suitable employment, and abide by all rules of the insti tution. (4) satisfy child support and family obligations, as required by the Court. (5) pay to the Clerk the costs of court and any additi onal sums shown below. $ $ $ $ $ *Name(s), address(es), amount(s) & social security number(s) of a ggrieved party(ies) to receive restitution: It is ORDERED that this: Judgment is continued upon payment of costs. case be consolidated for judgment with sentence is to run at the expiration of the sentence in . . PROBABLE CAUSE: Probable cause is found as to all Counts except , and the defendant is bound over to Superior for action by the grand jury. No probable cause is found as to Count(s)of this Warrant, and the Count(s) is dismissed. I certify that this Judgment is a true and complete copy of the original which is on file in thi s case. CERTIFICATION Signature Of District Court Judge 6. complete hours of community service during the first days of probation, as directed by the community service coordinator, and pay the fee prescribed by G.S. 143B-475.1(b) within days. 7. not be found in or on the premises of the complainant or . 8. not assault, communicate with or be in the presence of the complainant or . 9. Other: 1 2 3 1 2 3 AOC-CR-111, Side Two, Rev. 2/03 (Structured Sentencing) NOTE: If DWI, use AOC-CR-342 (active) or AOC-CR-310 (probation). If active sentence to DOC, u se AOC-CR-602. If supervised probation, use AOC-CR-604. 2003 Administrative Office of the Courts Date Received Date Served Date Returned Name Of Judicial Official Department Or Agency Of Officer Date Date Received Date Served Date Returned Name Of Judicial Official Department Or Agency Of Officer Date Date Waived District Attorney Attorney For Defendant At Time Of Trial Or Plea . Fine Restitution* Attorney's Fee Community Service Fee Other Date Date Date Delivered To Sheriff Name Of District Court Judge (Type Or Print)