Fill and Sign the Smith V Statefindlaw Form

IN THE CIRCUIT COURT OF COUNTY, MISSISSIPPI VS. NO. PETITION TO COMMIT DEFENDANT FOR MENTAL EXAMINATIONCOMES NOW the Petitioner, , father/mother of Defendant, , and petitions this Honorable Court to commit Defendant for mental examination to the Mississippi State Hospital located at Whitfield, or in the alternative, to any other approved institution, and in support of said petition would show the following facts, to -wit: I. Defendant was arrested on , , by the County Sheriff's Office on a charge of auto theft, and his/her date of birth is , , SSN II. Defendant is presently incarcerated in the County Jail, , Mississippi. III. Defendant has a history of mental problems retardation, and as a result thereof, he/she is experiencing physical and mental problems. IV. Defendant cannot communicate with his/her attorney, he/she does not understand his/her rights, and he/she should be committed to Hospital to receive the proper medical care, treatment, WHEREFORE, Petitioner prays that this Court issue an order instanter committing Defendant to the Mississippi State Hospital at , Mississippi, or in the alternative, to any other approved institution for immediate psychiatric examination and evaluation and for the treatment of drug related diseases. Respectfully submitted, _______________________________________ Attorney for Of counsel: Telephone: MSB # Attorney for STATE OF MISSISSIPPICOUNTY OF PERSONALLY came and appeared before me, the undersigned authority, in and for the jurisdiction aforesaid, the within named who, after being by me first duly sworn on oath, stated that the matters and facts contained in the above and foregoing document are true and correct to the best of his/her knowledge information and belief. ____________________________________ SWORN TO AND SUBSCRIBED BEFORE ME, this the day of , . __________________________________Notary Public My Commission expires:________________________ CERTIFICATE I, do hereby certify that I have this day mailed by United States mail, postage pre- paid, a true and correct copy of the foregoing Petition to Commit Defendant for Psychiatric Examination to the following: THIS the day of , . ___________________________________