Fill and Sign the State of North Carolina Indictment Form

Date Of Arrest & Check Digit No. (As Shown On Fingerprint Card)FORGING ENDORSEMENT [G.S. 14-120] On or about the date of offense shown and in the county named above the defendant named above unlawfully, willfully and feloniously did falsely make and forge an endorsement of UTTERING FORGED ENDORSEMENT [G.S. 14-120] And, on or about the date of offense shown and in the county named above, the defendant named above unlawfully, willfully and feloniously did utter, publish, pass and deliver as true the instrument which is described in the charge above and which contained the falsely made and forged endorsement which is described in the charge above. The defendant knew at the time that the endorsement was falsely made and forged and acted for the sake of gain and with the intent to injure and defraud.File No.FORGING ENDORSEMENT UTTERING FORGED ENDORSEMENT (Over)WARRANT FOR ARRESTSTATE OF NORTH CAROLINA In The General Court Of Justice District Court DivisionCountyTo any officer with authority and jurisdiction to execute a warrant for arrest for the offenses charged below:These act(s) were in violation of the laws referred to in this Warrant. This Warrant 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 charges above.SignatureAM PMI. II.THE STATE OF NORTH CAROLINA VS.Magistrate Assistant CSCDeputy CSC Clerk Of Superior CourtII. Offense In Violation Of G.S.I, the undersigned, find that there is probable cause to believe that:Offense Code(s) I. II.2528 2527I. The defendant acted for the sake of gain and with the intent to injure and defraud. (NOTE: Instead of describing the instrument with words and figures, you may attach the instrument or a photocopy of it to the warrant. If you do so, check the block below.)on a which is described as follows: See attached copy of instrument.AOC-CR-143, Rev. 8/97 (Structured Sentencing)Misdemeanor Offense Which Requires Fingerprinting PerName And Address Of Defendant County Of ResidenceTelephone No.Social Security No.Drivers License No. & StateRaceSexDate Of BirthAgeName Of Defendant's EmployerDate Of OffenseComplainant (Name, Address Or Department)Telephone No.County Of ResidenceNames & Addresses Of Witnesses (Including Counties & Telephone Nos.)Date Issued1997 Administrative Office of the CourtsCourt DateCourt TimeLocation Of Court 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:2 1 120COMMITMENT: 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 complied with the conditions of release pending appeal.pay costs and a fine of $CSCIf 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.RETURN OF SERVICEI certify that this Warrant was received and served as follows:REDELIVERYSignature Dep. CSC Assist. CSC CSCRETURN FOLLOWING REDELIVERYI certify that this Warrant was received and served as follows: By arresting the defendant and bringing the defendant This Warrant WAS NOT served for the following reason:Signature Of Officer Making ReturnAPPEAL ENTRIESThe 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 JudgeWAIVER OF PROBABLE CAUSE HEARINGThe undersigned defendant, with the consent of his/her attorney, waives the right to a probable cause hearing.Signature Of DefendantSignature Of Attorney By arresting the defendant and bringing the defendant before: This Warrant WAS NOT served for the following reason:Signature Of Officer Making ReturnPRIOR CONVICTIONS:No./Level:I (0)II (1-4)III (5+)Appointed Retained Waivedno contest no contestPLEA: guilty guilty not guiltyVERDICT: guilty guilty not guiltyMISD. CLASS:Signature Deputy CSC Assist. CSCbe imprisoned for a term ofdays in the custody of the sheriff.DOC. Pretrialdays served.Work releaseis recommended.is not recommended.[is ordered. (use form AOC-CR-602)]The Court finds that a longershorter period of probation, than that which is specified in G.S. 15A-1343.2(d), isWith 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 institution. (4) satisfy child support and family obligations, as required by the Court. (5) pay to the Clerk the costs of court and any additional sums shown below. $$$$$ *Name(s), address(es), amount(s) & social security number(s) of aggrieved party(ies) to receive restitution: It is ORDERED that this:Judgment is continued upon payment of costs.case be consolidated for judgment withsentence 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 Court for action by the grand jury.No probable cause is found as to Count(s)of this Warrant, and the Count(s) isI certify that this Judgment is a true and complete copy of the original which is on file in this case.CERTIFICATIONSignature Of District Court Judge6.completehours of community service during the firstdays of probation, as directed by theservice coordinator, and pay the fee prescribed by G.S. 143B-475.1(b)days. 7.not be found in or on the premises of the complainant8.not assault, communicate with or be in the presence of the complainant9.Other33If DWI, use AOC-CR-301 (active) or AOC-CR-310 (probation). If active sentence to DOC, use AOC-CR-602. If supervised probation, use AOC-CR-604. AOC-CR-143, Side Two, Rev. 8/97 (Structured Sentencing)NOTE:Date ReceivedDate ServedDate ReturnedName Of Judicial OfficialDepartment Or Agency Of OfficerDateDate ReceivedDate ServedDate ReturnedName Of Judicial OfficialDepartment Or Agency Of OfficerDateDate Waived 1997 Administrative Office of the CourtsDate Date Date Delivered To SheriffName Of District Court Judge (Type Or Print)FineRestitution*Attorney's FeeCommunity Service FeeOther .District AttorneyAttorney For Defendant At Time Of Trial Or Plea