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Nebraska State Court Form NOTICE UPON CONVICTION OF A MISDEMEANOR CRIME INVOLVING DOMESTIC VIOLENCE REQUIRED CC 6:10 NEW 07/08 Neb. Rev. Stat. § 29-2291 IN THE _________________________________________ COURT OF __________________COUNTY, NEBRASKA State of Nebraska Plaintiff vs. Defendant Case No. NOTICE UPON CONVICTION OF A MISDEMEANOR CRIME INVOLVING DOMESTIC VIOLENCE NOTICE TO DEFENDANT: You have been convicted of a misdemeanor crime involving violence where you are or were a spouse, intimate partner, parent, or guardian of the victim or are or were involved in another, similar relationship with the victim. Because of this conviction, it may be unlawful for you to possess or purchase a firearm including a rifle, pistol, or revolver, or ammunition, pursuant to federal law under 18 U.S.C. 922(g)(9). If you have any questions whether these laws make it illegal for you to possess or purchase a firearm, you should consult an attorney. This notice was given to the defendant on _________________________________. By the Court: _____________________________ Page 1 of 1 Notice Upon Conviction of a Misdemeanor Crime Involving Domestic Violence CC 6:10 NEW 07/08

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