Fill and Sign the Subchapter Iii Criminal Process Article 17 Criminal Form

STATE OF NORTH CAROLINADate Of Arrest & Check Digit No. (As Shown On Fingerprint Card)FORGERY [G.S. 14-119] On or about the date of offense shown and in the county named above the defendant named above unlawfully, willfully and feloniously did forge, falsely make and counterfeit a which is described as follows: (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.)Forgery of an Endorsement under G.S. 14-120 and Uttering a Forged Endorsement under G.S. 14-120 should not becharged with this Warrant. Use form AOC-CR-143. UTTERING [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 forged, falsely made and counterfeit instrument which is described in the charge above. The defendant acted for the sake of gain and with the intent to injure and defraud and with knowledge that the instrument was forged, falsely made and counterfeited.File No.FORGERY UTTERING(Over)WARRANT FOR ARRESTIn The General Court Of Justice District Court DivisionCountyTo any officer with authority and jurisdiction to execute a warrant for arrest for the offense(s) charged below:This act(s) was in violation of the law(s) 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 charge(s) 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.2520 2524 NOTE I. See attached copy of instrument.The forgery, false making and counterfeiting consisted of the following: (Describe how the instrument was forged, falsely made and counterfeited.) The defendant acted without authority and with the intent to injure and defraud.AOC-CR-109, Rev. 6/97 (Structured Sentencing)1997 Administrative Office of the CourtsLocation Of CourtCourt DateCourt TimeDate IssuedDate Of OffenseComplainant (Name, Address Or Department)County Of ResidenceTelephone No.Names & Addresses Of Witnesses (Including Counties & Telephone Nos.)Name Of Defendant's EmployerName And Address Of DefendantCounty Of ResidenceTelephone No.Date Of BirthAgeDrivers License No. & StateRaceSexSocial Security No. .PRIOR CONVICTIONS:No./Level: 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 1 120 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 complied with the conditions of release pending appeal.pay costs and a fine ofCSCIf 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 ReturnI (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 termdays in the custody of the sheriff.DOC. Pretrial CreditdaysWork releaseis recommended.is not recommended.[is ordered. (use form AOC-CR-602)]The Court finds thatlongershorter period of probation, than that which is specified in G.S. 15A-1343.2(d), is necessary.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 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 thatJudgment is continued upon payment ofcase be consolidated for judgment withsentence is to run at the expiration of the sentencePROBABLE CAUSE: Probable cause is found as to all Counts except, and the defendant is bound over to Superior Court for action by the grandNo 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 the communityservice 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.Other33AOC-CR-109, Side Two, Rev. 6/97 (Structured Sentencing) NOTE:If 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. 1997 Administrative Office of the CourtsDate WaivedDate Date Date Delivered To SheriffDate Name Of District Court Judge (Type Or Print)FineRestitution*Attorney's FeeCommunity Service FeeOtherDistrict AttorneyAttorney For Defendant At Time Of Trial Or PleaDate ReceivedDate ServedDate ReturnedName Of Judicial OfficialDepartment Or Agency Of OfficerDate ReceivedDate ServedDate ReturnedDateName Of Judicial OfficialDepartment Or Agency Of Officer