en-USWRIT en-USRETURN OF SERVICE en-USFile No. en-USSTATE OF NORTH CAROLINAen-US en-US Countyen-USIn The General Court Of Justice en-US District en-US Superior Court Divisionen-USSTATE VERSUS en-USAPPLICATION ANDen-USWRIT OF HABEAS CORPUSen-USAD PROSEQUENDUMen-USG.S. 15-10.3en-USName And Address Of Defendanten-USen-USCourt Dateen-USCourt Timeen-USName Of Prosecutor (type or print)en-USName Of Judge (type or print)en-USSignature Of Judgeen-USSignature Of Prosecutoren-USLocation Of Courten-USDate Writ Receiveden-USDate Writ Served On Custodianen-USDate Of Return Of Serviceen-USSignature Of Person Making Return Of Serviceen-USDate Def. Returned To Custodianen-USName Of Person Serveden-USDate Def. Received From Custodianen-USDateen-USRaceen-USSexen-USDate Of Birthen-USOffender ID (if any)en-USDate Of Application en-USTo Any Judge Of The Trial Division Named Above:en-USThe defendant named above is confined or committed in the custody of the agency named above. The prosecutor requests that a Writ of en-USHabeas Corpus Ad Prosequendum be issued to the agency, requiring that the defendant be delivered, on the court date and at the time en-USand place shown below, to the court in which the charge(s) referred to above are pending.en-USI certify that this Writ was received and served as follows. en-USTo The Agency Named Above:en-USThe defendant named above is confined or committed in your custody. Upon application of the prosecutor named above, you are en-USORDERED to deliver the defendant to the custody of the sheriff of this county so that the defendant may be brought before this Court on en-USthe court date and at the time and place referred to above.en-USTo: en-US The Sheriff Of This County en-US Other þ en-USYou are ORDERED to serve this writ upon the agency named above; to take the defendant into custody and bring him/her before this en-USCourt on the date and at the time and place shown above and, when the court proceeding has been completed and the defendant is en-USreleased by the court, to return the defendant to the custody of that agency unless the court directs otherwise. en-US en-USN.C. DACJJen-US en-US en-USSheriff ofen-US en-US en-US en-USCountyen-US en-US en-USJuvenile Justice Sectionen-USCHARGES PENDING FOR TRIAL en-USFile No.en-USOffense(s)en-USAPPLICATION en-US en-USDistrict Attorney en-US en-USAssistant District Attorney en-US en-USDistrict Court Judge en-US en-USSuperior Court Judge en-US en-USDeputy Sheriff en-US en-USOther þ en-US AM en-US PM en-USOriginal - Custodian Copy - District Attorney Copy - File American LegalNet, Inc. www.FormsWorkFlow.com