COVER SHEET STATE OF ARKANSAS CRIMINAL INFORMATION This criminal information cover sheet or the standard criminal information form is required by Supreme Court Administrative Order Number 8 to be completed for every defendant and filed by the prosecutor. The data contained herein shall not be admissible as evidence in any court proceeding or replace or supplement the filing and service of pleadings, orders, or other papers as required by law or Supreme Court rule. Instructions are located on the back of the form. County District Case Number Judge Division Filing Date Style of Case Prosecutor Providing Information Is D being charged as a Habitual? 9 Yes Adding Offense(s)? 9 Yes Dropping Offense(s)? 9 Yes 9 Yes Changing Offense(s)? 9 Yes Is victim under the age of 14? If yes, are you 9 Yes Are multiple D's charged in the information? Is this an Amended Information? 9 Yes Defendant's Full Name Date of Birth Address (Street, City, State, Zip) Race Sex SS# Arrest Date Driver's License No. Arrest Tracking # Alias 1 SID # Prosecutor's File # Alias 2 Alias 3 The attached information accuses the above named defendant of the following crime(s): Code # Offense _____________________________________________ Circuit Clerk/Deputy Clerk A/S/C Offense Date Counts F/M Class ________________________________________________ Prosecuting Attorney/Deputy Prosecuting Attorney AOC 2/07 American LegalNet, Inc. www.FormsWorkflow.com CRIMINAL INFORMATION IN THE CIRCUIT COURT OF _________________________ COUNTY, ARKANSAS ________________________ DISTRICT, ___________________ DIVISION State of Arkansas Case No. vs Filing Date Amended Information? 9 Yes If Yes: Multiple D's Charged Together 9 -Or- Multiple D's Charged Separately 9 Co-D's Adding Offense(s)? 9 Yes Dropping Offense(s)? 9 Yes Changing Offense(s)? 9 Yes D Charged As Habitual? 9 Yes Is victim under the age of 14? Related Case #'s 9 Yes Defendant's Full Name Date of Birth Address (Street, City, State, Zip) Race Sex SS# Arrest Date Driver's License No. Arrest Tracking # Alias 1 SID # Prosecutor's File # Alias 2 Alias 3 I, ___________________________________, Prosecuting/Deputy Prosecuting Attorney, __________ Judicial District, in the name of the State of Arkansas, ____________________________ County, accuse the above named defendant of the following crime(s): Code # Offense A/S/C Offense Date Counts F/M Class American LegalNet, Inc. www.FormsWorkflow.com Committed as follows: Count # __________ Offense ______________________________________________________________ The defendant on or about ______________________ (date), in _________________________ County, Arkansas did unlawfully against the peace and dignity of the State of Arkansas. 444444444444444444444444444444444444444444444444444444444444444444444444444444444444 Committed as follows: Count # __________ Offense ____________________________________________________________ The defendant on or about ______________________ (date), in _________________________ County, Arkansas did unlawfully against the peace and dignity of the State of Arkansas. 444444444444444444444444444444444444444444444444444444444444444444444444444444444444 Committed as follows: Count # __________ Offense ____________________________________________________________ The defendant on or about ______________________ (date), in _________________________ County, Arkansas did unlawfully against the peace and dignity of the State of Arkansas. 444444444444444444444444444444444444444444444444444444444444444444444444444444444444 Entered this ______ day of ________________________, 19_____. By _______________________________________ Prosecuting/Deputy Prosecuting Attorney ______________________________________, Prosecuting Attorney. AOC 2/07 American LegalNet, Inc. www.FormsWorkflow.com INSTRUCTIONS FOR COMPLETING CRIMINAL INFORMATION Pursuant to Supreme Court Administrative Order Number 8, the Office of the Prosecuting Attorney is responsible for the completion and filing of either the standard criminal information form or the criminal information cover sheet, a copy of which is to be forwarded by the circuit clerk to the Administrative Office of the Courts. Only one defendant shall be charged in each criminal information. Court Location. Fill in the name of the county, district, and division (if applicable) of the court in which the information is being filed. Style, Case #. Enter the name of the defendant for the style of the case, and the filing date (the month, day, and year the information is being filed). The clerk will assign and enter a case number upon filing. Amendment/Habitual. Complete each question only if the answer is "yes." If a previous information was filed against the same defendant for the same occurrence, indicate the type of changes from the original or most recent information. Indicate "yes" if the defendant is being charged as a habitual offender, pursuant to A.C.A. § 5-4-501 et. seq. Multiple Defendants. If the prosecutor checks "Multiple D's Charged Together" the clerk MUST assign the same case number to the information of each of the co-defendants listed on the information. If defendants will be charged in separate proceedings, the prosecutor should check "Multiple D's Charged Separately" and the related case numbers may be entered for case assignment and tracking purposes. Defendant Information. Enter all background and directory information about the defendant which is available. A.C.A. § 12-12-1007 requires that the arrest tracking number be provided at filing if the defendant has been arrested. Charging Information. Enter name of charging prosecutor, judicial district number, and county name. For each offense charged, list the Arkansas Code Annotated number of the offense, the title of the offense, whether the charge is for an attempt (A), solicitation (S) or conspiracy (C) (if none leave blank), the offense date, the number of counts, whether the charge is a felony (F) or misdemeanor (M), and its classification (Y, A, B, C, D, U). Narrative Statement. For each count or series of counts and offenses, complete the narrative description of the defendant's actions which constituted the offense. Complete the charging statement by entering the classification of the offense and the range of possible fine and incarceration for the offense. Use additional pages if necessary. Verification. Enter the date and the signature of the prosecuting authority. The clerk shall retain the original information in the case file and send a copy of the first page only of the information to the Administrative Office of the Courts. American LegalNet, Inc. www.FormsWorkflow.com CRIMINAL INFORMATION IN THE CIRCUIT COURT OF _________________________ COUNTY, ARKANSAS ________________________ DISTRICT, ___________________ DIVISION State of Arkansas Case No. vs Filing Date Amended Information? 9 Yes If Yes: Multiple D's Charged Together 9 -Or- Multiple D's Charged Separately 9 Co-D's Adding Offense(s)? 9 Yes Dropping Offense(s)? 9 Yes Changing Offense(s)? 9 Yes D Charged As Habitual? 9 Yes Is victim under the age of 14? Related Case #'s 9 Yes Defendant's Full Name Date of Birth Address (Street, City, State, Zip) Race Sex SS# Arrest Date Driver's License No. Arrest Tracking # Alias 1 SID # Prosecutor's File # Alias 2 Alias 3 I, ___________________________________, Prosecuting/Deputy Prosecuting Attorney, __________ Judicial District, in the name of the State of Arkansas, ____________________________ County, accuse the above named defendant of the following crime(s): Code # Offense A/S/C Offense Date Counts F/M Class American LegalNet, Inc. www.FormsWorkflow.com Committed as follows: Count # __________ Offense ______________________________________________________________ The defendant on or about ______________________ (date), in _________________________ County, Arkansas did unlawfully against the peace and dignity of the State of Arkansas. 444444444444444444444444444444444444444444444444444444444444444444444444444444444444 Committed as follows: Count # __________ Offense ____________________________________________________________ The defendant on or about ______________________ (date), in _________________________ County, Arkansas did unlawfully against the peace and dignity of the State of Arkansas. 444444444444444444444444444444444444444444444444444444444444444444444444444444444444 Committed as follows: Count # __________ Offense ____________________________________________________________ The defendant on or about ______________________ (date), in _________________________ County, Arkansas did unlawfully against the peace and dignity of the State of Arkansas. 444444444444444444444444444444444444444444444444444444444444444444444444444444444444 Entered this ______ day of ________________________, 20_____. By _______________________________________ Prosecuting/Deputy Prosecuting Attorney ______________________________________, Prosecuting Attorney. American LegalNet, Inc. www.FormsWorkflow.com