STATE OF GEORGIA IN THE MAGISTRATE COURT OF GWINNETT COUNTY STATE OF GEORGIA Warrant Numbers: VS. ____________________________________________________ Defendant ________________________________________________ SPECIAL CONDITIONS OF BOND I. It is hereby ORDERED that the Defendant shall be allowed to make a bond in the dollar amount set forth in the separate orders connected with the above listed warrant(s), subject to the following conditions: [ ] 1. [ ] 2. [ ] 3. [ ] 4. [ [ [ [ ] ] ] ] 5. 6. 7. 8. The Defendant shall stay away, absolutely, directly or indirectly, by person, telephone, messenger or any other means of communication from _________________________________________________________________________________________, hereinafter referred to as "victim". That includes, but is not limited to, the victim's home, school, and place of business or routes of travel to or from those locations. The Defendant shall stay away from the above locations regardless of whether the victim is present at such locations. Violations connected with contacting/following the victim may subject the Defendant to a separate prosecution for the felony offense of Aggravated Stalking. The only limited exception(s) to condition 1 (is) (are) as follows: __________________________________________________________________________________________________________ ___________________________________________________________________________________________________________ The Defendant may return to the victim=s residence one time only in the company of a law enforcement officer to retrieve his/her clothing and personal effects. DEFENDANT'S EXPRESS CONSENT TO DRUG/ALCOHOL TESTING: While the Defendant is out on bond the Defendant has freely and voluntarily consented to submit to random alcohol/drug tests upon the request of the State, from time to time hereafter, at his/her own expense and this order shall constitute a complete release and stipulation of all such results for the purposes of bond review. The Defendant acknowledges that any incriminating results would be grounds to revoke this bond and would be used against the Defendant in an independent prosecution. Defendant shall not violate any local, state or federal laws. Defendant shall not drink alcohol. Defendant shall not take or possess any drugs unless prescribed lawfully. Defendant shall not change present address without prior written notice to the State. [ ] 9. Other: _____________________________________________________________________________________________________ [ ] 10. Defendant shall have no violent contact with: ______________________________________________________________________ The terms and provisions of this bond order shall be subject to the future orders of any court of competent jurisdiction. Such Orders may include divorce, family violence, bond modifications, etcetera, that are connected with parties/victim(s). NOTICE TO DEFENDANT & VICTIM II. The sheriff, or any of his lawful deputies, are hereby directed to serve a copy of these Special Conditions of Bond on the Defendant and to have him/her sign an acknowledgment of receipt of these conditions. The Defendant shall not be eligible to post bond in this case until this has been completed. The Clerk of this Court shall mail a copy of these Special Conditions of Bond to the victim. MODIFICATIONS/VIOLATIONS III. This is a COURT ORDER. In the event a victim initiates any contact or initiates violations of this Court Order, the Defendant may be placed in a position of violating this Court Order and may be arrested. Should anyone desire a modification or revocation of the Special Conditions of Bond he/she shall file a written request for Modification of Special Conditions of Bond and shall serve written notice upon the respective prosecutor=s office, as follows:: Felonies: District Attorney's Office 75 Langley Drive Lawrenceville, GA 30045-6900 (770) 822-8400 Misdemeanors: Solicitor's Office 75 Langley Drive Lawrenceville, GA 30045-6900 (770) 822-8300 Violation(s) of this order may be heard upon the State's Motion to Revoke Bond, supported by sworn testimony or affidavit. In the event probable cause of such violation is found the Defendant will be arrested on an order revoking bond and will be brought before the appropriate Court immediately after his/her arrest for a further hearing. Violations connected with contacting/following the victim may subject the Defendant to a separate prosecution for the felony offense of Aggravated Stalking. SO ORDERED, this ______ day of ________________________, 20_____. _____________________________________________________ JUDGE, GWINNETT MAGISTRATE COURT DEFENDANT=S ACKNOWLEDGMENT OF SPECIAL CONDITIONS OF BOND - NOT ELIGIBLE TO POST BOND UNTIL SIGNED & WITNESSED I acknowledge receipt of the above conditions of bond. They have been fully explained to me. I realize that upon a violation of any of these special conditions, my bond may be revoked and I would be subject to immediate arrest and prosecution. I understand that I must give the State written notice of any change(s) in my address. I acknowledge that I have received and been given notice of these conditions of bond. This ______ day of ________________________, 20______. _____________________________________________________ Defendant _________________________________________________ Witness B Defendant=s signature MUST be witnessed. _____________________________________________________ Witness Name & Telephone Number, Printed. w:\Magforms & C:\myfiles\forms\Special Conditions of Bond Mag. 20-19 American LegalNet, Inc. www.FormsWorkflow.com