BENCH WARRANT TWO-SIDED FORM IN THE DISTRICT COURT OF THE SECOND CIRCUIT ______________________________ DIVISION STATE OF HAWAI‘I Form #2DC03 THE STATE OF HAWAI‘I vs. Name of ARRESTEE: DOB: SSN: Reserved for Court Use Address of ARRESTEE: Civil No. BW No. Filing Party(ies)/Filing Party(ies)' Attorney (Name, Attorney Number, Firm Name (if applicable), Address and Telephone and Facsimile Numbers) Plaintiff(s) Defendant(s) Date Bench Warrant Ordered: BENCH WARRANT THE STATE OF HAWAI‘I TO: The Director of Public Safety of the State of Hawai‘i, his/her deputy or any police officer or other person authorized by the laws of the State of Hawai‘i. Because above-named person (ARRESTEE) was duly ordered to appear before this Court at the Original Hearing Date and Time stated above, and failed to so appear: You are commanded to arrest and bring ARRESTEE before the Presiding District Judge of this Court, in his/her Courtroom, on the day and at the time designated by the checked box on the reverse side, then and there to show cause why ARRESTEE should not be found guilty of contempt of court. UNLESS AUTHORIZED IN WRITING, THIS WARRANT MAY NOT BE EXECUTED BETWEEN THE HOURS OF 10:00 P.M. AND 6:00 A.M. ON PREMISES NOT OPEN TO THE PUBLIC. Date: BAIL SET AT: $ Judge of the above-entitled Court SEE REVERSE SIDE BENCHWAR.2XX Reprographics (7/06) 2D-P-216 I certify that this is a full, true, and correct copy of the original on file in this office. Clerk, District Court of the above Circuit, State of Hawai‘i American LegalNet, Inc. www.FormsWorkflow.com COURT DATE AND ADDRESSES: G Hoapili Hale, Wailuku Division, 2145 Main Street, Wailuku, Hawai’i, on the third Thursday following date of service, and should said Thursday be a legal holiday then upon the next Thursday at 10:30 a.m., Courtroom 3D (Last name A-L) or Courtroom 3C (Last name M-Z). G Lahaina Division, 1870 Honoapiilani Highway, Lahaina, Hawai’i, at 8:30 a.m. on the third Wednesday following date of service, and should said Wednesday be a legal holiday then upon the next Wednesday. G Hana Division, 4974 Uakea Road, Hana, Hawai'i, at 9:00 a.m. on the first Tuesday of the next month following date of service, and should said Tuesday be a legal holiday then upon the following Tuesday of the next month. G Molokai Division, Kaunakakai, Molokai, Hawai'i, at 8:30 a.m. on the second Tuesday of the month following date of service, and should said Tuesday be a legal holiday then upon the second Tuesday of the following month. G Lanai Division, Lanai City, Lanai, Hawai'i, at 8:30 a.m. on the third Tuesday of the odd numbered month (January, March, May, July, September, November) following date of service, and should said Tuesday be a legal holiday then upon the third Tuesday of the following odd numbered month. I am duly authorized by Hawai'i law to serve this Bench Warrant and I executed this Bench Warrant on the following person: at on this day of , 20 . Signature of Serving Officer: Date: Print/Type Name: Badge No.: In accordance with the Americans with Disabilities Act if you require an accommodation or assistance, please contact the District Court Administration Office at PHONE NO. 244-2800, FAX 244-2849, or TTY 244-2865 at least ten (10) working days in advance of your hearing or appointment date. 2D-P-216 American LegalNet, Inc. www.FormsWorkflow.com