BENCH WARRANT IN THE DISTRICT COURT OF THE THIRD CIRCUIT ______________________________ DIVISION STATE OF HAWAI`I THE STATE OF HAWAI`I vs. Name of ARRESTEE: Form #3DC03 DOB: SSN: Address of ARRESTEE: Reserved for Court Use Civil No. BW No. Plaintiff(s) Filing Party/Attorney Name, Attorney Number (if applicable), Address, Telephone and Fax Numbers 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: $ BENCHWARRANT Judge of the above-entitled Court 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 CommonLook® 508 Certified Reprographics (02/10) 3D Page 1 of 2 American LegalNet, Inc. www.FormsWorkFlow.com 3D-P-258 COURT DATE AND ADDRESSES: G North and South Hilo Division, 777 Kilauea Ave., 2 nd Floor, Hilo, Hawai`i at 8:30 a.m. on the second Wednesday following the date of service, and should said Wednesday be a legal holiday then upon the next Wednesday. G Puna Division, 777 Kilauea Ave., 2nd Floor, Hilo, Hawai`i at 8:30 a.m. on the second Monday following the date of service, and should said Monday be a legal holiday then upon the next Monday. G North and South Kona Division, 79-1020 Haukapila St., Kealakekua, Hawai`i at 8:30 a.m. on the second Tuesday following the date of service, and should said Tuesday be a legal holiday then upon the next Tuesday. G Ka`u Division, 95-5669 Mamalahoa Highway, Na`alehu, Hawai`i at 9:00 a.m. on the second Wednesday of the month depending on when you receive this Order. You must appear on the second Wednesday of the month if you are served with this Order prior to 72 hours before the second Wednesday of the month. Otherwise, you must appear on the following month's second Wednesday. If the second Wednesday is a legal holiday, you must appear on the second Wednesday of the following month. G South Kohala Division, 67-5187 Kamamalu St., Kamuela, Hawai`i at 1:00 p.m. on the second, fourth or fifth Thursday of the month following the date of service which is at least 72 hours prior to the court date and should said Thursday be a legal holiday then upon the next Thursday. G Hamakua Division, 45-3362 Mamane St., Honoka`a, Hawai`i at 8:30 a.m. on the first Thursday of the month depending on when you receive this Order. You must appear on the first Thursday of the month if you are served with this Order prior to 72 hours before the first Thursday of the month. Otherwise, you must appear on the following month's first Thursday. If the first Thursday is a legal holiday, you must appear on the first Thursday of the following month. G North Kohala Division, 54-3900 Kapa`au Road, Kapa`au, Hawai`i at 1:00 p.m. on the fourth Wednesday of the month depending on when you receive this Order. You must appear on the fourth Wednesday of the month if you are served with this Order prior to 72 hours before the fourth Wednesday of the month. Otherwise, you must appear on the following month's fourth Wednesday. If the fourth Wednesday is a legal holiday, you must appear on the fourth Wednesday of the following 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 for your disability, please contact the ADA Coordinator at PHONE NO. (808) 961-7424, FAX (808) 961-7411, or TTY (808) 961-7422 at least ten (10) working days in advance of your hearing appointment date. For Civil related matters, please call or visit the District Court Civil Section at Hilo Division, 777 Kilauea Avenue, Hilo, Ph. (808) 961-7515 · Kohala Division, 67-5187 Kamamalu St., Kamuela, Ph. (808) 443-2030 · Kona Division, 79-1020 Haukapila St., Kealakekua, Ph. (808) 322-8700. CommonLook® 508 Certified Reprographics (02/10) 3D Page 2 of 2 American LegalNet, Inc. www.FormsWorkFlow.com 3D-P-258