Approved, SCAOOriginal - Court1st copy - Defendant2nd copy - Prosecutor3rd copy - Sheriff/Facility 4th copy - þ Originating law enforcement þ agency (when applicable) 5th copy - LEIN (when applicable)STATE OF MICHIGANJUDICIAL DISTRICTJUDICIAL CIRCUIT PRETRIAL RELEASE ORDER þ AMENDED CONDITIONS þ AMENDED LEIN EXPIRATION DATECASE NO. Bound Over from District CourtDistrict Case No:ORICourt addressCourt telephone no.MI- Date of arrestType of offense Misdemeanor þ FelonyArresting agencyAgency file no. Offense(s) þ Statute/ordinance citation(s) Purpose of next appearanceTime of appearanceDate of appearance Place of appearance At the court address above þ Other: TYPE OF BOND: þ þ þ Personal recognizance þ Cash/Surety þ þ þ Cash/Surety/10% Cash þ þ Real property* þ *Proof of value and interest in real property is required.Full bail amount$Bond set by Judge/Magistrate þ The State of MichiganTHE PEOPLE OF en-US Juvenile þ In the matter of en-US en-USven-USDefendant222s name, address, and telephone no.en-USDate of birthen-USCTN/TCN 1. þ þ a. þ Release on personal recognizance shall be ordered as required by MCR 6.106(C). þ þ þ b. þ Release on personal recognizance will not reasonably ensure þ appearance. þ en-US public safety. þ 2. þ Under 18 USC 922(g)(8), the court found, at a hearing, that the defendant/juvenile represents a credible threat to the þ physical safety of one or more persons as defined in 18 USC 922(g)(8) and 18 USC 921(a)(32) and named in item 4q. þ þ en-US**Needed for NCIC.en-USIT IS ORDERED: 3. þ þ a. þ The defendant/juvenile shall post a new bond and comply with the terms and conditions in item 4. þ þ b. þ The bond previously ordered is continued, and the defendant/juvenile shall comply with the terms and conditions in item 4. 4. þ The defendant/juvenile shall comply with the following terms and conditions that are checked: þ þ a. þ Personally appear for any examination, arraignment, trial, sentencing, or at any time and place as directed by this court. þ If represented by an attorney in this case, any notice to appear may be given to the defendant222s attorney instead of the þ defendant. þ þ þ b. þ Abide by any judgment entered in this case and surrender to serve any sentence imposed. þ þ þ c. þ Do not leave the State of Michigan without the permission of this court. þ þ þ d. þ Do not commit any crime while released. þ þ e. þ Immediately notify this court, in writing, of any change of address or telephone number. þ þ f. þ Make reports to a court agency as specified by this court or the agency. þ þ g. þ Do not use alcohol or any other illegal controlled substance. þ þ h. þ Participate in a substance abuse testing or monitoring program. en-US(See additional page for more conditions) American LegalNet, Inc. www.FormsWorkFlow.com Case No. en-USIT IS ORDEREDen-US (continued): þ þ i. þ Participate in a specified treatment program for any physical or mental condition, including substance abuse. þ þ j. þ Comply with restrictions on personal association, place of residence, place of employment, or travel. þ þ k. þ Surrender driver222s license or passport. þ þ þ l. þ Continue to seek employment. þ þ þ m. þ Comply with the following curfew: en-US þ þ n. þ Continue or begin an educational program. þ þ þ o. þ Remain in the custody of a responsible member of the community. The community member agrees to monitor the þ þ defendant/juvenile and report any violation of these release conditions to the court. þ þ p. þ Do not possess or purchase a firearm or other dangerous weapon. þ þ q. þ Do not harass, intimidate, beat, molest, wound, stalk, threaten, or engage in other conduct that would place any of the þ following persons or a child of any of the following persons in reasonable fear of bodily injury: spouse, former spouse, þ individual with whom the defendant has a child in common, resident or former resident of the defendant222s household. en-US þ þ r. þ Do not assault, harass, intimidate, beat, molest, wound, or threaten the following person(s): þ þ en-USName(s) þ þ s. þ Do not have (or cause any third party to have) any direct or indirect contact with the following person(s): þ ( en-USNote:en-US This condition also applies while the defendant/juvenile is in custody.) þ en-USName(s) þ þ t. þ Do not enter the following specified premises or areas: þ en-USAddress or other location þ þ May go to the address once, accompanied by a peace officer, to remove personal belongings. þ þ u. þ Other: þ 5. þ The þ sheriff þ en-US en-USCustodial agency/Facilityen-US þ shall hold the defendant/juvenile named above in its care and custody until bond is posted and the terms and conditions þ þ specified in item 4 are acknowledged. The defendant/juvenile shall be brought to all court appearances while in custody þ or as otherwise ordered. The sheriff or director or designee of the custodial facility is authorized to obtain and consent to þ routine, nonsurgical medical and dental care for the juvenile and emergency medical, dental, and surgical treatment of the þ juvenile. þ 6. þ This order shall be entered into LEIN, is effective when signed, and expires on en-US en-US . þ en-US(en-USNote:en-US Check when release is subject to conditions necessary to protect 1 or more named persons under MCL 765.6b or for NCIC.) en-USHeighten-USWeighten-USRaceen-USSexen-USDate of birthen-USHair coloren-USEye coloren-USOther identifying information en-USDate þ Judge/Magistrate þ Bar no. American LegalNet, Inc. www.FormsWorkFlow.com Case No. en-USI acknowledge and understand the terms and conditions of my release from jail. If I fail to perform all the terms and conditions, en-USI may be subject to arrest without a warrant, jail, contempt of court, and new conditions of release. If my release is revoked and en-USa bond was posted, the full amount of my bond, regardless of who posted it, may be forfeited. If I am arrested for a violation of en-USthese terms and conditions in another state, I waive all extradition proceedings and will be immediately returned to this state.en-USNOTICE OF FIREARMS RESTRICTIONen-US: If item 4q is a condition of my release, federal and/or state law may prohibit me from en-USpossessing or purchasing ammunition or a firearm (including a rifle, pistol, or revolver). en-USDate þ en-USDefendant/Juvenile222s signatureen-USBond deposited by Defendant: en-USIf all the terms and conditions of pretrial release are met, the money deposited (bond) will be en-USused to pay any fine, state minimum costs, restitution, statutory assessments, and other costs imposed. Any balance will be en-USreturned to me as authorized by statute and court rule. en-USDate þ en-USDefendant222s signature Bond deposited by þ Third Party: þ Surety/Agent: þ en-USI understand and agree that if the defendant fails to appear,en-USthe money deposited (bond) may be forfeited and a judgment entered for the entire amount of the bond. If the defendant en-USappears as directed, the full amount of the bond will be returned to me unless I deposited a 10% cash bond. In that instance,en-USthe court will return only 90% of the bond to me. en-USDate þ en-USSignature of depositor/surety/agent and identification (i.e. DLN) þ þ en-USName of depositor/surety/agent (type or print) þ en-USAddress þ en-USCity, state, zip Telephone no.en-USNote: þ If a third party or surety posted bond for the defendant, the court clerk may provide the third party or surety with a copy en-USof the terms and conditions of release.en-USACKNOWLEDGMENT OF PRETRIAL RELEASE CONDITIONS en-USAcknowledgment of Pretrial Release Conditions American LegalNet, Inc. www.FormsWorkFlow.com