Criminal Case Cover Sheet
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Criminal Case Cover Sheet Form. This is a New York form and can be use in District Court Federal.
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Tags: Criminal Case Cover Sheet, New York Federal, District Court
Criminal Case Cover Sheet
U.S. District Court
-
Northern District of New York
Please complete one Cover Sheet for each named defendant - Citation and Count Information is to
be recorded on Page 2.
Cover sheets are to be submitted to the Clerk at the time of filing - See Local Rule of Criminal
Procedure 57.1
Complaint
Information
Place of Offense:
County:
Indictment
Superseding
Related Case Information:
Magistrate Judge Case Number
Search Warrant Case Number (Misc. Number)
Rule 20/Rule 40 from District of
Superseding Indictment
Docket Number
Same Defendant
New Defendant
Is the Related Case Sealed?
order)
YES
NO (If related case is no longer sealed provide unsealing
Defendant Information:
Juvenile -
YES -
NO
If YES,
L - Please Include A Sealing Order (18 U.S.C. 5038)
Defendant Name
Alias Name
Address
Birth date:
SSN:
Sex:
Race:
Nationality US
Interpreter:
YES Location Status:
Arrest Date
NO
If YES,
[
[
List Language and/or Dialect:
] Already in Federal Custody as of
] Already in State Custody
[
L
in
] On Pretrial Release
Is the Accusatory Instrument to be Sealed?
Order
YES - NO
If YES,
L Provide Sealing
U. S. Attorney Information:
Assistant United States Attorney
Dated:
Bar #
Office:
SYRACUSE
CRIMINAL CASE COVER SHEET
Instructions:
a)
b)
c)
MATTER CITATION & COUNT FORM
US DISTRICT COURT - NDNY
List Title & Section (Index/Key Code) for each count
Please list only one (1)
count on each line.
Include a short description of the Title & Section.
List all named defendants associated with each count.
USA vs.
Case No.
* List all defendants associated with this count.
Title &
Section
Description of Offense
Citation Count Form Page
1
of
1
Count
Defendant(s)*
