STATE OF NORTH CAROLINA County Name Of Defendant Name And Address Of Witness File No. In The General Court Of Justice Superior Court Division STATE VERSUS CERTIFICATE FOR ATTENDANCE OF OUT-OF-STATE WITNESS G.S. 15A-813 Offense Social Security No. No. Of Days And Dates Presence Of Witness Required This cause was heard before the undersigned judge of the Superior Court of this County upon motion of the person named below for the issuance of a certificate under the authority of North Carolina General Statutes Section 15A-813 and as required under the laws of the state in which the witness resides. FINDINGS After hearing evidence, the Court finds the following facts: 1. The Superior Court of this County is a Court of record of the State of North Carolina. 2. This State has adopted the "Uniform Act to Secure Attendance of Witnesses from without a State in Criminal Proceedings" as set forth in North Carolina General Statutes Chapter 15A, Article 43. 3. The above-captioned case is a criminal proceeding in the Superior Court of this County in which the defendant is charged with the crime indicated above. 4. The witness, who is residing at the address and in the State referred to above, is a material and necessary witness in this case. 5. The presence of the witness will be required for the period set out above. 6. The State of North Carolina, pursuant to G.S. 15A-814, will grant the witness protection from arrest or service of process, civil or criminal, in connection with matters which arose before the witness's entrance in the State for the purpose of testifying in this case. 7. The State of North Carolina stands ready to tender to the witness the sum allowed by the laws of this State. 8. It is recommended that the witness be taken into immediate custody for the reasons set out below and delivered to an officer of this State in order to assure the witness's attendance in this State. ORDER It is ORDERED that: 1. This certificate, along with certified copies of the bill of indictment, be transmitted to the presiding judge of the Court named below. 2. This certificate shall constitute a request that summons be issued and served upon the witness at the address shown, or any other place as the witness may be found in that district, requiring the witness to appear and attend the trial of this case in the County and State on the dates indicated above and to remain there to testify as a witness. 3. The Clerk of Superior Court shall pay the witness the sum indicated below as expenses for travel, attendance, and lodging and meals. 4. The witness be taken into immediate custody and delivered to an officer of this State in order to assure the witness's attendance in this State. Reasons Witness Should Be Taken Into Immediate Custody Name Of Out-Of-State Court Amount To Be Paid For Attendance Amount To Be Paid For Travel $ Amount To Be Paid For Lodging And Meals $ $ Name And Title Of Person Making Motion Signature Of Presiding Judge Date SEAL Material opposite unmarked squares is to be disregarded as surplusage. Original-Foreign Court Copy-File AOC-CR-901M, Rev. 3/15 © 2015 Administrative Office of the Courts American LegalNet, Inc. www.FormsWorkFlow.com