File No. Law Enforcement Case No. LID No. STATE OF NORTH CAROLINA CRIMINAL SUMMONS I. FAILURE TO RETURN RENTAL PROPERTY II. FAILURE TO RETURN RENTAL PROPERTY WITH WRITTEN PURCHASE OPTION County SID No. FBI No. In The General Court Of Justice District Court Division To the defendant: THE STATE OF NORTH CAROLINA VS. I, the undersigned, find that there is probable cause to believe that on or about the date of offense shown and in the county named above you unlawfully and willfully did Name And Address Of Defendant (charge only one offense) I. FAILURE TO RETURN RENTAL PROPERTY [G.S. 14-167] (NOTE: Charge when rental agreement does not contain written option to purchase. Do NOT use for felony offense of failing to return rental vehicle with value of more than $4,000.) fail to return the property described below to the possession of the person, firm and corporation named below, from whom you rented it, at the expiration of the time for which it was rented. County Of Residence Telephone No. Race Date Of Birth Sex Social Security No. Age Drivers License No. & State Name Of Defendant's Employer Offense Code(s) I. 2646 II. 2676 II. FAILURE TO RETURN RENTAL PROPERTY WITH WRITTEN PURCHASE OPTION [G.S. 14-168.4] fail to return the property described below that was rented pursuant to a written agreement in which there was an option to purchase the property, when an event, , occurred that terminated the agreement, with the intent to defeat the rights of the owner named below. Describe Rental Property Offense In Violation Of G.S. Name Of Person, Firm, Corporation Or Owner 14-167, 14-168.4 Date Of Offense Complainant (Name, Address Or Department) County Of Residence Telephone No. Names & Addresses Of Witnesses (Including Counties & Telephone Nos.) This act was in violation of the law referred to in this Criminal Summons. This Summons is issued upon information furnished under oath by the complainant listed. You are ORDERED to appear before the Court at the location, date and time indicated below to answer to the charge. If you fail to appear, an order for your arrest may be issued and you may be held in CONTEMPT OF COURT and imprisoned for up to thirty (30) days or fined up to $500.00 or both. This penalty for failure to appear is in addition to any sentence which may be imposed for the crime charged. Signature Date Issued Location Of Court Deputy CSC Assistant CSC AOC-CR-144, Rev. 2/06 (Structured Sentencing) © 2006 Administrative Office of the Courts Magistrate Clerk Of Superior Court (Over) Court Date Court Time AM PM American LegalNet, Inc. www.USCourtForms.com If this Criminal Summons is not served within ninety (90) days, it must be returned to the Clerk of Court in the county in which it was issued with the reason for the failure of service noted thereon. The officer must state all steps taken by the department in attempting to serve the Summons and any information obtained about the whereabouts of the defendant. RETURN OF SERVICE I certify that this Criminal Summons was received and served as follows: Date Received Date Served Date Returned By personally serving this Criminal Summons on the defendant. This Criminal Summons WAS NOT served for the following reason: District Attorney Waived Attorney For Defendant Appointed Retained Not Indigent PLEA: guilty guilty not guilty VERDICT: no contest no contest PRIOR CONVICTIONS: No./Level: 0 guilty guilty not guilty I (0) II (1-4) M.CL. M.CL. 1 1 2 2 3 3 JUDGMENT: The defendant appeared in open court and freely, voluntarily and understandingly entered the above plea; on the above . verdict it is ORDERED that the defendant: pay costs and a fine of $ be imprisoned for a term of days in the custody of the sheriff. DOC.* Pretrial credit days served. Work release is recommended. is not recommended. [ is ordered. (use form AOC-CR-602)] The Court finds that a longer shorter period of probation, than that which is specified in G.S. 15A-1343.2(d), is necessary. Execution of the sentence is suspended and the defendant is placed on unsupervised probation* for months, subject to the following conditions: (1) commit no criminal offense in any jurisdiction. (2) possess no firearm, explosive or other deadly weapon listed in G.S. 14-269. (3) remain gainfully and suitably employed or faithfully pursue a course of study or of vocational training, that will equip the defendant for suitable employment, and abide by all rules of the institution. (4) satisfy child support and family obligations, as required by the Court. (5) pay to the Clerk the costs of court and any additional sums shown below. Fine Restitution** Attorney's Fee Community Service Fee Other $ Signature Of Officer Making Return A1 A1 III (5+) $ $ $ $ **Name(s), address(es), amount(s) & social security number(s) of aggrieved party(ies) to receive restitution: Department Or Agency Of Officer REDELIVERY/REISSUANCE Date Signature Dep. CSC Assist. CSC CSC 6. complete hours of community service during the first service coordinator, and pay the fee prescribed by G.S. 143B-262.4(b) within 7. not be found in or on the premises of the complainant or 8. not assault, communicate with or be in the presence of the complainant or 9. Other: RETURN FOLLOWING REDELIVERY/REISSUANCE I certify that this Criminal Summons was received and served as follows: Date Received Date Served Date Returned days of probation, as directed by the community days. . . By personally serving this Criminal Summons on the defendant. This Criminal Summons WAS NOT served for the following reason: Signature Of Officer Making Return It is ORDERED that this: case be consolidated for judgment with sentence is to run at the expiration of the sentence in Department Or Agency Of Officer . . COMMITMENT: It is ORDERED that the Clerk deliver two certified copies of this Judgment and Commitment to the sheriff and that the sheriff cause the defendant to be retained in custody to serve the sentence imposed or until the defendant shall have complied with the conditions of release pending appeal. APPEAL ENTRIES The defendant, in open court, gives notice of appeal to the Superior Court. The current pretrial release order is modified as follows: Judgment is continued upon payment of costs. Date Name Of District Court Judge (Type Or Print) Signature Of District Court Judge CERTIFICATION I certify that this Judgment is a true and complete copy of the original which is on file in this case. Date Signature Of District Court Judge AOC-CR-144, Side Two, Rev. 2/06 (Structured Sentencing) © 2006 Administrative Office of the Courts Date Date Delivered To Sheriff Signature Deputy CSC Assist. CSC CSC *NOTE: If DWI, use AOC-CR-342 (active) or AOC-CR-310 (probation). If active sentence to DOC, use AOC-CR-602. If supervised probation, use AOC-CR-604. American LegalNet, Inc. www.USCourtForms.com