en-USFile No. en-USIMPAIRED DRIVING - JUDGMENTen-USSUSPENDING SENTENCEen-US(For Offenses Committed Dec. 1, 2011 - Nov. 30, 2016) en-US COMMITMENT ON SPECIAL PROBATIONen-USG.S. 20-179en-US(en-USNOTE:en-US en-USThis form should be used for only one DWI conviction. Multiple convictions sentenceden-US en-USunder G.S. 20-179 may not be consolidated for judgment.)en-USName Of Defendant en-USRaceen-USSexen-USStateen-USDrivers License No.en-USDate Of Birthen-USCrt Rptr Initials en-USSTATE VERSUS en-USSTATE OF NORTH CAROLINAen-US en-USCounty en-US en-US en-US Seat of Court en-USIn The General Court Of Justice en-US District en-US Superior Court Division en-USAttorney For Stateen-USDate Of Offense en-US en-USDef. Found en-US Def. Waived � Not Indigent � Attorney � en-USAttorney For Defendant � Appointed � Retained en-USfor a minimum term ofen-USfor a maximum term ofen-US en-USOffense � en-US en-US en-USen-US en-USen-USen-USen-US en-US plea ( en-US pursuant to en-USAlforden-US en-US en-US en-USen-USen-US en-US en-USAggravated Level One.en-US en-US en-USLevel One.en-US en-US en-USLevel Two. en-US en-US en-USLevel Three.en-US en-US en-USLevel Four.en-US en-US en-USLevel Five.en-US en-US en-USen-US en-US months. en-USen-US en-US en-USSUSPENSION OF SENTENCE en-USSPECIAL PROBATION - G.S. 15A-1351 en-USen-US en-US. en-USen-US en-USen-US � en-US en-US � en-USNOTE:en-US en-USen-USen-USen-USen-US en-USREGULAR CONDITIONS OF PROBATION - G.S. 15A-1343(b) en-USNOTE: en-USen-USThe defendant shall:en-USen-USen-USen-US en-USen-USen-USen-US en-USen-USen-USen-US en-USFineen-USRestitution*en-USAttorney222s Feesen-USCommunity Service Feeen-USEHA Fee/CAM Feeen-USAppt Fee/Miscen-USTotal Amount Dueen-USCosts en-USen-US en-US en-US en-US � � en-US. en-USMONETARY CONDITIONS en-US$en-US$en-US$en-US$en-US$en-US$en-US$en-US$ � � en-US en en-US � � en-US en-US en-US days en-US � � en-US en-US en-US en-USen-US en-USDayen-USHour en-US en-US en-USen-US en-USDayen-USHouren-USDateen-USDateen-USand shall en-USremain in en-UScustody until: � � en-USen-US � � en-US en-US en-US days en-US months en-US hoursen-US � � 1. � in the custody of the Sheriff of this County. en-USen-US � � 2. � as an inpatient in en-US(name treatment facility)en-US en-US en-USen-US � en-USNOTE: en-USThis term shall NOT be reduced by good time, gain time, or parole, or, unless provided above, by jail or treatment time. en-USNOTE:en-US en-USen-US en-US �� en-US en-US en-US en-USOther: � en-US. American LegalNet, Inc. www.FormsWorkFlow.com en-US en-USen-USen-USen-USen-USen-USen-USen-USen-USen-USen-USen-US � � � � en-US � 17. � Complete en-US en-USen-US en-USen-US en-USen-US � en-US � en-US en-USen-US en-USen-US � � en-US en-US en-US en-USen-US � a. � en-US(offenses committed prior to December 1, 2012, only)en-USen-US � � en-US(offenses committed on or after December 1, 2012) en-USen-US en-US the defendant. en-US en-US en-USen-US en-USen-US en-US � � c. � en-US(Levels 1 and 2, only, for offenses committed on or after December 1, 2012)en-USen-US en-USen-US(maximum of 60)en-US en-US en-US � 19. � Other: en-USSPECIAL CONDITIONS OF PROBATION - G.S. 15A-1343(b1); 20-179 en-US[Check any that apply - G.S. 20-179(r)] � en-USen-US en-US en-USORDER OF COMMITMENT/APPEAL ENTRIES en-USSPECIAL ALCOHOL CONCENTRATION FINDING � � en-UStwoen-USen-USen-US � � en-US en-US � en-US.en-US en-USNOTE: en-USWithdrawal of appeal or remand to District Court requires that a new sentencing hearing be scheduled in District Court, unless certain conditions are en-USmet. G.S. 20-38.7(c). � � en-US � en-US Other: en-US en-US. en-USSIGNATURE OF JUDGE en-USCERTIFICATION en-USDateen-USName Of Presiding Judge (type or print)en-USSignature Of Presiding Judge en-USNOTE TO CLERK: en-USIf the defendant222s conviction is based on a violation of an offense involving impaired driving while the defendant222s drivers license is revoked en-USas a result of a prior impaired driving license revocation as defined in G.S. 20-28.2, report DWI Defendant Registration Stop to DMV using menu item #9 in STARS. en-USAlso report the defendant222s conviction to DMV in the usual manner. If there is a non-defendant vehicle owner, report registration stop to DMV using menu item #10 in en-USSTARS (unless the owner has been found to be an innocent owner). en-USen-USSignature Of Clerken-USDate � Deputy CSC � � en-USAsst. CSC � en-USClerk Of Superior Courten-USSEAL en-US � � � � en-US en-US � � � American LegalNet, Inc. www.FormsWorkFlow.com