Defendant(s) : ...................................................... File No. STATE OF NORTH CAROLINA In The General Court Of Justice District Court Division THE PEOPLE OF THE STATE OF NEW YORK County MAGISTRATE'S ORDER FOR FUGITIVE TO I, the undersigned, find that the defendant named above has been arrested without a warrant and the defendant's detention is justified because the crime named above is punishable by death or imprisonment for a term exceeding one year and there is probable cause to believe that on or about the date of offense shown and in the demanding state and county named above the crime named above was committed and the GREETINGS: named above has been charged with the commission of that crime and has fled from justice. defendant Crime(s) In Demanding State Date Of Offense WE COMMAND YOU, that all business and excuses being of aside, you and each of you attend before This Magistrate's Order is issued pursuant to Section 15A-734laidthe North Carolina General Statutes upon the Honorable at the Court information furnished under oath by the arresting officer(s) shown. A copy of this Order has been delivered , located at Countyto the defendant. of THE STATE OF NORTH CAROLINA VS. in room , on the day of , 20 , at o'clock in the noon, and at any recessed Name And Address Of Defendant or adjourned date, to testify and give evidence as a witness in this action on the part of the Name Of Demanding State And County Of Offense County Of Residence Telephone No. Race Date Of Birth Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a result of your failure to comply. Sex Social Security No. Age Drivers License No. & State Court in Witness, Honorable County, , one of the Justices of the day of , 20 Name Of Defendant's Employer Offense Code(s) (Attorney must sign above and type name below) Arrest Under G.S. 9901 15A-734 Date Of Arrest & Check Digit No. (As Shown On Fingerprint Card) Attorney(s) for Arresting Officer (Name, Department, Phone No.) Office and P.O. Address Date Issued Signature Magistrate AOC-CR-909M, Rev. 10/97 1997 Administrative Office of the Courts Location Of Court District Court Judge Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: Court Date Superior Court Judge Court Time AM PM American LegalNet, Inc. www.USCourtForms.com