COURT COUNTY . . . . . . . . . . . .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . : STATE OF NORTH CAROLINA : County STATE VERSUS Name Of Defendant Race Date Of Birth File No. Calendar No. General Court Of Justice In The District : Plaintiff(s) Superior Court Division JUDICIAL SUBPOENA PROSECUTOR'S REQUEST FOR TEMPORARY CUSTODY : OF DEFENDANT FOR TRIAL -againstSex Index No. : Social Security No. . Name Of Institution Where Confined : G.S. 15A-711(a) CHARGES PENDING FOR TRIAL Defendant(s) : . . File. No.. . . . . . . . .Offense(s). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. .. ...... THE PEOPLE OF THE STATE OF NEW YORK To The Custodian Of The Institution Named Above: TO The defendant named above is confined in your institution and his presence is required for the trial of the charge referred to above. The undersigned prosecutor requests that you temporarily release the defendant to the custody of the law enforcement agency named below so that the agency may produce the defendant for trial at the date, time and place GREETINGS: shown below. Under G.S. 15A-711(a) the request of the prosecutor is sufficient authorization for the release and must be honored. WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before Sheriff Of This County , the Honorable Court Law Enforcement Agency To Receive Temporary Custody: at the Other located at County of Court Date Court Time Location Of Court AM in room , on the day of ,PM 20 , at o'clock in the noon, and at any recessed or adjourned date, to testify and give evidence as a witness in this action on the part of the Date Of Request SWORN AND SUBSCRIBED TO BEFORE ME Date Signature Your failure to comply with this subpoena is punishable Or Print) Name (Type 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. Date Commission Expires Signature Of Person Authorized To Administer Oaths Title District Attorney RETURN OF SERVICE Witness, Honorable Court in County, day of , 20 I certify that this Prosecutor's Request was received and served as follows: Date Request Received Date Request Served On Custodian Name Of Person Served Date Def. Received From Custodian Assistant District Attorney , one of the Justices of the Date Of Return Of Service Signature Of Person Making sign above and type (Attorney must Return Of Service Date Def. Returned To Custodian Deputy Sheriff name below) Other Attorney(s) for NOTE TO PROSECUTOR: Give original and two copies to law enforcement agency. File third copy with the Clerk. Defendant is confined awaiting trial on charges pending in another prosecutorial district, give notice of this request to the defendant and to the prosecutor for that prosecutorial district. Office and copy to the defendant. Take defendant into NOTE TO LAW ENFORCEMENT OFFICER: Deliver the original to the custodian and aP.O. Address temporary custody, produce him for trial and after trial return him to custodian unless court directs otherwise. Complete Return of Service on copy and file with the Clerk. Keep second copy for your records. AOC-CR-900M, Rev. 10/96 1997 Administrative Office of the Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com