IN THE DISTRICT COURT OF _______________ COUNTY, STATE OF OKLAHOMA CRIMINAL COVER SHEET STATE OF OKLAHOMA vs ____________________________________ CF__________ CM_________ JDL_________ JS __________ JT __________ JD __________ JDHT _______ JDLH _______ (Felony) (Misdemeanor) (Juvenile Delinquent) (Juvenile/Supervision) (Juvenile/Treatment) (Juvenile/Deprived) (Juvenile/Mental) (Juvenile/Show Cause) Defendant _______________________________________________________________________ DEFENDANT INFORMATION Last Name: ________________ First Name: _______________ Middle Name: __________ Address: _________________________________________________________________ City: ____________________ State: ___________________ ZIP: _________________ Address Type: __H ___W ____Other Phone: Home# _____________ Phone: Cell# ______________ Phone: Work# ________________ Email: _____________________ Date/Birth: _____________ Driver License #: _____________ Driver License State: ________ SS#/EIN#: _____________ Race: ____________________ Gender: ____M ____F Language/Dialect: ________ Additional Defendants: ___Y ___N Total Number of Defendants: ___ ________________________________________________________________________ ATTORNEY INFORMATION (If licensed in Oklahoma, fill in address information, only if it has changed since registering with the Oklahoma Bar Association.) (Attach additional cover sheets for additional attorneys.) Last Name: _________________ First Name: ________________ Middle Name: __________ Address: _________________________________________________________________ City: _____________________ State: ____________________ ZIP: _________________ Bar Number (Required): _________ Telephone: _________________ Email: ________________ ________________________________________________________________________ OFFENSES OKLA. STAT. NCIC COUNT(S) OFFENSES CHARGED CITATION CODE 1. 2. 3. 4. Signature: District Attorney/Defendant Attorney: _____________________________ 1 American LegalNet, Inc. www.FormsWorkFlow.com