GF-148, 05/18 Commitment Order for Non-Payment of Fine/Forfeiture 247247345.47, 778.09, and 973.07, Wisconsin Statutes This form shall not be modified. It may be supplemented with additional material. STATE OF WISCONSIN, CIRCUIT COURT, COUNTY Case Caption: Commitment Order for Non - Payment of Fine/ Forfeiture Case No. Name of Person ( ) Sex Race Height Weight Eye Color Hair Color Other Identifying Characteristics To: Any law enforcement officer and to the jailor of County On [Date] , the above-named person was convicted and ordered to pay the following fine/forfeiture: Description Amount Amount Paid Balance Due Length Total Due: $ The balance due has not been paid within the period ordered by the court. IT IS ORDERED: Any law enforcement officer arrest and detain the above-named person in custody for days or until the amount due is paid, or until the person is discharged by due course of law. Amount Due: $ , The defendant has the right to request a court hearing if the defendant believes the defendant is indigent and cannot pay the amount due. DISTRIBUTION: 1. Court 2. Law Enforcement 3. Person/Attorney Geographic restriction: Statewide Nationwide Wi thin county of ORI Within adjacent counties of ORI Other: American LegalNet, Inc. www.FormsWorkFlow.com