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Application For Statement Of Charges For Bad Check DC-CR 44 - Maryland
| Application For Statement Of Charges For Bad Check Form. This is a Maryland form and can be used in Criminal District Court Statewide . |
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(City/County) DISTRICTCOURTOF MARYLANDFOR .................................................................................... LOCATEDAT(COURTADDRESS) RELATEDCASES: DISTRICTCOURT ............................................. CASENUMBER ............................................. ............................................. COMPLAINANT/APPLICANT DEFENDANT ...................................................................................................................................................................................... PrintedName PrintedName ...................................................................................................................................................................................... NumberandStreetAddress NumberandStreetAddress ...................................................................................................................................................................................... City,State,andZipCode Telephone City,State,andZipCode Telephone...........................................................................................CC#.................................................................................... Agency,Sub-agency,andI.D.# (OfficerOnly) DEFENDANTSDESCRIPTION:DriversLicense#................................................Sex......Race.............Ht................Wt......................Hair............Eyes..............Complexion....................Other......................................D.O.B......................ID.................................................. APPLICATIONFOR STATEMENTOF CHARGESFOR BAD CHECK I, the undersigned,applyfor a statementof chargesor warrantwhichmay leadto the arrestof the abovenamed Defendantbecauseon or about..........................................................at..................................................................................... Date Place ...............................................................................................................................................,the abovenamedDefendantdid unlawfullyobtain........................................................................havinga valueof $..........................................................from(fulllegalnameof businessor person):............................................................................................................................by utteringa certainbad check dated:................................................CheckNo:......................................................................ACCOUNTNO: ................................................................DrawnBy:......................................................................................on the (name/addressof bank):..................................................................................................................................................presentedto (fulllegalname of businessor person):........................................Payableto: .....................................................Said checkwas returnedfrombank marked:.................................................on (date)............................................................REGISTEREDLETTERSENT(Date): ...........................RETURNEDMARKED: .......... (Continuedon attached...........................................pages)(DC/CR44A) I solemnlyaffirmunderthe penaltiesof perjurythatthe contentsof this Applicationare trueto the best of my knowledge, informationand belief. ...................................................................................................................................................................................... Date OfficersSignature I have read or had read to me and I understandthe Noticeon the back of this form. ...................................................................................................................................................................................... Date ApplicantsSignature Subscribedand swornto beforeme this.....................day of.................................................................................,................ Month YearTime:.............................M Judge/Commissioner..................................................................................I.D....................... I understandthat a chargingdocumentwillbe issuedand thatI mustappearfor trialon.............................................. Date at............................................................,whennotifiedby the Clerk,at the courtlocationshownat the top of thisform. Time ........................................................................................... ApplicantsSignature I declinedto issuea chargingdocumentbecauseof lackof probablecause. ...................................................................................................................................................................................... Date Commissioner I.D.WitnessesNamesand Addresses: .................................................................................................................................................................................................... Name NumberandStreet/Agency/Sub-agency/I.D. City,State,Zip .................................................................................................................................................................................................... Name NumberandStreet/Agency/Sub-agency/I.D. City,State,Zip TRACKINGNUMBER DC/CR44 (Rev.10/2002) <<<<<<<<<********>>>>>>>>>>>>> 2 NOTICETO APPLICANTFOR A CHARGINGDOCUMENT You are makingan applicationfor a chargingdocumentwhichmay leadto the arrestand detentionof theindividualyou are charging.If, as a resultof your application,a chargingdocumentis issuedby the commissioner,it willnot be possiblefor the commissionerto withdrawthe document.The chargemay onlybe disposedof by trialor by actionof the StatesAttorney. You will be requiredto appearat the trialas a witness.Failureto appearon the date setby the courtcouldresultin your arrestfor failureto obeya courtorder. The applicationwhichyou are filingis beingfiledunderoath.CriminalLaw Article 9-503,of the AnnotatedCodeof Marylandprovidesthatany personwho makesa falsestatementor reportof a crimeor causessuch a falsereportor statementto be made to any officialor agencyof this State,knowingthe same,or any materialpartthere
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