Application For Criminal Warrant

ttttttttttttttttttttttt MAGISTRATE COURT OF FULTON COUNTY - APPLICATION FOR CRIMINAL WARRANT - r j rr . :-A INFORMATIONABOUTYOU ANDYOURCHILDOR CHILDREN 12 .10" COUNTY Your Name hone: Phone Your Where d Address YouWAC? Street What d~ Youdo. TO ILIVEIN County YourSocial Security Number: Childs Name Age Date of Birth This ChildLives With: 0 Me 0 OTHER: 0 Me 0 OTHER: O Me 0 OTHER: THE FATHERIMOTHER OFTHE CHILD OR CHILDRENIS: Homephone NAME ADDRESS Workphone Street Otherphone Zip 0 Work Day Monday thru Friday? Hours: - to City State 0 OtherWorkOsys OtherAddress Work Hours: Hours: to THIS PERSON LIVES IN COUNTY He/she NICKNAMES works for Race Sex Age Work address Beard? OYes 0No Moustache? OYes 0No Type of job HairColor? Scars? Carltrucklvan What Tag? 0 GA? Date of Or motorcycle kind? Birth Colorof . Sec. motor vehicle Year? Soc rr YOURRELATIONSHIPWITHTHE FATHERIMOTHER CHECKTHE BOX IF THE STATEMENT IS TRUE - CHECK AS MANY BOXES AS NECESSARY 0 I have NEVERbeen married to the fatherfmother O I am COMMON LAW married to thefatherfmother but separated. 0 I was COMMON LAW marriedto the fatherfmotherfrom to Tmoeth. year) Font , year 0 I am MARRIED to the fatherfmother, butseparated. 0 I was MARRIED to the fatherfmother from to Irnonin,yeah montn.year) 0 There IS a Court Ordertelling the father/motherto pay childsupport. Howmuch?S 0 There is NOT a CourtOrder tellingthe fatherfmother to pay childsupport. HOW THELAST TIME I RECEIVEDSUPPORT FROM THE FATHERIMOTHERWAS MUCH? $ Font year Are you(or is anyone else)now receivingTANF or other State money for the child(ren)? 0 Yes0 No Has a Court givencustodyor guardianshipof the children)to anyonebut you? 0 Yes0 No Is the fatherfmother payingany child support into court? 0 Yes0 No Haveyou ever BEFORE takenout an Abandonmentwarrant against thefatherfmother? 0 Yes0 No Haveyou ever BEFORE asked that an Abandonmentwarrant against the fatherlmother bedismissed? 0 Yes0 No I DOSOLEMNLY SWEAR (ORAFFIRM) THAT ALL THE INFORMATIONCONTAINEDIN THIS APPLICATION FOR A CRIMINAL WARRANT IS TRUE AND CORRECT. Sworn to and subscribedto before me Tours" naure this Day of Todaysdate Deputy Clerk American LegalNet, Inc. www.USCourtForms.com WHITE - WARRANT OFFICE CANARY - COMPLAINANT PINK - AGENCY 14-330-0401