Docstoc

EG GRE WILLIS S IMINAL DI

Document Sample
EG GRE WILLIS S IMINAL DI Powered By Docstoc
					                                                       EG
                                                    GRE WILLIS  S
                                               IMINAL DI
                                             CRI               ATTORNEY
                                                       ISTRICT A      Y

                                        HLESS CH
                                    WORTH            FFIDAVIT
                                               HECK AF      T
                                                                 ollincountyda.co
                                                            www.co              om
                                                                                                         _______________
                                                                                              PID #: _____             __________
                                                                                              LETTER SE                __________
                                                                                                        ENT: ___________
             ned             a
The undersign affiant, who after being duly sw                   s
                                               worn by me, makes the following                          D:
                                                                                              DATE PAID _____________  __________
            nder oath. I have a good reason to be
statements un                                                     eve
                                                elieve and do belie that:                                :
                                                                                              RECEIPT #: ________________________
                                                                                                         :
                                                                                              REMARKS: ______________  __________
        ____________
_________                      ____________
                   _____________          __ ________ ___________ _           ________
                                                                   _________ __
        F
NAME OF PERSON WR   RITING CHECCK(S)          IDENTIFFICATION # STATE         DOB
                                                                              D
        ____________
_________                      ____________
                   _____________          _____________           _____________
                                                       ____________           _________
         VE         S/PHONE NUMB
IF YOU HAV AN ADDRESS                                   S            HE          ASE
                               BER DIFFERENT FROM WHAT IS LISTED ON TH CHECK, PLEA PRINT

             alled the accused, did commit the off
hereinafter ca                  d                                                    s                f                 following facts, as shown
                                                 fense of theft by passing a worthless check. My belief is based on the fo
by the approp                 d
             priately completed information as set out below, to-witt:

   ITEM      CHECK CE ERTIFIED MAIL   DATE                        AM
                                                                   MOUNT OF                       WAS
                                                                                        HOW CHECK W                     OF         O
                                                                                                                   NAME O PERSON WHO
          D           S
PURCHASED NUMBER SIGNED FOR          WRITTEN                        CHECK                 DISHONOREDD                 TOOOK CHECK
OR SERVICEE            Y
                       YES   NO                                                         NSF AC OTHHER
___________ _________
          _                       _________                      __________
                                                                  $_                                                  ________________
                                                                                                                  ________              ___

___________ _________
          _                                      _________       __________
                                                                  $_                                                   _______________
                                                                                                                   ________             _____

___________ _________
          _                                      _________       __________
                                                                  $_                                                   _______________
                                                                                                                   ________             _____

___________ __________
          _                                      _________        _
                                                                  $ __________                                         ________________
                                                                                                                    _______              _____

         B            FY         ER?___________ WAS CHECK A POST-DATED O HOLD CHECK
DID YOUR BUSINESS VERIF ID OF MAKE                                     OR         K?_________

        K           W            S?____________ HAS PARTIAL P
WAS CHECK DEPOSITED WITHIN 30 DAYS                                     N           ____________
                                                            PAYMENT BEEN MADE?______

         R                        EN         __________
HAS ALL OR PART OF THE PROPERTY BEE RETURNED?_

                     ERSON AT ______
CHECK WAS PASSED IN PE                           _______________
                                   _______________                           ______ IN COLLIN COUNTY.
                                                               _______________              N

          _______________
___________                            _______________
                        ________________                           ________________
                                                     _______________                            ___________
                                                                                 ________________
                        G
NAME OF PERSON TAKING CHECK                          A
                                                     ADDRESS                                   TE,
                                                                                      CITY, STAT ZIP

          _______________
___________                            _______________
                        ________________                           ________________
                                                     _______________                            ___________
                                                                                 ________________
PHONE #                               F
                               DATE OF BIRTH                                     UDE STATE)
                                                                       DL # (INCLU

             ar                  t                                                        f                 that
I hereby swea and affirm that the above information is true and correct to the best of my knowledge; th the above chec                          n
                                                                                                                               ck(s) was given in Collin
             as;                 (s)
County, Texa that said check( was not a post-dated or hold chec                           eck(s) was believe to have been goo when it was acc
                                                                       ck(s); that said che                ed                  od                cepted;
             ck(s) was presented to the bank for payment within 30 days after receipt that proper ident
that said chec                   d                 p                                      t;                                  uired on each check listed
                                                                                                            tification was requ                  k
                                 turn receipt reques has been sent for each check lis
above; that a certified notice ret                  sted                                                     re               as
                                                                                          sted above and mor than 10 days ha passed and restit   tution
has not been paid; that I person
              p                 nally received said check(s) or that by virtue of my emp
                                                                       y                                     he               ake                n
                                                                                         mployment I have th authority to ma this affidavit on behalf
             ;
of the holder; and that I underst                                      ant                 for             who
                                 tand that if charges are filed, a warra will be issued f the accused, w may be placed in jail.

             t                  c                 C
I understand that upon filing a check(s) with the Collin County Crim                    orney’s Office, tha organization ass
                                                                      minal District Atto                 at                sumes full control of the
                                es
matter and the check(s) become a part of the off                      e
                                                 ficial records of the Collin County Cr                  Attorney’s Office an will not be retu
                                                                                        riminal District A                   nd              urned to
             ant                                  s                  able
the complaina or the maker of the check, unless that office is una to prosecute th case.he

          _______________
___________                            _______________
                        ________________                           ________________
                                                     _______________                            ___________
                                                                                 ________________
         M
NAME OF MERCHANT                ADDRES SS                           ATE, ZIP
                                                            CITY, STA                         PHONE #

          _______________
___________                            _________
                        ________________                                           ________________
                                                                         ___________                            ___________
                                                                                                 ________________
PRINTED NAAME OF AFFIAN NT                                               AFFIANT’S S             ND
                                                                                    SIGNATURE AN TITLE

        ED                     E             ___         _______________
SUBSCRIBE AND SWORN TO BEFORE ME THIS_________ DAY OF ____                             __________
                                                                       ____________, 20_

         sion Expires_____
My Commiss                                                a                 of             _______________
                         _______________ Notary Public in and for the State o Texas_________             __________

Seal

				
DOCUMENT INFO
Shared By:
Categories:
Tags:
Stats:
views:12
posted:8/19/2011
language:Italian
pages:1
Description: State of Ar. Hot Check Affidavit document sample