ategory and type of offense listed below: tot only an) (Cheek only one) I 0 to 5 days —X-- Petty II 6 to 10 days Minor III 11 to 20 days Misdem. IV 21 to 60 days Felony V 61 days and over 6. Has this case been previously filed in this District Court? (Yes or No) No If yes: Judge C

priate category and type of offense listed below: (Check only one) (Check only one) I 0 to 5 days Petty II 6 to 10 days Minor III 11 to 20 days Misdem. IV 21 to 60 days X Felony X V 61 days and over 6. Has this case been previously filed in this District Court? (Yes or No) No If yes: Judge: C

ategory and type of offense listed below: (Ora only ono) (Chock only Ono) I 0 to 5 days _X_ Petty II 6 to 10 days Minor III 11 to 20 days Misdem. IV 21 to 60 days Felony V 61 days and over 6. Has this case been previously filed in this District Court? (Yes or No) No If yes: Judge C

priate category and type of offense listed below: (Check only one) (Check only one) I 0 to 5 days Petty II 6 to 10 days Minor III 11 to 20 days Misdem. IV 21 to 60 days X Felony V 61 days and over 6. Has this case been previously filed in this District Court? (Yes or No) No If yes: Judge: Case

tegory and type of offense listed below: (CheCk ONY On, / (Cho* only and I 0 to 5 days _X__ Petty II 6 to 10 days Minor III 11 to 20 days Misdem. IV 21 to 60 days Felony V 61 days and over 6. Has this case been previously filed in this District Court? (Yes or No) Mn If yes: Judge:

gory and type of offense listed below: (Chock tati orwol (Chock My one) I 0 to 5 days _X__ Petty II 6 to 10 days Minor III 11 to 20 days Misdem. IV 21 to 60 days Felony V 61 days and over 6. Has this case been previously filed in this District Court? (Yes or No) _No — If yes: Judge:

gory and type of offense listed below: (O+sck on•y Ono) (ChM* Only Ofol) I 0 to 5 days _X__ Petty II 6 to 10 days Minor III 11 to 20 days Misdem. IV 21 to 60 days Felony V 61 days and over 6. Has this case been previously filed in this District Court? (Yes or No) Sin_ If yes: Judge:

ategory and type of offense listed below (Chat; arty Ofill) Whstk Only cons) 0 to 5 days _X_ Petty II 8 to 10 days Minor III 11 to 20 days Misdem. 21 to 60 days Felony 61 days and over 6. Has this case been previously filed in this District Court? (Yes or No) -Igo_ If yes: Judge: Cas

te category and type of offense listed below puck onlf OM (the& atone) I 0 to 5 days __X___ Petty II 8 to 10 days Minor III 11 to 20 days Misdem. if 21 to 60 days 61 days and over Felony 6. Has this case been previously filed In this District Court? (Yes or No) Na ___ If yes: Judge:

ory and type of offense listed below. (Check odor 0001 (Check WI err( I 0 to 5 days ___X___ Petty II 6 to 10 days Minor III 11 to 20 days Misdem. Felony IV 21 to 60 days V 61 days and over 6. Has this case been previously filed in this District Court? (Yes or No) _No__ If yes: Judge:

category and type of.offense listed below: ion only enii - riain ereini I 0 to 5 days _X___ Petty II 6 to 10 days Minor III 11 to 20 days Misdem. IV 21 to 60 days Felony V 61 days and over 6. Has this case been previously filed in this District Court? (Yes or No) ..No- —. If yes: Jud