DEPOSITION
Form CR-57 (back)
Rev.8/98
Any Law Enforcement Agency Contacted?
Yes
No
If yes, which one? ________________________________________________________________________________
I make this statement for the purpose of securing a WARRANT/SUMMONS against the named of accused. I understand that I am instituting a criminal
proceeding and cannot dismiss this case. I further understand that if any of the foregoing facts are untrue, I may, in addition to any other punishment
provided by law, be taxed with court costs in the proceeding.
Sworn to and Subscribed before me this
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__________________________ day of
Complainant
____________________, __________.
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Social Security Number
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Judge/Clerk/Magistrate
Address
WITNESSES
Name
Address
Telephone Number
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MAGISTRATE NOTES
Warrant or Summons issued?
Yes
No
Warrant Number: __________________________________________
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