Texas Court Forms For Juveniles Page 37

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CLERK’S AFFIDAVIT FOR CAPIAS PRO FINE: JNA
CAUSE NUMBER: _______________
STATE OF TEXAS
§
IN THE MUNICIPAL COURT
VS.
§
CITY OF __________________
___________________
§
__________COUNTY, TEXAS
I, ___________________, being duly sworn, upon oath, state that I have good reason to believe and do believe that on or
about the _____ day of _____________, 20___, _________________________________________, Defendant, defaulted in
payment of a fine and court costs. My belief is based upon the following:
I am the Municipal Court Clerk and custodian of the records for the Municipal Court, City of __________________________,
______________________________________ County, Texas. On __________________, 20___, I personally examined the official
records of this Municipal Court. The records indicate that the Defendant in the above styled and numbered cause was charged with the
offense
of__________________________________________________________________________________________________,
and was found guilty of the offense, on the _____ day of ______________, 20___. The judgment in the above styled case indicate
that the Defendant was ordered to make (a payment)(certain prescribed payments) on the fine and costs imposed on the following
date(s):
____________________________________________________________________________________________________________
___________________________________________________________________________________________________________ .
The official court record indicates that the Defendant did not appear on the _____ day of _______________, 20___ to make a
payment or to request an extension as ordered by the Court. The official court record shows that said Defendant owes
________________________________ dollars ($__________) in fine and court costs to satisfy the judgment.
At the time of default, Defendant, a child, was at least 10 years of age and younger than 17 years of age. As required by law, the Court
proceeded under Article 45.050, Code of Criminal Procedure, to compel the individual to discharge the judgment. According to court
records, the Defendant is of date 17 years of age or older.
______________________________
Affiant
Sworn to and subscribed before me on _____ day of _______________, 20___.
___________________________________
(Judge) (Clerk) (Deputy Clerk)
City of ____________________________
JUVENILES 08/13
TMCEC 2013 FORMS BOOK
229

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