APPENDIX A. APPENDIX OF FORMS
Form
Form 1.Complaint
Form 2.Arrest Warrant and Return
Form 3.Summons
Form 4.Receipt for Property Taken from Defendant
Form 5.Order Holding the Defendant to Answer Criminal Charges in Circuit Court/Order of
Discharge of Defendant
Form 6.Order to Summon Grand Jury
Form 7.Information
Form 8.Indictment
Form 9.Warrant of Arrest after Indictment
Form 10.Summons Issued after Indictment
Form 11.Information for Habitual Offender
Form 12.Motion and Order Pertaining to Filing of Pretrial Motions & Setting a Trial Date
Form 13.Order for Psychiatric Exam
Form 14.Subpoena
Form 15.Subpoena to Produce Documents
Form 16.Consent to Transfer of Case for Plea & Sentence
Form 17.Affidavit for Change of Judge
Form 18.Judgment of Conviction (plea)
Form 19.Judgment of Conviction (trial) Judgment of Acquittal (trial)
Form 20.Defendant's Approval to Institute a Presentence Investigation before Conviction or Plea of
Guilty
Form 21.Defendant's Consent to the Court's Inspection of Presentence Report Prior to Plea of Guilty,
Nolo Contendere, or Finding of Guilt
Form 22.Defendant's Waiver of Preparation of Presentence Investigation and Report
Form 23.Order for Presentence Investigation
Form 24.Order Suspending Imposition of Sentence
Form 25.Judgment of Conviction and Order Suspending Sentence
Form 26.Order of Discharge from Probation Supervision
Form 27.Order of Dismissal and Discharge (Suspended Imposition of Sentence)
Form 28.Notice of Preliminary Hearing on Revocation of Probation
Form 29.Waiver of Preliminary Hearing on Revocation of Probation
Form 30.Summons
Form 31.Notice of Probation Revocation Hearing
Form 32.Warrant of Arrest
Form 33.Petition for Revocation of Probation
Form 34.Official Statement
Form 35.Affidavit in Support of Request for Search Warrant
Form 36.Search Warrant
Form 37.Search Warrant Issued Upon Oral Testimony Original
Form 38.Search Warrant Issued Upon Oral Testimony Duplicate Original
Form 39.Verified Inventory
Form 40.Application and Order for Court Appointed Counsel
Form 41.Application for Court Appointed Counsel Instructions
Form 42.Personal Recognizance Bond and Appearance Bond
Form 43.Waiver of Extradition Rights
Form 44.Order Specifying Methods and Conditions of Release
Form 45.Order Issuing a Bench Warrant
Form 46.Bench Warrant
Form 47.Dismissal of Complaint, Indictment, Information
Form 1. Complaint
(SDCL 23A-2-1, 23A-2-2)
STATE OF SOUTH DAKOTA ) IN CIRCUIT COURT
) ss. (MAGISTRATE DIVISION)
COUNTY OF __________ ) _______ JUDICIAL CIRCUIT
STATE OF SOUTH DAKOTA, )
Plaintiff, ) COMPLAINT FOR ________
v. ) VIOLATION OF
__________, ) (SDCL ________)
Defendant. )
The undersigned being duly sworn upon oath charges:
That on or about the ____ day of ____, 20__, in the County of ____, State of South Dakota, ____
did commit the public offense(s) of ____ (SDCL ____) in that (s)he did
____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
contrary to statute in such case made and provided against the peace and dignity of the State of South
Dakota.
That the complainant states that this Complaint is based upon ________________________
__________________________________________________________________________
(Incorporate any affidavits by reference).
Dated this ____ day of ____, 20__, at ____, South Dakota.
_______________________________________
Complainant
_______________________________________
(Official Title)
Subscribed and sworn to before me, a ____, on this ____ day of ____, 20__.
_______________________________________
(Magistrate)(Circuit Judge)(Notary)
REQUEST FOR (ARREST WARRANT)(SUMMONS)
____, the undersigned prosecuting attorney, hereby requests a(n) (Arrest Warrant)(Summons)
to be issued based upon the above Complaint.
_______________________________________
Prosecuting Attorney
Form 2. Arrest Warrant and Return
(SDCL 23A-2-4, 23A-2-10, 23A-2-12)
STATE OF SOUTH DAKOTA IN CIRCUIT COURT
ss. (MAGISTRATE DIVISION)
COUNTY OF ________ ________ JUDICIAL CIRCUIT
STATE OF SOUTH DAKOTA,
Plaintiff,
v. WARRANT OF ARREST
________,
Defendant.
TO ANY LAW ENFORCEMENT OFFICER OF THIS STATE:
Complaint upon oath having been this date laid before me that the crime(s) of ____ (SDCL
____), (____ count(s)), (has)(have) been committed and accusing ____ thereof;
You are therefore commanded forthwith to arrest the above-named ____ and bring (him)(her)
before me at the courtroom of the ____ County Magistrate Court, or in case of my absence or
inability to act, before the nearest or most accessible Magistrate.
Bond in the above matter shall be set in the sum of $____.
This Warrant of Arrest may be served: ____ (PLACE INITIALS IN APPROPRIATE BLANK)
___ At any time of the day or night.
___ Only during the daytime (8:01 a.m. to 7:59 p.m.).
Dated this ____ day of ____, 20__, at ____, South Dakota.
_______________________________________
(Magistrate)(Circuit Court Judge
STATE OF SOUTH DAKOTA
ss. RETURN
COUNTY OF ________
I hereby certify that a copy of the above Warrant was received by me on the ____ day of ____,
20__. I executed the same on the ____ day of ____, 20__, by delivering a copy to ____ at ____.
_______________________________________
Law Enforcement Officer
Form 3. Summons
(SDCL 23A-2-6)
STATE OF SOUTH DAKOTA IN CIRCUIT COURT
ss. (MAGISTRATE DIVISION)
COUNTY OF ________ ________ JUDICIAL CIRCUIT
STATE OF SOUTH DAKOTA,
Plaintiff,
v. SUMMONS
________,
Defendant.
TO: ______________________________
(Include address if known)
Complaint upon oath having been this date laid before me that the crime(s) of ____ (SDCL
____), (____ count(s)), (has)(have) been committed and accusing you thereof;
You are therefore hereby summoned to appear before me at the courtroom of the ____ County
Magistrate Court in the city of ____, State of South Dakota, on the ____ day of ____, at __.m., to
answer the Complaint that has been filed against you.
Bond in the above matter shall be set in the sum of $____.
If you fail to appear, a warrant will be issued for your arrest.
Dated this ____ day of ____, 20__, at ____, South Dakota.
_______________________________________
(Magistrate)(Circuit Judge)
STATE OF SOUTH DAKOTA
ss. RETURN
COUNTY OF ________
I hereby certify that a copy of the above Summons was received by me on the ____ day of ____,
20__. I executed the same on the ____ day of ____, 20__, by delivering a copy to ____ at ____.
_______________________________________
Law Enforcement Officer
This Summons was received by me on the ____ day of ____, 20__.
_______________________________________
Defendant
Form 4. Receipt for property taken from defendant
(SDCL 23A-3-8)
RECEIPT FOR PROPERTY TAKEN FROM DEFENDANT
Describe Fully
__________________________________________________________________________
SURNAME FIRST MIDDLE DATE A.M. ____ BOOKING NO.
P.M. ____
__________________________________________________________________________
ALIAS
__________________________________________________________________________
ADDRESS CITY STATE PHONE NO. SOC. SEC. OR GOV'T
SERIAL NUMBER
__________________________________________________________________________
BILLFOLD OR PURSE WATCH JEWELRY RINGS
__________________________________________________________________________
TIE PIN CUFF LINKS KNIFE PENS
__________________________________________________________________________
PAPERS TIE BELT KEYS
__________________________________________________________________________
WEAPONS SERIAL #S NCIC CHECK
____POS. ____NEG.
__________________________________________________________________________
WEAPONS SERIAL #S NCIC CHECK
____POS. ____NEG.
__________________________________________________________________________
CASH AND CURRENCY STATEMENT OTHER PROPERTY
BILLS TOTAL __________________
$100 ______________ ________ __________________
50 ______________ ________ __________________
20 ______________ ________ __________________
10 ______________ ________ __________________
5 ______________ ________ __________________
1 ______________ ________ __________________
SILVER ______________ ________ __________________
GRAND TOTAL $________ __________________
THE ABOVE DESCRIBED PROPERTY HAS BEEN TAKEN THIS DATE FROM THE ABOVE
NAMED DEFENDANT.
__________________________________________________________________________
SIGNATURE TITLE ____ A.M.
DATE/ / ____ P.M.
__________________________________________________________________________
I HEREBY ACKNOWLEDGE THAT I HAVE RECEIVED ALL PROPERTY LISTED ABOVE,
EXCEPT AS HEREINAFTER LISTED:
__________________________________________________________________________
__________________________________________________________________________
____ A.M.
SIGNATURE DATE/ / ____ P.M.
__________________________________________________________________________
1. Copy filed with Clerk of Courts
2. Copy given to the Defendant
Form 5. Order holding the defendant to answer criminal charges in circuit court/order of
discharge of defendant
(SDCL 23A-4-6, 23A-4-7)
STATE OF SOUTH DAKOTA IN CIRCUIT COURT
ss. (MAGISTRATE DIVISION)
COUNTY OF ________ ________ JUDICIAL CIRCUIT
STATE OF SOUTH DAKOTA, (ORDER HOLDING THE
Plaintiff, DEFENDANT TO ANSWER
v. CRIMINAL CHARGES IN
________, CIRCUIT COURT) (ORDER
Defendant. DISMISSING COMPLAINT)
A Preliminary Hearing was held before me on the ____ day of ____, 20__, at the ____ County
Courthouse, at ____, South Dakota. The State was represented by ____, as prosecuting attorney, and
the Defendant was present with his counsel, ____.
(PLACE INITIALS IN THE APPROPRIATE BLANK)
* * * * * * * * * * * * * * * *
____ It appearing to me from the evidence that there is probable cause to believe that (a) criminal
offense(s) (has)(have) been committed and that the Defendant committed the offense(s), it is
ORDERED, that the Defendant be held to answer in Circuit Court for the following offense(s):
Bond will (continue as previously ordered)(be in the amount of $____).
* * * * * * * * * * * * * * * *
____ It appearing to me that the evidence presented does not sustain probable cause that (a)
criminal offense(s) (has)(have) been committed and that the Defendant committed the offense(s),
it is, therefore,
ORDERED that the Defendant be discharged and the complaint dismissed and bond, if any, will
be refunded to the Defendant.
* * * * * * * * * * * * * * * *
Dated this ____ day of ____, 20__, at ____, South Dakota.
_______________________________________
(Magistrate)(Circuit Judge
ATTEST:
______________________________
Clerk of Court
Form 6. Order to summon grand jury
(SDCL 23A-5-1)
STATE OF SOUTH DAKOTA IN CIRCUIT COURT
COUNTY OF ________ ________ JUDICIAL CIRCUIT
IN THE MATTER OF THE ss
________, ORDER SUMMONING
COUNTY GRAND JURY GRAND JURY
It appearing to the satisfaction of the undersigned, that it is desirable to draw and summon a
Grand Jury within and for this County of the State of South Dakota for the investigation (of public
offenses within said county)(of misconduct in office) it is
ORDERED, that the Clerk of this Court draw and summon a Grand Jury within and for this
County of the State of South Dakota in the manner prescribed by the statutes of this State pertaining
thereto; and it is further
ORDERED, that said Grand Jury shall be summoned to attend at the sitting of this Court on the
____ day of ____, 20__, at the hour of __.m., then and there to be sworn and receive the charge of
this Court and to commence its duties.
Dated this ____ day of ____, 20__, at ____, South Dakota.
BY THE COURT:
_______________________________________
Circuit Court Judge
ATTEST:
______________________________
Clerk of Court
(SEAL)
Form 7. Information
(SDCL 23A-6-4, 23A-6-10, 23A-9-1)
STATE OF SOUTH DAKOTA IN CIRCUIT COURT
ss.
COUNTY OF ________ ________ JUDICIAL CIRCUIT
STATE OF SOUTH DAKOTA,
Plaintiff, INFORMATION FOR
v. ________
________, (SDCL ________)
Defendant.
____, as prosecuting attorney, in the name of and by the authority of the State of South Dakota,
makes and files this Information against ____, and charges as to:
COUNT I
That on or about the ____ day of ____, 20__, in the County of ____, State of South Dakota, ____
did commit the public offense of ____ (SDCL ____) in that ____ did __________, contrary to the
statute in such case made and provided against the peace and dignity of the State of South Dakota.
Dated this ____ day of ____, 20__, in ____, South Dakota.
_______________________________________
Prosecuting Attorney
STATE OF SOUTH DAKOTA
ss.
COUNTY OF ________
____, being first duly sworn, states that he is the prosecuting attorney for the above matter, that
he has read the foregoing Information, and the same is true to his own best knowledge, information
and belief.
_______________________________________
Prosecuting Attorney
Subscribed and sworn to before me this ____ day of ____, 20__.
_______________________________________
_______________________________________
Title
WITNESSES KNOWN TO THE PROSECUTING ATTORNEY AT THE TIME OF THE
FILING OF THIS INFORMATION:
WITNESSES WHO BECAME KNOWN TO THE PROSECUTING ATTORNEY AFTER THE
FILING OF THE INFORMATION AND ENDORSED WITH THE PERMISSION OF THE
COURT:
STATE OF SOUTH DAKOTA NOTICE OF DEMAND
ss.
COUNTY OF ________ FOR ALIBI DEFENSE
I, ____, prosecuting attorney in the above matter, hereby state that the alleged offense was
committed at ____ __.m. on the ____ day of ____, 20__, at ____, South Dakota. I hereby request
that Defendant or his attorney serve upon me a written notice of his intention to offer a defense of
alibi within ten days as provided in SDCL 23A-9-1. Failure to provide such notice of an alibi defense
may result in exclusion of any testimony pertaining to an alibi defense.
_______________________________________
Prosecuting Attorney
Form 8. Indictment
(SDCL 23A-5-18, 23A-6-4, 23A-6-26, 23A-9-1)
STATE OF SOUTH DAKOTA IN CIRCUIT COURT
ss.
COUNTY OF ________ ________ JUDICIAL CIRCUIT
STATE OF SOUTH DAKOTA,
Plaintiff,
v. INDICTMENT FOR ________
________, (SDCL ________)
Defendant.
THE ____ COUNTY GRAND JURY CHARGES:
COUNT I
That on or about the ____ day of ____, 20__, in the County of ____, State of South Dakota, ____
did commit the public offense of ____ (SDCL ____) in that ____ did __________, contrary to statute
in such case made and provided against the peace and dignity of the State of South Dakota.
Dated this ____ day of ____, 20__, at ____, South Dakota.
_______________________________________
"A TRUE BILL"
THIS INDICTMENT IS MADE WITH THE CONCURRENCE OF AT LEAST SIX GRAND
JURORS.
_______________________________________
Grand Jury Foreman
WITNESSES WHO TESTIFIED BEFORE THE GRAND JURY IN REGARD TO THIS
INDICTMENT:
STATE OF SOUTH DAKOTA REQUEST FOR (WARRANT)
ss.
COUNTY OF ________ (SUMMONS)
I, ________, prosecuting attorney in the above matter do hereby request a (Warrant) (Summons)
to be issued against the above Defendant(s).
Dated this ________ day of ________, 20____.
_______________________________________
Prosecuting Attorney
STATE OF SOUTH DAKOTA NOTICE OF DEMAND
ss.
COUNTY OF ________ FOR ALIBI DEFENSE
I, ____, prosecuting attorney in the above matter hereby state that the alleged offense was
committed at ____ __.m. on the ____ day of ____, 20__, at ____, South Dakota. I hereby request
that Defendant and his attorney serve upon me a written notice of his intention to offer a defense of
alibi within ten days as provided in SDCL 23A-9-1. Failure to provide such notice of an alibi defense
may result in exclusion of any testimony pertaining to an alibi defense.
_______________________________________
Prosecuting Attorney
Form 9. Warrant of arrest after indictment
(SDCL 23A-6-26, 23A-6-27)
STATE OF SOUTH DAKOTA IN CIRCUIT COURT
ss.
COUNTY OF ________ ________ JUDICIAL CIRCUIT
STATE OF SOUTH DAKOTA,
Plaintiff,
v. WARRANT OF ARREST
________, AFTER INDICTMENT
Defendant.
TO: ANY LAW ENFORCEMENT OFFICER IN SOUTH DAKOTA
An Indictment having been this day laid before me that the crime(s) of ____ (SDCL ____)
(has)(have) been committed and accusing ____ thereof;
You are therefore commanded forthwith to arrest the Defendant and bring (him)(her) before me
at the courthouse in the city of ____, State of South Dakota, or, in the case of my absence or inability
to act, before the nearest or most accessible Magistrate. This Warrant of Arrest may be served at any
time of the day or night.
The Defendant shall be admitted to bail in the amount of $____.
Dated this ____ day of ____, 20__, at ____, South Dakota.
BY THE COURT:
_______________________________________
Circuit Court Judge
ATTEST:
____________________________
Clerk of Court
(SEAL)
STATE OF SOUTH DAKOTA RETURN OF LAW
ss.
COUNTY OF ________ ENFORCEMENT OFFICER
I hereby certify that the above Warrant of Arrest came in my possession on the ____ day of ____,
20__. I executed the same on the ____ day of ____, 20__, by delivering a copy to ____ at ____.
_______________________________________
Law Enforcement Officer
Form 10. Summons issued after indictment
(SDCL 23A-6-26, 23A-6-28)
STATE OF SOUTH DAKOTA IN CIRCUIT COURT
ss.
COUNTY OF ________ ________ JUDICIAL CIRCUIT
STATE OF SOUTH DAKOTA,
Plaintiff,
v. SUMMONS ISSUED
________, AFTER INDICTMENT
Defendant.
On the ____ day of ____, 20__, an Indictment was filed with this Court charging you, ____, with
the crime(s) of ____ in violation of SDCL ____. You are hereby summoned to appear before the
Circuit Court of the ____ Judicial Circuit at the ____ County Courthouse in the city of ____, South
Dakota, on the ____ * day of ____, at ____ __.m., to answer the Indictment that has been filed
against you.
* This date must not be more than 10 days after the date of the Indictment.
Bond in the above matter shall be set in the sum of $____.
Dated this ____ day of ____, 20__, at ____, South Dakota.
_______________________________________
Circuit Court Judge
STATE OF SOUTH DAKOTA
ss. RETURN
COUNTY OF ________
I certify that the above Summons came into my possession on the ____ day of ____, 20__. I
executed the same on the ____ day of ____, 20__.
_______________________________________
Law Enforcement Office
STATE OF SOUTH DAKOTA
ss.
COUNTY OF ________
This Summons was received by me at ________ on the ________ day of ________, 20____.
_______________________________________
Defendant
Form 11. Information for habitual offender
(SDCL 23A-7-7, 22-7-7, 22-7-11)
STATE OF SOUTH DAKOTA IN CIRCUIT COURT
ss.
COUNTY OF ________ ________ JUDICIAL CIRCUIT
STATE OF SOUTH DAKOTA,
Plaintiff, PART II.
v. INFORMATION FOR
________ HABITUAL OFFENDER
Defendant. (SDCL 22-7-7)
____, as prosecuting attorney in the name of and by the authority of the State of South Dakota,
upon his oath informs this Court, that ____ is a Habitual Offender, as that term is defined by SDCL
22-7-7 in that ____ has on (a) prior occasion(s) been convicted of (a) felony(ies), said felony(ies)
being as follows:
(State time, place, court of adjudication, and specific crime with corresponding statute for each
felony)
contrary to the statute in such case made and provided against the peace and dignity of the State of
South Dakota.
Dated this ____ day of ____, 20__, at ____, South Dakota.
_______________________________________
Prosecuting Attorney
STATE OF SOUTH DAKOTA
COUNTY OF ________
I, ____ prosecuting attorney in the above case, being duly sworn upon oath depose and state that
I have read the foregoing Information (Part II) and the same is true to the best of my knowledge,
information and belief.
_______________________________________
Prosecuting Attorney
Subscribed and sworn to before me this ____ day of ____, 20__, at ____, South Dakota.
_______________________________________
_______________________________________
Title
WITNESSES KNOWN TO THE STATE AT THE TIME AND THE FILING OF THIS
INFORMATION:
WITNESSES KNOWN TO THE STATE AFTER THE FILING OF THE INFORMATION
AND ENDORSED WITH THE PERMISSION OF THE COURT:
ATTEST:
______________________________ Clerk of Court
(SEAL)
Form 12. Motion and order pertaining to filing of pretrial motions and setting a trial date
(SDCL 23A-8-4)
STATE OF SOUTH DAKOTA IN CIRCUIT COURT
ss.
COUNTY OF ________ ________ JUDICIAL CIRCUIT
STATE OF SOUTH DAKOTA, MOTION AND ORDER
Plaintiff, PERTAINING TO FILING
v. OF PRETRIAL MOTIONS
________, AND SETTING
Defendant. A TRIAL DATE
____, prosecuting attorney, in and for the State of South Dakota, respectfully moves this Court
to set a date certain for filing of pretrial motions and to schedule a trial date in the above matter.
Dated this ____ day of ____, 20__.
_______________________________________
Prosecuting Attorney
ORDER
Pursuant to the above motion and SDCL 23A-8-4, it is
ORDERED, that all pretrial motions in this case shall be filed on or before the ____ day of ____,
20__ with appropriate notice given to counsel as provided by the South Dakota Code of Criminal
Procedure. It is further
ORDERED that any pretrial motions filed will be heard on the ____ day of ____, 20__, at ____,
South Dakota at ____ __.m., or as soon thereafter as counsel may be heard. It is further
ORDERED, that the trial in this matter is to commence on the ____ day of ____, 20__, at ____
__.m., at the ____ County Courthouse, ____, South Dakota.
Dated this ____ day of ____, 20__.
_______________________________________
Circuit Court Judge
ATTEST:
______________________________ Clerk of Court
(SEAL)
Form 13. Order for psychiatric exam
(SDCL 23A-10-4)
STATE OF SOUTH DAKOTA IN CIRCUIT COURT
COUNTY OF ________ ________ JUDICIAL CIRCUIT
STATE OF SOUTH DAKOTA,
Plaintiff,
v. ORDER FOR PSYCHIATRIC
________ EXAMINATION
Defendant.
A motion has been made by ____, the prosecuting attorney in this case, requesting the Defendant
to submit to a psychiatric examination and the Defendant has entered a plea of not guilty and not
guilty by reason of mental illness to the charges against (him)(her). It is, therefore,
ORDERED, that the Defendant be committed to ____ at ____, South Dakota for examination
to determine the following:
1. Whether the Defendant has the present ability to understand the nature and purpose of the
proceedings taken against (him)(her) as to be able to conduct (his)(her) own defense in a rational
manner and to assist (his)(her) counsel in so doing;
2. Whether (assuming the commission of the acts charged for purposes of such examination) at
the time and place thereof the Defendant was capable of knowing the wrongfulness of that act.
IT IS FURTHER ORDERED that such determination be promptly communicated to me only.
It is further
ORDERED that the Sheriff of this County transport and convey said Defendant, ____, to ____
at ____, South Dakota and deliver (him)(her) into the custody of ____ or his representative and that
said Defendant remain in the custody of ____ until the examination is completed, at which time
(he)(she) will be returned to ____ by the Sheriff of this County. No statement made by an accused
in the course of any examination provided for by this section, whether the examination was with or
without the consent of the accused, shall be admitted in evidence against him on the issue of guilt
in any criminal proceeding except for impeachment purposes.
Dated this ____ day of ____, 20__.
BY THE COURT:
_______________________________________
Circuit Court Judge
ATTEST:
______________________________ Clerk of Court
(SEAL)
Form 14. Subpoena
(SDCL 23A-14-2)
STATE OF SOUTH DAKOTA IN CIRCUIT COURT
ss.
COUNTY OF ________ ________ JUDICIAL CIRCUIT
STATE OF SOUTH DAKOTA,
Plaintiff, v. SUBPOENA
________,
Defendant.
TO: ____________________________
(Name and Address)
You are commanded to appear before (____ County Grand Jury)(Magistrate ____)(Circuit Court
Judge ____) at the ____ County Courthouse, in ____, South Dakota, on the ____ day of ____, 20__,
at ____ __.m., as a witness in a criminal action prosecuted by the State of South Dakota.
Dated this ____ day of ____, 20__, at ____, South Dakota.
_______________________________________
Prosecuting Attorney
STATE OF SOUTH DAKOTA
RETURN
COUNTY OF ________
I, ____, do hereby certify that the above subpoena came into my possession on the ____ day of
____, 20__. I delivered the above subpoena to the above-named witness on the ____ day of ____,
20__.
Dated this ____ day of ____, 20__, at ____, South Dakota.
_______________________________________
Signature
Form 15. Subpoena to produce documents
(SDCL 23A-14-2)
STATE OF SOUTH DAKOTA IN CIRCUIT COURT
ss.
COUNTY OF ________ ________ JUDICIAL CIRCUIT
STATE OF SOUTH DAKOTA,
Plaintiff,
v. SUBPOENA TO PRODUCE
________, DOCUMENTS
Defendant.
TO: ____________________________
(Name and Address)
You are commanded to appear before (____ County Grand Jury)(Magistrate ____)(Circuit Court
Judge ____) at ____, in ____, South Dakota, on the ____ day of ____, 20__, at ____ __.m., to testify
and give evidence as a witness in the above-entitled criminal case.
You are required to bring with you and produce at the aforesaid time and place the following:
_________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
Dated this ____ day of ____, 20__, at ____, South Dakota.
_______________________________________
Prosecuting Attorney
STATE OF SOUTH DAKOTA
RETURN
COUNTY OF ________
I, ____, do hereby certify that the above subpoena came into my possession on the ____ day of
____, 20__. I delivered the above subpoena to the above-named witness on the ____ day of ____,
20__.
Dated this ____ day of ____, 20__, at ____, South Dakota.
_______________________________________
Signature
Form 16. Consent to transfer of case for plea and sentence
(SDCL 23A-17-1)
STATE OF SOUTH DAKOTA IN CIRCUIT COURT
ss.
COUNTY OF ________ ________ JUDICIAL CIRCUIT
STATE OF SOUTH DAKOTA,
Plaintiff,
v. CONSENT TO TRANSFER
________ OF CASE FOR
Defendant. PLEA AND SENTENCE
I, ____, Defendant have been informed that a(n) ____ (Indictment)(Information)(Complaint) is
pending against me in the above case in the County of ____. I wish to plead (guilty)(nolo contendere)
to the offense(s) charged and to consent to the disposition of the case in the County of ____ in which
I am (under arrest), (held) or (present) and to waive any trial in the above matter.
Dated this ____ day of ____, 20__, at ____, South Dakota.
_______________________________________
Defendant
_______________________________________
Counsel for Defendant
APPROVED
____________________________
____________________________
Prosecuting Attorney for the
Prosecuting Attorney for the
County of ________
County of ________
Form 17. Affidavit for change of judge
(SDCL 23A-21-1, 15-12-26)
STATE OF SOUTH DAKOTA IN CIRCUIT COURT
ss.
COUNTY OF ________ ________ JUDICIAL CIRCUIT
STATE OF SOUTH DAKOTA,
Plaintiff,
v. AFFIDAVIT FOR
________ CHANGE OF JUDGE
Defendant.
I, ____, Prosecuting Attorney in and for the County of ____, State of South Dakota, being duly
sworn upon oath state:
1. That this affidavit is being submitted for a change of judge pursuant to SDCL 15-12-26.
2. That this affidavit is being made in good faith for a change of judge and not for the purpose
of securing delay.
3. That in the ordinary course of litigation of this action or some issue(s) therein, I expect trial
to be had before the Honorable ____ who is sought to be disqualified.
4. That I have good reason to believe and do actually believe that the State of South Dakota
cannot have a fair and impartial trial before the Honorable ____.
Dated this ____ day of ____, 20__.
_______________________________________
Prosecuting Attorney
ATTEST:
____________________________
Clerk of Court
(SEAL)
Form 18. Judgment of conviction (plea)
(SDCL 23A-27-4, 23A-27-27)
(PLEA)
STATE OF SOUTH DAKOTA IN CIRCUIT COURT
ss.
COUNTY OF ________ ________ JUDICIAL CIRCUIT
STATE OF SOUTH DAKOTA
Plaintiff,
v. JUDGMENT OF CONVICTION
________,
Defendant.
An (Information)(Indictment) was filed with this Court on the ____ day of ____, 20__, charging
the Defendant with the crime(s) of ____ (SDCL ____). The Defendant was arraigned on said
(Information)(Indictment) on the ____ day of ____, 20__. The Defendant, the Defendant's attorney,
____, and ____, prosecuting attorney, appeared at the Defendant's arraignment. The Court advised
the Defendant of all constitutional and statutory rights pertaining to the charge(s) that had been filed
against the Defendant. The Defendant pled (guilty)(nolo contendere) to the charge(s) of ____ (SDCL
____).
It is the determination of this Court that the Defendant has been regularly held to answer for said
offense(s); that said plea was voluntary, knowing and intelligent; that the Defendant was represented
by competent counsel; and that a factual basis existed for the plea.
It is, therefore, the JUDGMENT of this Court that the Defendant is guilty of ____ in violation
of SDCL ____.
SENTENCE
On the ____ day of ____, 20__, the Court asked the Defendant if any legal cause existed to show
why Judgment should not be pronounced. There being no cause offered, the Court thereupon
pronounced the following sentence:
ORDERED that the Defendant ________________________________________________
__________________________________________________________________________
_________________________________________________________________________.
It is further
(PLACE INITIALS IN APPROPRIATE BLANK(S) IF ANY OF THE FOLLOWING ARE
DESIRED)
____ * ORDERED that the costs of prosecution shall be paid by the Defendant in the amount of
$____.
____ ** ORDERED that the execution of the sentence is stayed for an optional period of ____
days. At the conclusion of said period the Defendant will surrender to ____ at ____ __.m., at ____,
South Dakota.
Dated this ____ day of ____, 20__, at ____, South Dakota.
BY THE COURT:
_______________________________________
Circuit Court Judge
ATTEST:
____________________________
Clerk of Court
OPTIONAL
* The costs of prosecution may be included pursuant to SDCL 23A-27-26 and 23A-27-27.
** 23A-33-1 allows a stay of up to 30 days if the Defendant indicates a desire to appeal.
Form 19. Judgment of conviction (Trial)--Judgment of acquittal (Trial)
(SDCL 23A-27-4)
(TRIAL)
STATE OF SOUTH DAKOTA IN CIRCUIT COURT
ss.
COUNTY OF ________ ________ JUDICIAL CIRCUIT
STATE OF SOUTH DAKOTA,
Plaintiff, (JUDGMENT OF
v. CONVICTION)
________, (JUDGMENT OF
Defendant. ACQUITTAL)
An (Information)(Indictment) was filed in this Court on the ____ day of ____, 20__, charging
the Defendant with the crime(s) of ____(SDCL ____). The Defendant was arraigned on said
(Information)(Indictment) on the ____ day of ____, 20__. The Defendant, the Defendant's attorney,
____, and ____, prosecuting attorney, appeared at the Defendant's arraignment. The Court advised
the Defendant of all constitutional and statutory rights pertaining to the charge(s) against the
Defendant. The Defendant pled not guilty to the charge(s) in the (Information)(Indictment). The
Defendant requested a (jury)(court) trial on the charge(s) contained in the (Information)(Indictment).
A trial commenced on the ____ day of ____, 20__, in ____, South Dakota on the charge(s). On
the ____ day of ____, 20__, the ____ returned a verdict of:
___________________________________
___________________________________________________________________________________________________________________________________________________________.
It is, therefore,
ORDERED that a Judgment of (guilty) (acquittal) is entered as to the following:
__________________________________________________________________
_________________________________________________________________________.
SENTENCE *
On ____, 20__, the Court asked the Defendant whether any legal cause existed to show why
Judgment should not be pronounced. There being no cause offered, the Court thereupon pronounced
the following sentence:
ORDERED that the Defendant ________________________________________________
__________________________________________________________________________
_________________________________________________________________________.
It is further
(PLACE INITIALS IN APPROPRIATE BLANK(S) IF ANY OF THE FOLLOWING ARE
DESIRED)
____ ** ORDERED that the cost of prosecution shall be paid by the Defendant in the amount of
$____.
____ *** ORDERED that the execution of the sentence is stayed for an optional period of ____
days. At the conclusion of said period, the Defendant will surrender to ____ at ____ __.m., at ____,
South Dakota.
Dated this ____ day of ____, 20__, at ____, South Dakota.
BY THE COURT:
_______________________________________
Circuit Court Judge
ATTEST:
____________________________
Clerk of Court
* If a guilty verdict is returned, insert the following.
** The costs of prosecution may be included pursuant to SDCL 23A-27-26 and 23A-27-27.
*** 23A-33-1 allows a stay of up to 30 days if the Defendant indicates a desire to appeal.
Form 20. Defendant's approval to institute a presentence investigation before conviction or plea
of guilty
(SDCL 23A-27-5)
STATE OF SOUTH DAKOTA IN CIRCUIT COURT
ss.
COUNTY OF ________ ________ JUDICIAL CIRCUIT
STATE OF SOUTH DAKOTA, DEFENDANT'S APPROVAL
Plaintiff, TO INSTITUTE A
v. PRESENTENCE
________, INVESTIGATION
Defendant. BEFORE CONVICTION
OR PLEA
I, ____, hereby consent to a presentence investigation by the Court Services Officer of this
Circuit. This investigation is for the purpose of obtaining information useful to the Court in the event
that I should hereafter plead guilty or nolo contendere or be found guilty. By this consent, I do not
admit any guilt or waive any right. I understand that any report prepared can be shown to the Court
at any time before I have been found guilty only if I so agree in writing. Otherwise, I understand that
any report prepared will not be shown to anyone unless I have been found guilty or entered a plea
of nolo contendere or guilty.
I have read, or had read to me, the foregoing consent and fully understand it. No promise has
been made to me as to what final disposition will be made in my case.
Dated this ____ day of ____, 20__.
____________________________
_____________________________
Date
Signature of Defendant
____________________________
_____________________________
Date
Defendant's Attorney
ATTEST:
____________________________
Clerk of Court
Form 21. Defendant's consent to the court's inspection of presentence report prior to plea of
guilty, nolo contendere, or finding of guilt
(SDCL 23A-27-5)
STATE OF SOUTH DAKOTA IN CIRCUIT COURT
ss.
COUNTY OF ________ ________ JUDICIAL CIRCUIT
STATE OF SOUTH DAKOTA, DEFENDANT'S CONSENT TO
Plaintiff, THE COURT'S INSPECTION
v. OF PRESENTENCE REPORT
________, PRIOR TO PLEA OF GUILTY,
Defendant. NOLO CONTENDERE, OR
FINDING OF GUILT
I, ____, hereby consent to review of my presentence report by a judge at any time, including the
time prior to entry of a plea of guilty or nolo contendere or a finding of guilt.
I have read, or had read to me, the foregoing consent and fully understand it. No promise has
been made to me as to what the final disposition of my case will be.
____________________________
_____________________________
Date
Signature of Defendant
____________________________
_____________________________
Date
Defendant's Attorney
ATTEST:
____________________________
Clerk of Court
Form 22. Defendant's waiver of preparation of presentence investigation and report
(SDCL 23A-27-5)
STATE OF SOUTH DAKOTA IN CIRCUIT COURT
ss.
COUNTY OF ________ ________ JUDICIAL CIRCUIT
STATE OF SOUTH DAKOTA DEFENDANT'S WAIVER
Plaintiff, OF PREPARATION
v. OF PRESENTENCE
________, INVESTIGATION
Defendant. AND REPORT
I, ____, hereby waive my right to have a Court Services Officer of the Circuit Court of South
Dakota conduct a presentence investigation for presentation to the sentencing court. This
investigation and report which I now forego is for the purpose of obtaining information useful to the
Court in setting sentence.
I have read, or had read to me, and fully understand the preceding waiver form.
____________________________
_____________________________
Date
Signature of Defendant
____________________________
_____________________________
Date
Defendant's Attorney
ATTEST:
____________________________
Clerk of Court
Form 23. Order for presentence investigation
(SDCL 23A-27-5, 23A-7-9)
STATE OF SOUTH DAKOTA IN CIRCUIT COURT
ss.
COUNTY OF ________ ________ JUDICIAL CIRCUIT
STATE OF SOUTH DAKOTA,
Plaintiff, ORDER FOR
v. PRESENTENCE
________, INVESTIGATION
Defendant.
The Defendant having (entered a plea of guilty) (a verdict of guilty rendered against (him) (her))
(indicated a desire to enter a plea of guilty) for the offense(s) of __________________
__________________________________________________________________________
__________________________________________________________________________
and the Court desiring a presentence investigation (and the Defendant consenting thereto) it is,
therefore,
ORDERED that the Court Services Department of this Judicial Circuit Court submit a
presentence investigation report regarding said Defendant to this Court, and it is further
ORDERED that the (sentencing)(arraignment) of said Defendant be postponed pending receipt
of such report by the Court. The time of (sentencing)(arraignment) is set for the ____ day of ____,
20__, at ____ __.m., at the courtroom of this Court at ____, South Dakota.
Dated this ____ day of ____, 20__.
BY THE COURT:
_______________________________________
Circuit Court Judge
ATTEST:
____________________________
Clerk of Court
Form 24. Order suspending imposition of sentence
(SDCL 23A-27-13)
STATE OF SOUTH DAKOTA IN CIRCUIT COURT
ss.
COUNTY OF ________ ________ JUDICIAL CIRCUIT
STATE OF SOUTH DAKOTA
Plaintiff,
v. ORDER SUSPENDING
________, IMPOSITION OF SENTENCE
Defendant.
An (Information)(Indictment) was filed in this Court on the ____ day of ____, 20__, charging
the Defendant with the crime(s) of ____(SDCL ____). The Defendant was arraigned on said
(Information)(Indictment) on the ____ day of ____, 20__. The Defendant, the Defendant's attorney,
____, and ____, the prosecuting attorney appeared at the Defendant's arraignment. The Court advised
the Defendant of (his)(her) constitutional and statutory rights pertaining to the charges that had been
filed against the Defendant. The Defendant pled (guilty)(not guilty) to the charge(s) of ____
(SDCL____).
(PLACE INITIALS IN APPROPRIATE BLANK)
____ It is the determination of this Court that the Defendant has been regularly held to answer
for said offense(s); that said plea was voluntary, knowing and intelligent; that the Defendant was
represented by competent counsel; and that a factual basis existed for the plea.
____On the ____ day of ____, 20__, a verdict of guilty was returned as to the charge(s) of
____(SDCL ____).
Upon this ____ day of ____, 20__, the Court being satisfied that the ends of justice and the best
interests of the public as well as the Defendant will be served thereby and the Court receiving a
(plea)(verdict) of guilty to a crime that is not punishable by life imprisonment and the Defendant
never before having been convicted of a crime which would constitute a felony in this state, this
Court exercises its judicial clemency under SDCL 23A-27-13 and with the consent of the Defendant
suspends the imposition of the sentence upon the Defendant. It is, therefore,
ORDERED, that the imposition of sentence is suspended pursuant to SDCL 23A-27-13 and the
Defendant is placed on probation for a period of ____, upon the following terms and conditions:
(1) That the Defendant shall be placed under the supervision of the Chief Court Service
Officer of this Judicial Circuit, or his representative thereof, for a period of ____.
(2) That the Defendant obey all of the conditions placed upon him by the Court Service
Officer (said conditions to be attached and incorporated by reference with this Order and
to be signed by the Defendant).
(3) Additional provisions: ____________________________________________________
__________________________________________________________________________
_________________________________________________________________________.
It is further
ORDERED that the Court expressly reserves control and jurisdiction over the Defendant for the
period of sentence imposed and that this Court may revoke the suspension at any time and reinstate
the sentence without diminishment or credit for any of the time that the Defendant was on probation.
It is further
ORDERED, that the Court reserves the right to amend any or all of the terms of this Order at any
time.
Dated this ____ day of ____, 20__, at ____, South Dakota.
BY THE COURT:
_______________________________________
Circuit Court Judge
ATTEST:
____________________________
Clerk of Court
The undersigned hereby admits service of the above Order and acknowledges receiving a copy
of the conditions of probation and further consents to all conditions and terms set out therein.
Dated this ____ day of ____, 20__.
Dated this ________ day of ________, 20____.
_______________________________________
Defendant
_______________________________________
Defendant's Attorney
Form 25. Judgment of conviction and order suspending sentence
(SDCL 23A-27-18)
STATE OF SOUTH DAKOTA IN CIRCUIT COURT
ss.
COUNTY OF ________ ________ JUDICIAL CIRCUIT
STATE OF SOUTH DAKOTA,
Plaintiff, JUDGMENT OF CONVICTION
v. AND ORDER SUSPENDING
________, SENTENCE
Defendant.
An (Information)(Indictment) was filed in this Court on the ____ day of ____, 20__. The
Defendant was arraigned on said (Information)(Indictment) on the ____ day of ____, 20__. The
Defendant, and the Defendant's attorney, ____, and ____, prosecuting attorney, appeared at the
Defendant's arraignment. The Court advised the Defendant of (his)(her) constitutional and statutory
rights pertaining to the charges filed against the Defendant.
(PLACE INITIALS IN APPROPRIATE BLANK)
____The Defendant pled not guilty to the offense(s) of ____ (SDCL ____).
____The Defendant plead (guilty)(nolo contendere) to the offense(s) of ____ (SDCL ____).
____The Defendant was found guilty by verdict of the offense(s) of ____ (SDCL ____ on the
____ day of ____, 20__).
____It was the determination of this Court that the Defendant has been regularly held to answer
for said offense(s); that the plea was voluntary, knowing, and intelligent; that the Defendant was
represented by competent counsel, and that a factual basis exists for the plea.
It is, therefore the
JUDGMENT of this Court that the Defendant is guilty of ____ in violation of SDCL ____.
SENTENCE
On the ____ day of ____, 20__, the Court asked whether any legal cause existed to show why
sentence should not be pronounced. There being no cause offered, the Court thereupon pronounced
the following sentence:
ORDERED, that the Defendant, __________ __________ __________.
It is further
ORDERED that the above sentence be suspended for a period of _____ and Defendant is placed
on probation on the following conditions: __________ __________ __________.
It is further
ORDERED that the Court expressly reserves control and jurisdiction over the Defendant for the
period of sentence imposed and that this Court may revoke the suspension any time and reinstate the
sentence without diminishment or credit for any of the time that the Defendant was on probation. It
is further
ORDERED, that the Court reserves the right to amend any or all of the terms of this Order at any
time.
Dated this ____ day of ____, 20__, at ____, South Dakota.
BY THE COURT:
_______________________________________
Circuit Court Judge
ATTEST:
____________________________
Clerk of Court
(SEAL)
The undersigned admits receiving a copy of the above and consents to all conditions as set forth
above and agrees to obey all conditions.
Dated this ____ day of ____, 20__.
_______________________________________
Form 26. Order of discharge from probation supervision
(SDCL 23A-27-14)
STATE OF SOUTH DAKOTA IN CIRCUIT COURT
ss.
COUNTY OF ________ ________ JUDICIAL CIRCUIT
STATE OF SOUTH DAKOTA,
Plaintiff, ORDER OF
v. DISCHARGE FROM
________, SUPERVISED PROBATION
Defendant.
It appearing to the Court that the Defendant has complied with the terms and conditions of
probation it is, therefore,
ORDERED that the Defendant be and hereby is, released from supervised probation on the
condition that (he) (she), abide by all federal and State laws, and municipal ordinances, (and further
condition that (he) (she)) ________________________________________________
__________________________________________________________________________
_________________________________________________________________________.
Dated this ________ day of ________, 20____.
BY THE COURT:
_______________________________________
Circuit Court Judge
ATTEST:
____________________________
Clerk of Court
Form 27. Order of dismissal and discharge (Suspended imposition of sentence)
(SDCL 23A-27-14)
STATE OF SOUTH DAKOTA IN CIRCUIT COURT
ss.
COUNTY OF ________ ________ JUDICIAL CIRCUIT
STATE OF SOUTH DAKOTA,
Plaintiff, ORDER OF DISMISSAL
v. AND DISCHARGE
________, OF SUSPENDED
Defendant. IMPOSITION OF SENTENCE
The Defendant (pled guilty)(was found guilty by verdict) on the ____ day of ____, 20__, of the
offense(s) of ____ (SDCL ____). This Court suspended the imposition of sentence and placed the
Defendant on probation on the ____ day of ____, 20__, pursuant to SDCL 23A-27-13. It appearing
to the Court upon proper showing that the Defendant has observed all the conditions of probation
imposed by the Court, it is
ORDERED that the above-entitled action be and is hereby dismissed and the Defendant
discharged. It is further
ORDERED that all official records in this action be sealed along with all recordation relating to
the Defendant's arrest, indictment or information, trial, and dismissal and discharge. It is further
ORDERED that a non-public copy of this Order be forwarded to the South Dakota Division of
Criminal Investigation, Office of the Attorney General, Pierre, South Dakota. It is further
ORDERED that the fingerprinting contributor request from the Federal Bureau of Investigation,
the return to the contributor all fingerprint identifying data submitted to the Federal Bureau of
Investigation for purposes of disqualifications or disabilities imposed by law for convictions of a
crime.
Dated this ____ day of ____, 20__, at ____, South Dakota.
BY THE COURT:
_______________________________________
Circuit Court Judge
ATTEST:
____________________________
Clerk
By:________________________
Deputy
COPIES TO:
1-Defendant 1-Certified-DCI
1-Sheriff/Police
Department
1-State's Attorney
Form 28. Notice of preliminary hearing on revocation of probation
STATE OF SOUTH DAKOTA IN CIRCUIT COURT
ss.
COUNTY OF ________ ________ JUDICIAL CIRCUIT
STATE OF SOUTH DAKOTA,
Plaintiff, NOTICE OF PRELIMINARY
v. HEARING ON REVOCATION
________, OF PROBATION
Defendant.
TO: ____, DEFENDANT, PLEASE TAKE NOTICE:
That a hearing will be held before the ____ at ____, South Dakota, commencing at ____, __.m.
on the ____ day of ____, 20__, to determine whether there is probable cause to revoke your
probation. Copies of the Order placing you on probation and the petition for revocation of your
probation are attached hereto and made a part hereof.
You are accused of having violated the terms and conditions of your probation by:
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
You have the following rights:
1. To be present at such hearing and to speak on your own behalf;
2. To be present when witnesses testify against you and to cross-examine them;
3. To require that persons who have given adverse information on which this probation
revocation proceeding is based be made available for questioning in your presence, unless the
hearing officer determines that a particular informant would be subjected to risk of harm if his
identity were disclosed;
4. To present any relevant evidence you may have in the form of letters, affidavits, documents
and other writings; and
5. To compel persons to attend the hearing and to testify and produce evidence in your behalf.
The inquiry at the hearing will be directed to the question of whether there is probable cause to
believe that you did in fact violate any of the terms and conditions of your probation.
If, at the conclusion of the hearing, the hearing officer determines that there is probable cause
to believe that you have violated any of the terms and conditions of your probation, or, in the event
that you should waive your right to such a preliminary hearing, a final hearing on revocation will be
held to determine whether your probation should be revoked. Otherwise, these revocation
proceedings will be dismissed and you will continue on your probation.
Dated at ____, South Dakota, this ____ day of ____, 20__.
_______________________________________
Hearing Officer
ADMISSION OF SERVICE
Receipt of a true copy of the above and foregoing Notice of Preliminary Hearing on Revocation
of Probation is hereby acknowledged at ____ this ____ day of ____, 20__.
_______________________________________
Defendant
Witness:
____________________________
Form 29. Waiver of preliminary hearing on revocation of probation
STATE OF SOUTH DAKOTA IN CIRCUIT COURT
ss.
COUNTY OF ________ ________ JUDICIAL CIRCUIT
STATE OF SOUTH DAKOTA,
Plaintiff, WAIVER OF PRELIMINARY
v. HEARING ON REVOCATION
________, OF PROBATION
Defendant.
I, ____, the above-named Defendant, have been fully advised of my right to have a preliminary
hearing to determine whether there is probable cause to believe that I have violated the terms and
conditions of my probation as alleged in the attached Petition for Revocation of Probation of which
I have been furnished a true copy; and of my rights to appear at such a hearing and speak on my own
behalf, to require persons who have given adverse information on which said petition is based to be
made available (unless the hearing officer determines that a particular informant would be subjected
to risk of harm if his identity were disclosed), to be present when witnesses testify against me and
to cross-examine them, to present relevant evidence in the form of letters, affidavits, documents and
other writings, and to compel persons to attend the hearing to and testify and produce evidence in
my behalf.
With a full understanding of these rights and not acting under any threat, fear, coercion or
promise and acting of my own free will, I hereby waive my right to a preliminary hearing on
revocation of my probation and request that I be taken before the Honorable ____, Judge at ____ for
a final hearing on the attached Petition for Revocation of Probation.
Dated at ____, South Dakota, this ____ day of ____, 20__.
_______________________________________
Defendant
Witness:
____________________________
Form 30. Summons
SUMMONS
STATE OF SOUTH DAKOTA IN CIRCUIT COURT
ss.
COUNTY OF ________ ________ JUDICIAL CIRCUIT
STATE OF SOUTH DAKOTA,
Plaintiff,
v. SUMMONS
________,
Defendant.
THE STATE OF SOUTH DAKOTA TO THE ABOVE NAMED DEFENDANT:
You are hereby summoned and ordered to appear before the Honorable ____, Circuit Judge, at
the ____ County Courthouse at ____, South Dakota, at the hour of ____ p.m. on the ____ day of
____, 20__, pursuant to the attached Notice of Probation Revocation Hearing, to answer the charges
of probation violations as set forth in the attached Petition for Revocation of Probation.
Dated this ____ day of ____, 20__.
_______________________________________
Circuit Judge
ADMISSION OF SERVICE
Receipt of a true copy of the above and foregoing Summons is hereby acknowledged at ____,
this ____ day of ____, 20__.
_______________________________________
Defendant
Witness:
____________________________
Form 31. Notice of probation revocation hearing
NOTICE OF PROBATION REVOCATION HEARING
STATE OF SOUTH DAKOTA IN CIRCUIT COURT
ss.
COUNTY OF ________ ________ JUDICIAL CIRCUIT
STATE OF SOUTH DAKOTA,
Plaintiff,
v. NOTICE OF PROBATION
________, REVOCATION HEARING
Defendant.
TO: ____, DEFENDANT, PLEASE TAKE NOTICE:
That a hearing will be held before the Honorable ____, at the ____, in ____, South Dakota,
commencing at ____, __.m. on the ____ day of ____, 20__, to determine whether your probation
should be revoked and sentence imposed for your conviction of the crime of ____.
You are accused of having violated the terms and conditions of your probation as set forth in the
attached Petition for Revocation of Probation.
You have the right to be present at such hearing and to defend in person and by counsel. If you
do not have the financial means with which to hire an attorney of your choice and desire the
assistance of an attorney, one will be appointed by the Court to represent you at public expense.
However, if counsel is appointed for you, the fees and expenses paid by the county to such an
attorney on behalf will become a lien against your property as provided by South Dakota Code of
Criminal Procedure.
In addition you also have the following rights:
1. To be present when witnesses testify against you and to cross-examine them;
2. To require that persons who have given adverse information on which this probation
revocation inquiry is based be made available for questioning in your presence, unless the judge
determines that a particular informant would be subjected to risk of harm if his identity were
disclosed;
3. To present any relevant evidence you may have in the form of letters, affidavits, documents
and other writings;
4. To compel persons to attend the hearing and to testify and produce evidence in your behalf.
The inquiry at the hearing will be directed to the questions of whether you did in fact violate any
of the terms and conditions of your probation, and, if so, whether your probation should be revoked.
If it is decided that you have violated your probation, either you will be continued on probation
on the same or modified terms and conditions or your probation will be revoked and sentence
imposed.
Dated at ____, South Dakota, this ____ day of ____, 20__.
_______________________________________
Judge
ADMISSION OF SERVICE
Receipt of a true copy of the above and foregoing Notice of Probation Revocation Hearing is
hereby acknowledged at ____, South Dakota, this ____ day of ____, 20__.
____________________________
_____________________________
Witness
Defendant
Form 32. Warrant of arrest
STATE OF SOUTH DAKOTA IN CIRCUIT COURT
ss.
COUNTY OF ________ ________ JUDICIAL CIRCUIT
STATE OF SOUTH DAKOTA,
Plaintiff,
v. WARRANT OF ARREST
________,
Defendant
THE STATE OF SOUTH DAKOTA TO ANY SHERIFF OR OTHER PEACE OFFICER IN
THIS STATE:
A Petition for Revocation of Probation having been this day laid before me charging that the
above-named Defendant, ____, has violated the terms and conditions of his probation;
You are therefore commanded forthwith to arrest the above-named Defendant, ____, and bring
him before me at ____, or in case of my absence or inability to act, before the nearest or most
accessible circuit judge or magistrate judge in this county.
Dated at ____, South Dakota, this ____ day of ____, 20__.
_______________________________________
Circuit Judge
____________________________
Commission Note.
Form 33. Petition for revocation of probation
STATE OF SOUTH DAKOTA IN CIRCUIT COURT
ss.
COUNTY OF ________ ________ JUDICIAL CIRCUIT
STATE OF SOUTH DAKOTA,
Plaintiff, PETITION FOR
v. REVOCATION
________, OF PROBATION
Defendant.
____, being first duly sworn upon his oath states and charges that:
____, the above-named Defendant was placed on probation on the ____ day of ____, 20__,
pursuant to this Court's order of probation, a copy of which is attached hereto and made a part hereof
by reference.
Said defendant has violated the terms and conditions of his probation by: _______________
__________________________________________________________________________
__________________________________________________________________________
WHEREFORE, Petitioner prays that the above-named Defendant, ____, be required to appear
before this court forthwith and that a hearing be held to determine whether the order of probation
herein should be revoked and sentence be imposed.
_______________________________________
Prosecuting Attorney
Subscribed and sworn to before me this ____ day of ____, 20__.
(SEAL)
ADMISSION OF SERVICE
Receipt of a true copy of the above and foregoing Petition for Revocation of Probation is hereby
acknowledged at ____, South Dakota, this ____ day of ____, 20__.
_______________________________________
Defendant
Witness:
____________________________
Form 34. Official statement
(SDCL 23A-27-32)
STATE OF SOUTH DAKOTA IN CIRCUIT COURT
ss.
COUNTY OF ________ ________ JUDICIAL CIRCUIT
STATE OF SOUTH DAKOTA,
Plaintiff,
v. OFFICIAL STATEMENT
________,
Defendant.
CHARGE: ________________________________________________________________
COMMITTED AS FOLLOWS, TO-WIT: That on the ________ day of ________, 20____, the
above-named Defendant ___________________________________________
__________________________________________________________________________
__________________________________________________________________________
PLEADS: __________________________ VERDICT _____________________________
__________________________________________________________________________
__________________________________________________________________________
ASSOCIATES _____________________________________________________________
HABITS __________________________________________________________________
REPUTATION ____________________________________________________________
CRIMINAL RECORD ______________________________________________________
__________________________________________________________________________
__________________________________________________________________________
DISPOSITION BEHAVIOR WHILE AWAITING TRIAL __________________________
__________________________________________________________________________
__________________________________________________________________________
JUDGE'S COMMENTS: _____________________________________________________
__________________________________________________________________________
__________________________________________________________________________
Dated this ________ day of ________, 20____, at ________, South Dakota.
_______________________________________
Judge of the Circuit Court
_______________________________________
Prosecuting Attorney
ATTEST:
____________________________
Clerk of Court
Form 35. Affidavit in support of request for search warrant
(SDCL 23A-35-4, 23A-35-9)
STATE OF SOUTH DAKOTA IN CIRCUIT COURT
ss. MAGISTRATE DIVISION
________ COUNTY ________ JUDICIAL CIRCUIT
STATE OF SOUTH DAKOTA,
Plaintiff, AFFIDAVIT IN SUPPORT OF
v. REQUEST FOR
________, SEARCH WARRANT
Defendant.
(In the Matter of ________)
The undersigned, being duly sworn upon oath, respectfully requests a Search Warrant to be
issued for the following property (describe with particularity): __________ __________ __________
The undersigned respectfully requests that the Search Warrant be issued to permit a search at the
following premises for the above-described property (Describe premises or area with legal
description and particularity):
________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
The undersigned requests a Search Warrant to be issued because the above-described property
is:
(PLACE INITIALS IN THE APPROPRIATE BLANK)
____Property that constitutes evidence of the commission of a criminal offense;
____Contraband, the fruits of crime, or things otherwise criminally possessed;
____Property designed or intended for use in, or which is or has been used as the means of,
committing a criminal offense.
The undersigned further requests:
(PLACE INITIALS IN THE APPROPRIATE BLANK)
____Execution of Search Warrant at night pursuant to 23A-35-4;
____That no notice be given prior to the execution of the Search Warrant pursuant to SDCL
23A-35-9;
____Authorization to serve the Search Warrant on Sunday;
____Execution of the Search Warrant during the daytime.
The facts in support of the issuance of a Search Warrant are as follows:
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
_______________________________________
Signature of Affiant
_______________________________________
(Official Title)
Subscribed to and sworn before me, in my presence this ____ day of ____, 20__.
____________________________
(Magistrate)(Circuit Court Judge)
(Notary)
Form 36. Search warrant
(SDCL 23A-35-4)
STATE OF SOUTH DAKOTA IN CIRCUIT COURT
MAGISTRATE DIVISION
COUNTY OF ________ ________ JUDICIAL CIRCUIT
STATE OF SOUTH DAKOTA,
Plaintiff,
v. SEARCH WARRANT
________,
Defendant.
(In the Matter of ________)
TO ANY LAW ENFORCEMENT OFFICER IN THE COUNTY OF ____
Proof by Affidavit(s) has been made before me by ____ that there is probable cause to believe
that the property described herein may be found at the location set forth herein and the property is:
(PLACE INITIALS IN APPROPRIATE BLANK)
____Property that constitutes evidence of the commission of a criminal offense;
____Contraband, the fruits of crime, or things otherwise criminally possessed;
____Property designed or intended for use in, or which is or has been used as the means of,
committing a criminal offense.
YOU ARE THEREFORE commanded to search (describe premises or area with legal description
and particularity) ________________________________________________
__________________________________________________________________________
__________________________________________________________________________
for the following property (describe with particularity):_____________________________
__________________________________________________________________________
______________________________________________________________. It is further
ORDERED, that this Search Warrant shall be executed within ten (10) days after the signing of
this Warrant pursuant to SDCL 23A-35-4.
This Warrant may be executed in accordance with my initials placed below:
(YOU MUST INITIAL AT LEAST ONE BLANK)
____You may serve this Warrant at any time of day or night because reasonable cause has been
shown to authorize a nighttime execution pursuant to SDCL 23A-35-4.
____You may serve this Warrant only during the daytime. Night is that period from 8:00 p.m.
to 8:00 a.m. local time.
____You may execute this Warrant without notice of execution required by SDCL 23A-35-8 in
that probable cause exists to demonstrate to me that if notice were given prior to execution (that the
property sought may be easily and quickly destroyed or disposed of), (that danger of life or limb of
the officer or another may result).
____You may serve this warrant on Sunday.
If the above-described property be seized, it should be returned to me at the Courthouse of this
Court.
Dated this ____ day of ____, 20__, at ____, South Dakota.
_______________________________________
(Magistrate)(Circuit Judge)
Form 37. Search warrant issued upon oral testimony original
(SDCL 23A-35-4)
STATE OF SOUTH DAKOTA IN CIRCUIT COURT
MAGISTRATE DIVISION
COUNTY OF ________ ________ JUDICIAL CIRCUIT
STATE OF SOUTH DAKOTA,
Plaintiff, SEARCH WARRANT ISSUED
v. UPON ORAL TESTIMONY
________, ORIGINAL
Defendant.
(In the Matter of ________)
TO ANY LAW ENFORCEMENT OFFICER IN THE COUNTY OF ____:
Oral testimony having been communicated to me by ____ that there is probable cause to believe
that the property described herein may be found at the locations set forth herein and the property is:
(PLACE INITIALS IN APPROPRIATE BLANK)
____Property that constitutes evidence of the commission of a criminal offense;
____Contraband, the fruits of crime, or things otherwise criminally possessed;
____Property designed or intended for use in, or which is or has been used as the means of,
committing a criminal offense.
YOU ARE THEREFORE commanded to search (describe premises or area with legal description
and particularity): __________________________________________________
__________________________________________________________________________
__________________________________________________________________________
for the following property (describe with particularity):_____________________________
__________________________________________________________________________
______________________________________________________________. It is further
ORDERED, that this Search Warrant shall be executed within ten (10) days after the signing of
this Warrant pursuant to SDCL 23A-35-4.
This Warrant may be executed in accordance with my initials placed below:
(YOU MUST INITIAL AT LEAST ONE BLANK)
____You may serve this Warrant at any time of day or night because reasonable cause has been
shown to authorize a nighttime execution pursuant to SDCL 23A-35-4.
____You may serve this Warrant only during the daytime. Night is that period from 8:00 p.m.
to 8:00 a.m. local time.
____You may execute this Warrant without notice of execution required by SDCL 23A-35-8 in
that probable cause exists to demonstrate to me that if notice were given prior to execution (that the
property sought may be easily and quickly destroyed or disposed of), (that danger of life or limb of
the officer or another may result).
____You may execute this Warrant on Sunday.
If the above-described property be seized, it should be returned to me at the Courthouse of this
Court.
I am satisfied that the circumstances are such as to make it reasonable to dispense with the
written affidavit. The grounds for application for issuance of the Search Warrant exist as a
communication orally made to me in a statement which has been electronically recorded and upon
the return of the Warrant will be transcribed and certified as accurate and attached hereto.
The exact time of the issuance of the Duplicate Warrant was ____ __.m. on the ____ day of
____, 20__.
Dated this ____ day of ____, 20__, at ____, South Dakota.
_______________________________________
(Magistrate)(Circuit Judge)
Form 38. Search warrant issued upon oral testimony duplicate original
(SDCL 23A-35-4)
STATE OF SOUTH DAKOTA IN CIRCUIT COURT
MAGISTRATE DIVISION
COUNTY ________ JUDICIAL CIRCUIT
STATE OF SOUTH DAKOTA,
Plaintiff, SEARCH WARRANT ISSUED
v. UPON ORAL TESTIMONY
________, DUPLICATE ORIGINAL
Defendant.
(In the Matter of ________)
TO ANY LAW ENFORCEMENT OFFICER IN THE COUNTY OF ____:
Oral testimony having been communicated to me by ____ that there is probable cause to believe
that the property described herein may be found at the locations set forth herein and the property is:
(PLACE INITIALS IN APPROPRIATE BLANK)
____Property that constitutes evidence of the commission of a criminal offense;
____Contraband, the fruits of crime, or things otherwise criminally possessed;
____Property designed or intended for use in, or which is or has been used as the means of,
committing a criminal offense.
YOU ARE THEREFORE commanded to search (describe premises or area with legal description
and particularity) __________________________________________________
__________________________________________________________________________
__________________________________________________________________________
for the following property (describe with particularity):_____________________________
__________________________________________________________________________
______________________________________________________________. It is further
ORDERED, that this Search Warrant shall be executed within ten (10) days after the signing of
this Warrant pursuant to SDCL 23A-35-4.
This Warrant may be executed in accordance with my initials placed below:
(YOU MUST INITIAL AT LEAST ONE BLANK)
____You may serve this Warrant at any time of day or night because reasonable cause has been
shown to authorize a nighttime execution pursuant to SDCL 23A-35-4.
____You may serve this Warrant only during the daytime. Night is that period from 8:00 p.m.
to 8:00 a.m. local time.
____You may execute this Warrant without notice of execution required by SDCL 23A-35-8 in
that probable cause exists to demonstrate to me that if notice were given prior to execution (that the
property sought may be easily and quickly destroyed or disposed of), (that danger to life or limb of
the officer or another may result).
____You may execute this Warrant on Sunday.
If the above-described property be seized, it should be returned to me at the Courthouse of this
Court.
I am satisfied that the circumstances are such as to make it reasonable to dispense with the
written affidavit. The grounds for application for issuance of the Search Warrant exist as a
communication orally made to me in a statement which has been electronically recorded and upon
the return of the Warrant will be transcribed and certified as accurate and attached hereto.
Dated this ____ day of ____, 20__, at ____, South Dakota.
_______________________________________
(Magistrate)(Circuit Judge)
_______________________________________
(Title)
By: ______________________________
(Law Enforcement Officer)
(Prosecuting Attorney
Form 39. Verified inventory
(SDCL 23A-35-10)
STATE OF SOUTH DAKOTA IN CIRCUIT COURT
ss. (MAGISTRATE DIVISION)
COUNTY OF ________ ________ JUDICIAL CIRCUIT
STATE OF SOUTH DAKOTA,
Plaintiff,
v. VERIFIED INVENTORY
________,
Defendant.
(In The Matter of ________)
I, ______, a law enforcement officer of the State of South Dakota, executed a Search Warrant
dated ______, issued by the Honorable ______, and do swear that the following inventory contains
a true and detailed account of all property taken by me during the execution of the above-described
Warrant: __________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
Dated this ____ day of ____, 20___, at ____, South Dakota.
_______________________________________
Law Enforcement Officer
Subscribed to and sworn to before me, a Notary Public, on this ____ day of ____, 20__.
____________________________
(Notary Public)
* I the (Undersigned)(Applicant for Search Warrant) do hereby state that the above inventory was
taken in my presence and is true and correct.
____________________________
(Notary Public)
Subscribed to and sworn to before me, a Notary Public, on this ____ day of ____, 20__.
____________________________
(Notary Public)
* A search warrant issued upon oral testimony must have the inventory signed by the Applicant
pursuant to 23A-35-7.
Form 40. Application and order for court appointed counsel
(SDCL 23A-40)
STATE OF SOUTH DAKOTA IN CIRCUIT COURT
ss.
COUNTY OF ________ ________ JUDICIAL CIRCUIT
STATE OF SOUTH DAKOTA,
Plaintiff, APPLICATION & ORDER
v. FOR COURT
________, APPOINTED COUNSEL
Defendant.
APPLICATION
I, the above Defendant, (being the subject of a criminal investigation)(having been charged with
the offense of ____ a (felony)(misdemeanor)), having (an action pending to revoke
probation)(suspended sentence)(suspended imposition of sentence)(a final proceeding to revoke a
parole) do hereby, and having been duly sworn upon oath under the penalties of perjury state as
follows:
1. I am financially unable to hire counsel to represent me in this matter and desire an attorney to
be appointed.
2. I am (employed)(unemployed)(self-employed). If employed or self-employed, my weekly
income is $____ and my place of business is ____
3. I have ____ number of dependents.
4. My gross income for the past two years is ____.
5. That the following amounts accurately represent my assets and debts (including joint assets and
joint debts):
ASSETS
Cash on hand and in banks
$. . . . . . . . . .
Accounts and notes receivable
$. . . . . . . . . .
Investments (bonds, stocks, etc.)
$. . . . . . . . . .
Real estate
$. . . . . . . . . .
Automobile (type & year)
$. . . . . . . . . .
Household goods
$. . . . . . . . . .
Other personal property
. $. . . . . . . . . .
Any other assets
$. . . . . . . . . .
TOTAL ASSETS
$. . . . . . . . . .
DEBTS
Debts to banks
. $. . . . . . . . . .
Debts to others
$. . . . . . . . . .
Mortgages on real estate
$. . . . . . . . . .
Other debts
$. . . . . . . . . .
TOTAL DEBTS
$. . . . . . . . . .
6. Any anticipated receivables, such as land sales, gifts, inheritances, allotments, etc.
$__________
Dated this ____ day of ____, 20__.
_______________________________________
Defendant
Subscribed and sworn to before me this ____ day of ____, 20__.
_______________________________________
(Magistrate)(Circuit Judge)
(Notary Public)
ORDER
Upon reading the above and foregoing application and the Court being satisfied that the
defendant is indigent and financially unable to obtain counsel. It is
ORDERED that ____ of ____, South Dakota, being a member of the Bar is hereby appointed to
represent the Defendant in all matters pertaining to this action unless or until relieved by this Court.
Dated this ____ day of ____, 20__.
BY THE COURT:
_______________________________________
Judge
ATTEST:
____________________________
Clerk of Court
Form 41. Application for court appointed counsel instructions
READ THIS BEFORE FILLING OUT APPLICATION FOR COURT-APPOINTED COUNSEL
In any criminal investigation or in any criminal action or action for revocation of suspended
sentence or probation in the circuit or magistrate court or in a final proceeding to revoke a parole,
where it is satisfactorily shown that the defendant is without means and unable to employ counsel
and pay for the necessary expenses of his representation without undue hardship, the judge of the
circuit court or the magistrate shall assign, at any time following his arrest or commencement of
detention without formal charges, counsel for his representation, who shall appear for and defend
the accused upon the charge against him, or take other proper legal action to protect the rights of the
person detained without formal charge.
There is hereby created a lien, enforceable as upon all the property, both real and personal, of any
person, including the parents of a minor child, for whom legal counsel or a public defender has been
appointed. The services rendered and expenses incurred thereunder shall constitute a claim against
such person and his estate, enforceable according to law in an amount to be determined by the
presiding judge of the circuit court and paid by the county chargeable therefor.
Counsel so assigned pursuant to SDCL 23A-40-6 shall, after the disposition of said cause, be
paid by the county in which such action is brought a reasonable and just compensation for such
services and for necessary expenses and costs incident to the proceedings in an amount to be fixed
by the judge of the circuit court or the magistrate.
Immediately upon payment by the chargeable county, a statement of claim showing the name and
residence of the recipient shall be filed for record by the county auditor in the office of register of
deeds in the county where the recipient resides and a certified copy of such lien may be, then and
thereafter filed in any other county in which such recipient may have or acquire an interest in real
or personal property. Such lien shall be enforceable unless satisfied for a period of ten years from
the date of such lien at which time such lien shall expire and be null and void.
The board of county commissioners of the county filing such lien is authorized to enforce,
foreclose, satisfy, compromise, settle, subordinate, release, or otherwise dispose of any lien hereby
imposed.
Whenever the court finds that funds are available for payment from or on behalf of a defendant
to carry out, in whole or in part, the provisions of this chapter, the court may authorize that such
funds be paid to the court for deposit with the county treasurer, to be placed in the county general
fund as a reimbursement to the county to carry out the provisions of this section. Such
reimbursement shall be a credit against any lien created by the provisions of this chapter against the
property of such defendant.
I hereby certify that I have read each and every one of the provisions printed above and,
understanding each and every one of them, I hereby make this a part of my application for court
appointed counsel.
Dated at ____, South Dakota, this ____ day of ____, 20__.
__________
Signature of applicant.
WITNESS to signature:
_______________________________________
Signature of applicant.
Form 42. Personal recognizance bond and appearance bond
(SDCL 23A-43-2)
STATE OF SOUTH DAKOTA IN CIRCUIT COURT
ss.
COUNTY OF ________ ________ JUDICIAL CIRCUIT
STATE OF SOUTH DAKOTA,
Plaintiff, PERSONAL RECOGNIZANCE
v. BOND AND
________, APPEARANCE BOND
Defendant.
Non-surety: ________ I, the undersigned Defendant, acknowledge that I and (my) ________
Surety: ________ We, the undersigned, jointly and severally acknowledge that we
(am)(are)(jointly and severally) bound to pay to the County of ____ the sum of $____,
1 and there has
been deposited with the Clerk of the Court the sum of $____ in cash
2 or ____,
3 a sum not exceeding
10% of the amount of the bond.
4
The conditions of this Bond are:
(1) That the Defendant, ____, is to appear before ____, (Judge)(Magistrate) of the ____
Judicial Circuit at ____ South Dakota, at the ____ County Courthouse on the ____ day
of ____, 20__, at __.m., and in such other places as Defendant may be required to appear
in accordance with any and all orders and directions relating to the Defendant's
appearance in the above-entitled matter as may be given or issued by the Magistrate or the
Circuit Court Judge of the ____ Judicial Circuit or any other Circuit Court to which the
Defendant may be removed, or the cause transferred;
(2) The Defendant is not to depart from the ____ Judicial Circuit or the jurisdiction of any
other Circuit Court in the State of South Dakota to which the Defendant may be removed
or the cause transferred after he has appeared in such other Court pursuant to the terms
of this Bond, except in accordance with the Orders or Warrants as may be issued by the
Magistrate or the Circuit Court Judge of the ____ Judicial Circuit or a Circuit Court Judge
of any other Judicial Circuit in South Dakota;
(3) That the Defendant is to abide by any judgment entered in any such matter by
surrendering himself to serve any sentence imposed and obeying any order or direction
in connection with such judgment as the court imposing it may prescribe.
(4) That the Defendant will not violate a state or federal law or municipal ordinance;
(5) That the Defendant will keep the court or (his)(her) attorney, if represented by counsel,
advised of (her)(his) whereabouts at all times.
If the Defendant appears as ordered and otherwise obeys and performs the foregoing conditions
of this Bond, then this Bond is to be void. If the defendant fails to obey or perform any of the
conditions, payment of the amount of this Bond shall be due forthwith. Forfeiture of this Bond for
any breach of its conditions may be declared by any Judge or Magistrate having cognizance of the
above-entitled matter at the time of such breach. If the Bond is forfeited and if the forfeiture is not
set aside or remitted, judgment may be entered upon motion in such Court of this State against each
debtor jointly and severally for the amount above stated, together with interest and costs. Execution
may be issued and payment secured as provided by the South Dakota Code of Criminal Procedure
and other laws of the State of South Dakota.
It is agreed and understood that this is a continuing Bond (including any proceeding on appeal
or review) which shall continue in full force and effect until such time as the undersigned are duly
exonerated.
FAILURE TO APPEAR AT THE TIMES REQUESTED MAY RESULT IN THE
CONVICTION OF A CLASS 5 FELONY (5 Years imprisonment in the State Penitentiary and/or
a fine of $5,000 may be imposed) IF THE FAILURE TO APPEAR OCCURRED IN A FELONY
CASE. FAILURE TO APPEAR IN A MISDEMEANOR CASE MAY RESULT IN A PENALTY
OF ONE YEAR IN THE COUNTY JAIL OR $1,000 FINE OR BOTH.
This Bond is signed on this ____ day of ____, 20__ at ____, South Dakota.
_______________________________________
Defendant
_______________________________________
Surety
_______________________________________
Surety
Name of Defendant __________
Address __________
Name of Surety __________
Address __________
Name of Surety __________
Address __________
Based upon the above, it is
ORDERED that Defendant be released upon signing the agreement below.
_______________________________________
(Magistrate)(Circuit Judge)
-----
1 Where no deposit is required delete the remainder of this paragraph.
2 Where no sureties are required, indicate full amount of cash deposited with clerk.
3 If a form of security other than cash is deposited, describe.
4 If the amount ordered to be paid exceeds 10% of the bond, delete.
DEFENDANT'S AGREEMENT TO CONDITIONS OF BOND
I, ____, understand the methods and conditions for my release which are specified above and the
penalties and forfeitures applicable in the event I violate any condition or fail to appear as required.
I agree to comply fully with each of the conditions imposed upon my release, and to notify the
Court promptly in the event I change the address indicated below.
Dated this ____ day of ____, 20__.
_______________________________________
Defendant's Signature
WITNESS:
____________________________
Def. Name ________
Address ________
________
Phone No. ________
S. D. Driver's License No. ________
Approved ________, 20____.
By ________
Title ________
JUSTIFICATION OF SURETIES
I, the undersigned, under oath say that I reside at ____; and that my net worth is the sum of ____
Dollars ($ ).
I further say that:
_______________________________________
Surety
Sworn to and subscribed before me this ____ day of ____, 20__.
_______________________________________
(Notary Public) (Magistrate)
(Circuit Court Judge)
I, the undersigned surety, under oath say that I reside at ____; and that my net worth is the sum
of ____ Dollars ($ ).
I further say that:
_______________________________________
Surety
Sworn to and subscribed before me this ____ day of ____, 20__.
_______________________________________
(Notary Public)(Magistrate)(Circuit
Court Judge)
Form 43. Waiver of extradition rights
STATE OF SOUTH DAKOTA IN ________ COURT
COUNTY OF ________ ________ JUDICIAL CIRCUIT
STATE OF SOUTH DAKOTA,
Plaintiff,
v. WAIVER OF
________, EXTRADITION RIGHTS
Defendant.
As a condition of the acceptance by the court of a(n)(appearance bond)(personal recognizance
bond) signed by the Defendant whereunder the Defendant asks the court to approve and release said
Defendant on (his)(her) own recognizance and as (his)(her) own surety, the Defendant does hereby
expressly waive and forego any and all rights whatsoever that (he)(she) may have under the
provisions of the South Dakota Uniform Criminal Extradition Act, and acts amendatory thereto, and
under the provisions of any Tribal By-law or Ordinance under which the Defendant may reside that
pertains to or purports to give the said Defendant any right or rights to apply to the Tribal Court for
extradition procedures from the jurisdiction of the said tribe to the jurisdiction of the said State of
South Dakota, and Defendant does hereby expressly affirm and agree as follows:
(1) to surrender (himself)(herself) to the sheriff of this County or to any of his authorized
deputies, or to any law enforcement officer of the State of South Dakota, or to any
authorized officer of the Bureau of Indian Affairs or to any Indian Tribe, for the purpose
of securing the return of the Defendant to jurisdiction of the State of South Dakota;
(2) that should it be necessary, for any reason, to arrest the Defendant, or otherwise take
(him)(her) into physical custody to effect (his)(her) return to the jurisdiction of the State
of South Dakota, the Defendant does hereby agree to hold harmless any such law
enforcement officer or police officer exercising any power of arrest under this instrument.
The Defendant by signing this instrument hereby acknowledges (his)(her) understanding of the
terms of this instrument and acknowledges (he)(she) has executed the same for the purpose of
securing (his)(her) release on (his)(her) personal recognizance or on a bond with (himself)(herself)
as the sole surety or with others, to answer the charges contained in a criminal case pending against
(him)(her) in the above-entitled court.
Signed and dated at ____, South Dakota, this ____ day of ____, 20__.
_______________________________________
Defendant's Signature
WITNESS:
____________________________
Form 44. Order specifying methods and conditions of release
(SDCL 23A-43-6)
STATE OF SOUTH DAKOTA IN CIRCUIT COURT
ss.
COUNTY OF ________ ________ JUDICIAL CIRCUIT
STATE OF SOUTH DAKOTA,
Plaintiff, ORDER SPECIFYING
v. METHODS AND
________, CONDITIONS OF RELEASE
Part I-Preferred Methods of Release
|
It is hereby ORDERED that the Defendant be released,
provided (Check One):
|
Personal
Recognizance
|
________ that he promises to appear at all scheduled
hearings as required.
|
Unsecured
Bond
|
______ that he will execute a bond binding himself to pay
_______ County the sum of ________ dollars ($ ) in the
event that he fails to appear as required.
[NOTE: The judicial officer is required to release the
defendant by one of the above methods unless he determines
that such a release will not reasonably assure the appearance
of the defendant as required. In the event such a
determination is made, the judicial officer shall, either in lieu
of or in addition to the above methods of release, impose the
first condition of release listed below which will reasonably
assure the appearance of the person for trial. If no single
condition gives that assurance, any combination of
conditions may be used.]
|
Part II-Conditions of Release
|
|
Upon finding that release by one of the above methods will
not by itself reasonably assure the appearance of the
Defendant, it is hereby FURTHER ORDERED that the
Defendant be released on the condition(s) checked below:
|
Third Party
|
|
Custody
|
________ (1) The Defendant is placed in the custody of
(Name of person/organization) _____________________
(Address) ______________________________________
(City & State)________ Telephone ________ who agrees (a)
to supervise the Defendant in accordance with conditions 2
and 5 as checked below, (b) to use every effort to assure the
appearance of the Defendant at all scheduled hearings before
this Court, and (c) to notify this Court immediately in the
event the Defendant violates any condition of his release or
disappears.
SIGNED: __________________
Custodian or Proxy
|
Restrictions on Travel,
Association, or Place of
Abode
|
________ (2) The Defendant will comply with each of the
following conditions: __________________________
______________________________________________
______________________________________________
|
10% Deposit
|
________ (3) The defendant will execute a bond binding
himself to pay to ________ County of South Dakota, the
sum of ________ dollars ($ ) and will deposit with the
Clerk of Court the sum of ________ dollars ($ ), in
________ (cash/security), being not more than 10% of the
amount of the bond, such deposits to be returned upon the
court's determination that the Defendant has performed the
conditions of his release.
|
Cash or Surety Bond
|
________ (4) The Defendant will execute a bond in the
amount of ________ dollars ($ ) either secured by the
under-takings of sufficient solvent sureties or by the deposit
of an equal amount of cash or other security in lieu thereof.
|
Part-time Release
|
________ (5) (a) The Defendant will be released from
________ (a.m./p.m.) to ________ (a.m./p.m.) on ________
(specify days of the week) on condition that he return to
custody at the specified time at such place of confinement as
this Court shall designate.
|
Other Conditions
|
________ (5) (b) The Defendant agrees that he will comply
with the following other conditions of release:
______________________________________________
[NOTE: A defendant for whom conditions of release are
imposed and who after twenty-four hours from the time of
release hearing continues to be detained as a result of his
inability to meet the conditions of release, shall, upon
application, be entitled to have the conditions reviewed by
the judge/magistrate who imposed them.]
|
Part III-Appearance and Penalties
|
Appearance
|
It is hereby FURTHER ORDERED that the Defendant shall
appear next at ________ on the ________ day of ________,
19____ at ________ (a.m./p.m.) and at such other places and
times as this Court may order or direct.
|
Penalties
|
If the Defendant violates any condition of his release, a
warrant for his arrest will be issued immediately. After
arrest, the terms and conditions of any further release will be
redetermined.
If the Defendant fails to appear before any court or judicial
officer as required, an additional criminal case may be
instituted against him. If the failure to appear is in
connection with a charge of felony or while awaiting
sentence after conviction, the penalty is a fine of not more
than $5,000 or imprisonment for not more than five years, or
both; if he fails to appear in connection with a misdemeanor
charge, the fine may be $1,000 or not more than one year in
the county jail or both.
|
Part IV-Acknowledgment by Defendant
|
Acknowledgment
|
I, ________ understand the methods and conditions of my
release which have been checked above and the penalties and
forfeitures applicable in the event I violate any condition or
fail to appear as required.
I agree to comply fully with each of the obligations imposed
on my release and to notify this Court promptly in the event I
change the address indicated below.
__________________________
Defendant
__________________________
Address
__________________________
City/State Telephone
|
RELEASE ORDERED:
|
Date: ________
(________ County Sheriff's Office)
(________ Police Department)
Your copy of the Order Specifying Methods and Conditions
of Release constitutes your authority for the commitment of
the Defendant until such time as all conditions of release are
complied with. You are authorized to process the Defendant
for release upon notification from the Clerk of Courts.
You are directed to produce the Defendant before the
appropriate judge or magistrate at the time and place
specified above, if the Defendant is still in your custody.
|
_______________________________________
(Magistrate)(Circuit Court Judge)
COPIES TO:
Appropriate Law Enforcement Officer
Prosecuting Attorney
Defendant
Form 45. Order issuing a bench warrant
(SDCL 23A-43-21)
STATE OF SOUTH DAKOTA IN CIRCUIT COURT
ss.
COUNTY OF ________ ________ JUDICIAL CIRCUIT
STATE OF SOUTH DAKOTA,
Plaintiff,
v. ORDER ISSUING
________, A BENCH WARRANT
Defendant.
On the ____ day of ____, 20__, the Defendant ____, was released pursuant to SDCL 23A-43.
It appearing to me by (motion)(affidavit) that the Defendant has materially breached a condition of
release without good cause, it is
ORDERED, that forfeiture of the bail be declared and the Clerk of Courts is directed to issue a
warrant for the Defendant's arrest.
Dated this ____ day of ____, 20__.
BY THE COURT:
_______________________________________
(Circuit Court Judge)(Magistrate)
ATTEST:
____________________________
Clerk of Court
Form 46. Bench warrant
(SDCL 23A-27-21)
STATE OF SOUTH DAKOTA IN CIRCUIT COURT
ss.
COUNTY OF ________ ________ JUDICIAL CIRCUIT
STATE OF SOUTH DAKOTA,
Plaintiff,
v. BENCH WARRANT
________,
Defendant.
TO: ANY LAW ENFORCEMENT OFFICER OF THE STATE OF SOUTH DAKOTA
On the ____ day of ____, 20__, the Defendant ____ was charged by
(Indictment)(Information)(Complaint) with the offense(s) of ____ (SDCL ____). On the ____ day
of ____, 20__, the Honorable ____ issued an Order directing the arrest of the Defendant for a breach
of the conditions of (his)(her) release prior to the disposition of the charges that have been filed
against (him)(her).
You are therefore commended to arrest the above-named ____ and bring (him)(her) before the
Honorable ____ or in (his)(her) absence or inability to act, the nearest or most accessible Magistrate.
Dated this ____ day of ____, 20__, at ____, South Dakota.
BY THE COURT:
_______________________________________
Clerk of Courts
(SEAL)
Form 47. Dismissal of (Complaint) (Indictment) (Information)
(SDCL 23A-44-2)
STATE OF SOUTH DAKOTA IN CIRCUIT COURT
ss. (MAGISTRATE DIVISION)
COUNTY OF ________ ________ JUDICIAL CIRCUIT
STATE OF SOUTH DAKOTA,
Plaintiff, DISMISSAL OF
v. (COMPLAINT)(INDICTMENT)
________, (INFORMATION)
Defendant.
Pursuant to SDCL 23A-44-2, ____ prosecuting attorney, dismisses the
(Complaint)(Information)(Indictment) that has been filed in this case.
Dated this ____ day of ____, 20__, at ____, South Dakota.
_______________________________________
Prosecuting Attorney
ATTEST:
____________________________
Clerk of Court