Opinion
CASE/CITATION NO: .2:2011-mj-00163-DAD
08-03-2011
UNITED STATES OF AMERICA v. Herrera
ORDER TO PAY
SOCIAL SECURITY #:__________________________
DATE OF BIRTH: _________________________
DRIVER'S LICENSE #: _________________________
ADDRESS:
City _________________________ State _________________________ Zip Code _________________________
I UNDERSTAND THAT IF I MOVE PRIOR TO PAYING ANY FINE, RESTITUTION, PENALTY ASSESSMENT OR PROCESSING FEE IN THIS CASE, I MUST NOTIFY THE UNITED STATES ATTORNEY IN WRITING WITHIN SIXTY (60) DAYS OF ANY CHANGE IN MY RESIDENCE ADDRESS OR MAILING ADDRESS: FAILURE TO PAY COULD RESULT IN A WARRANT BEING ISSUED OR AN ABSTRACT AGAINST MY DRIVER'S LICENSE OR VEHICLE BEING ISSUED.
I CERTIFY THAT ALL OF THE ABOVE INFORMATION IS TRUE and CORRECT .
DATE: _________________________
Defendant's Signature _________________________
YOU ARE HEREBY ORDERED TO PAY/COMPLY WITH THE FOLLOWING:
(√) Fine: $_____ and a penalty assessment of $ _____ for a TOTAL AMOUNT OF: $ _____ within _____ days/months: or payments of $ _____ per: month, commencing _____ and due on the _____ of each month until paid in full.
() Restitution: __________
() Community Service __________with fees not to exceed $ __________ completed by __________
PAYMENTS must be made by CHECK or MONEY ORDER, payable to: Clerk, USDC and mailed to (circle one):
CENTRAL VIOLATIONS BUREAU
PO BOX 70939
CHARLOTTE, NC 28272-0939
CLERK, USDC
2500 TULARE ST., RM. 1501
FRESNO, CA 93721-1322
CLERK, USDC
501 I STREET, STE. 4-200
SACRAMENTO, CA 95814-2322
Your check or money order must indicate your name and case/citation number shown above to ensure your account is credited for payment received.
DALE A. DROZD
U.S. MAGISTRATE JUDGE