SBI FINAL DISPOSITION REPORT 00?020'00
11-15-02
WHEN COMPLETED SUBMIT TO: NORTH CAROLINA STATE BUREAU OF INVESTIGATION (SBI)

3320 GARNER ROAD

PO Box 29500

RALEIGH, NC. 27025-0500

ATTN: CRIMINAL INFORMATION

AND IDENTIFICATION SECTION CKN Number-
I 
To BE COMPLETED BY ARRESTING AGENCY 5 i TO BE COMPLETED BY OPPICE
. . . ?l 
SID NOV FBI No. .
COURT LEVEL: El DISTRICT El SUPERIOR
COURT DOCKET NUMBER COURT DISPOSITION DATE
NAME ON FINGERPRINT CARD SUBMITTED To SBI 
MIDDLE El DISMISSED DISMISSED LEAVE
RACE DATE OF BIRTH 
CONVICTED OF:
SEX SOCIAL SECURITY No. . I
. Cl CONSOLIDATED FOR JUDGMENT WITH CASE 

ARREST No. (OCA) DATE OF ARREST 

 

OFFENSES CHARGED AT ARREST

 

CONTRIBUTOR OF [include Address 3i ORI Nd]

 

COURT ORDERED EXPUNGEMENT
[Copy of Certified Court Order Must Be Attached and
Submitted by Arresting Agency]

 

 

SIGNATURE



 

 

 

 

 

 

 

 

 

 

 

[Note: if this block is checked, a copy Of the final disposition reflecting the
original judgement must be attached]



PLEA Cl VERDICT CI

MISDEMEANOR El FELONY CI

SPLIT SENTENCE: Cl Yes El No

JUDGEMENT:

Days Months Years

Active Sentence - 

Probation - 

Suspended - . 
FINE: COST: 

RESTITUTION: ATTORNEY FEE:

 

 

El CASE APPEALED FROM DISTRICT COURT
CASE APPEALED TO APPELLATE DIVISION

[Submit copy Of this form and retain original until
final judgement after Appellate decision]

 

 

l_
ADDITIONAL iN FOR MATION:

 

 

DATE COUNTY

 

SIGNATURE

 

Deputy 080 El Assistant 080 El Clerk of Superior Court

 

if additional space is needed, check and continue on reverse side Of form.