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«Print page 1. TABLE OF CONTENTS Abduction By Relative See Kidnapping Abuse, Animal Abuse, Child Abuse, Vulnerable Adult Accessory After The Fact ...»

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… did knowingly, willfully with fraudulent intent to [obtain a benefit/ obtain credit/obtain goods/obtain services/obtain other item of value/access health information/access health care] to wit: _____(describe)], having a value of ____(amount), $100,000 or greater, use a skimming device to [access/read/scan/obtain/memorize/store personal identification information/store payment device number] from the magnetic [strip/stripe] from a credit card issued to ________(name) without consent of ________(name), an individual authorized to use the credit card.

–  –  –

… did knowingly, willfully with fraudulent intent to [obtain a benefit/ obtain credit/obtain goods/obtain services/obtain other item of value/access health information/access health care] to wit: _____(describe)], having a value of ____(amount), at least $10,000 but less than $100,000, use a skimming device to [access/read/scan/obtain/memorize/store personal identification information/store payment device number] from the magnetic [strip/stripe] from a credit card issued to ________(name) without consent of ________(name), an individual authorized to use the credit card.

–  –  –

… did knowingly, willfully with fraudulent intent to [obtain a benefit/ obtain credit/obtain goods/obtain services/obtain other item of value/access health information/access health care] to wit: _____(describe)], having a value of ____(amount), at least $1,000 but less than $10,000, use a skimming device to [access/read/scan/obtain/memorize/store personal identification information/store payment device number] from the magnetic [strip/stripe] from a credit card issued to ________(name) without consent of ________(name), an individual authorized to use the credit card.

CR 8-301(d)(2)

MISDEMEANOR

$500 – 18 MONTHS *1_1278* **SKIM DEV OBT BENEFIT – UND $1,000** … did knowingly, willfully with fraudulent intent to [obtain a benefit/ obtain credit/obtain goods/obtain services/obtain other item of value/access health information/access health care] to wit: _____(describe)], having a value of less than $1,000, use a skimming device to [access/read/scan/obtain/memorize/store personal identification information/store payment device number] from the magnetic [strip/stripe] from a credit card issued to ________(name) without consent of ________(name), an individual authorized to use the credit card.

–  –  –

… did knowingly, willfully with fraudulent intent [possess/obtain/help another to possess/help another to obtain] a [re-encoder/skimming] device for the unauthorized [use/sale/transfer] of [personal identifying information/payment device number].

–  –  –

…did, as a partner in _____(name partnership), fraudulently [convert/appropriate] to [his/her] own use ____ (describe), [money/property] of _____ said partnership.

–  –  –

…did as a corporate [officer/agent] of ____ (name corporation) fraudulently [sign/assent to] a publication for the public and shareholders containing untruthful representations of said corporation’s affairs, assets, and liabilities to [enhance/depress] the market value of its [shares/corporate obligation]/thereby accomplishing fraud, to wit: ____ (describe fraudulent intent and name or describe victim(s).

–  –  –

…did knowingly make a false statement of a material fact for the purpose of influencing a housing agency ________ (name agency) regarding [an application for housing assistance/an action affecting housing assistance already provided].

–  –  –

…did, with fraudulent intent, knowingly and willfully possess a counterfeit document, to wit: _________ (type of document).

–  –  –

...did [manufacture/counterfeit/cause to be counterfeit/willingly aid in counterfeiting/willingly assist in counterfeiting] U.S.

currency with intent to defraud.

–  –  –

...did [counterfeit/cause to be counterfeited/willingly aid in counterfeiting/willingly assist in counterfeiting] ______ (describe document).

–  –  –

…did [willfully/willfully attempt] and without proper authority [alter/ deface/destroy/remove/conceal] a public record, to wit:

______ (describe record).

–  –  –

...did knowingly and fraudulently obtain [money/goods], to wit:

_______(describe items or state amount of money) by means of a counterfeited document, to wit: ______(describe document).

–  –  –

...did [issue/pass/possess] counterfeited ______ (describe prescription or other practitioner's order) for _____ (name drug or prescription medication), knowing it to be counterfeit.

–  –  –

…willfully did [manufacture/produce/display/advertise/offer for sale/sell/possess] with the intent to [sell/distribute] [goods/services], to wit: __________ (describe), having a value of $1,000.00 or more, knowing the said [good/service] were [bearing/identified] by a counterfeit mark.

–  –  –





…willfully did [manufacture/produce/display/advertise/offer for sale/sell/possess] with the intent to [sell/distribute] [goods/services], to wit: __________ (describe), having a value of under $1,000.00, knowing the said [good/service] were [bearing/identified] by a counterfeit mark.

–  –  –

NOTES: "Intellectual Property" means a trademark service mark, offered for sale, manufactured, or distributed, or identifying services offered or rendered, without the authority of the owner of the intellectual property. State or federal registration of intellectual property is prima facie evidence that the intellectual property is a trademark or trade name.

–  –  –

…[did/did cause to be/did aid in/did assist in] [counterfeit/counterfeited/counterfeiting/issue/ issued/issuing] a token without the authority of the person who lawfully [issued/sold/gave away] the token.

–  –  –

...did [wilfully/corruptly] [embezzle/steal/withdraw/ impair/distroy/alter] a [will/codicil/patent/deed/assignment of patent/writ of administration/review/record], with the intent to [defeat/injure/alter] the [estate/right] of _____ (name).

–  –  –

… did with intent to deprive, knowingly and willfully obtain by [deception/intimidation/undue influence], _______(describe property), having a value less than $1,000 and belonging to _______(victim),[knowing/having reasonable knowledge] that said victim is [a vulnerable adult/at least 68 years old].

–  –  –

… did with intent to deprive, knowingly and willfully obtain by [deception/intimidation/undue influence], _______(describe property), having a value of _____(amount), at least $1,000 but less than $10,000 and belonging to _______(victim),[knowing/having reasonable knowledge] that said victim is [a vulnerable adult/at least 68 years old].

–  –  –

… did with intent to deprive, knowingly and willfully obtain by [deception/intimidation/undue influence], _______(describe property), having a value of _____(amount), at least $10,000 but less than $100,000 and belonging to _______(victim),[knowing/having reasonable knowledge] that said victim is [a vulnerable adult/at least 68 years old].

–  –  –

General Note: In all of the following sections where the selection between oath and affirmation is offered, an oath is a swearing, by whatever form. An affirmation is used by Quakers and other persons who have conscientious scruples against taking an oath, who are therefore allowed to make affirmation in any mode which they may declare to be binding upon their conscience.

Commissioners should generally use the word "oath" unless clearly otherwise indicated. In any instance in which the affidavit or transcript says "swear and affirm," or words to that effect, Commissioners may use the words "oath and affirmation" or "affidavit and affirmation." without having to choose between the two unless otherwise clearly indicated.

–  –  –

did as a public employee, [demand/receive] a [bribe/fee/reward/testimonial] to _______(choose from below).

1. influence the performance of [his/her]official duties.

2. [neglect/fail to perform] [his/her] official duties.

–  –  –

…did by [corrupt means/threat/force] endeavor to [influence/impede] ____ (name), a [juror/witness/court officer], in the discharge of [his/her] official duty.

–  –  –

…did, by [threat/force/corrupt means] [obstruct/impede/try to obstruct/try to impede] the administration of justice in __________(name court in State and case number if available).

–  –  –

NOTE: CR 9-401 - DEFINITIONS

"PLACE OF CONFINEMENT"

(i) A correctional facility:

(ii) A facility of the Department of Health and Mental Hygiene;

(iii) Any other facility in which a person is confined under color of law.

"CORRECTIONAL FACILITY" means:

A facility that is operated for the purpose of detaining or confining adults who are charged with or found guilty of a crime.

A "Place of Confinement" does not include" (i) A detention center for juveniles;

(ii) A facility for juveniles listed under HS 9-226(b);

(iii) A place identified in a juvenile community detention order; or (iv) A privately operated, hardware secure facility for juveniles committed to the Department of Juvenile Services.

“HARDWARE SECURITY FACILITY” means a facility that is securely locked or fenced to prevent escape.

–  –  –

...did deliver contraband to wit _______________(item) to _______________(person) who was [detained at/confined in] _______________ (place of confinement).

–  –  –

...did deliver contraband: to wit _______________(item) to _______________(person) [detained at/confined in] _______________(place) with the intent to effect an escape.

–  –  –

...did possess contraband: to wit _______________(item) with the intent to deliver to _______________(person) [detained at/confined in] _______________(place) to effect an escape.

–  –  –

...did [deposit/conceal] contraband: to wit _______________(item) [in/about/on land appurtenant to] _______________, a place of confinement, to effect an escape.

–  –  –

… did [possess/receive] a controlled dangerous substance, to wit: _______ (substance) while [detained/confined] in __________ (facility), a place of confinement.

–  –  –

… did [deposit/conceal] _______ (device), [telecommunication device/telecommunication device charger/SIM card] [in/about] [______ (facility)/property appurtenant _______ (facility)] with the intent that the device be obtained by ________ (name) while [he/she] was [detained/confined] in ________ (facility) where signs are posted that indicate such conduct is prohibited.

–  –  –

...did [make/cause to be made] a false [report/statement] of the [commission of a crime/existence of a condition imminently dangerous to public health and safety] to ___(official/agency), knowing the same to be false and with the intent that the said [official/agency] [investigate/consider/take action] in connection with such [statement/report].

–  –  –

…did threaten ____ (name), [an individual/friend/family member of an individual], with physical violence with intent to [coerce/induce/solicit] ___ (name) [to participate in/to prevent _____ (name) from leaving],______ a criminal gang.

–  –  –

...did [sell/dispense/give] to ____ (name) ____ (substance given) for the purpose of treating, curing, and alleviating ____ (venereal disease), the defendant not being a [doctor/a health department/ other governmental agency].



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