Criminal report.

Each committing trial court judge at the time commitment papers are sent by her or him to the proper trial court, and the sheriff when an arrest is made, other than on a capias, shall transmit to the prosecuting attorney of the trial court having jurisdiction, a report in the following form:

CRIMINAL REPORT

Date: ________ Name and address of defendant: ________ Age: ________ . If under 18, give name and address of parent, next friend, or guardian: ________ Name of offense, such as murder, assault, robbery, etc.: ________ Date and place where committed: ________ Value of property stolen: ________ Kind of property stolen: ________ Kind of building robbed: ________ Name and address of owner of property stolen or building robbed: ________ Name and address of occupant of building robbed: ________ Name of party assaulted or murdered: ________ Weapon used in assault or murder: ________ Exhibits taken at scene of crime or from defendant: ________ Name of custodian of such exhibits: ________ Location of building or place where offense committed: ________ Previous prison record of defendant: ________ Has defendant been arrested: ________ Does defendant desire to plead guilty: ________ Names and addresses of state witnesses: ________ Name of defendant’s lawyer: ________ If defendant is released on bond, names and addresses of sureties: ________ Brief statement of facts: ________ Name of committing trial court judge: ________ If additional space required, use reverse side of this sheet.

(Signature of party making this report.)