NEW ALBANY POLICE DEPARTMENT - New Albany, Ohio

Addendum A
Rule 4
Waiver of Extradition
I, , being years of age, residing at
, understand that I am being detained in Franklin
County, Ohio, because of a warrant issued for my arrest by the
Court
of
County, Ohio. I further understand that I have the right to remain in custody in
Franklin County, Ohio until I have been taken before a court of record having jurisdiction of the offense
charged against me so bail for my release can be determined. I also understand that before leaving Franklin
County I have the right to consult with an attorney or other person of my choice. Having read this waiver and
understanding its contents, I waive only the above listed rights so that I may be transported to
County, Ohio where I will be taken, without unnecessary delay, before the court having issued
the warrant for my arrest, where bail can be determined and I will be given the right to consult with an attorney
or other person of my choice.
Signature
Witnessed by:
Date
Printed Name
Signature
Printed Name
Signature
PD-00-218
Revised December 21, 2010