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Declaration re Passport and Other Travel Documents, Case 2:20-mj-01341-DUTY (Dkt. 11, C.D. Cal.)

Summary

Keith Middlebrook, the defendant in United States of America v. Keith Middlebrook, Case Number 20-1341M (C.D. Cal.), signed this declaration on March 27, 2020 at Los Angeles. The statement marked on the form says the declarant is unable to locate any passport or other travel document, will surrender any that is found to the U.S. Pretrial Services Agency immediately, and will not apply for one while the case is pending. It was filed 03/27/20 as Document 11 in Case 2:20-mj-01341-DUTY.

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Full text

Case 2:20-mj-01341-DUTY Document 11 Filed 03/27/20 Page 1 of 1 Page ID #:45
FILED
CLERK, U.S. DISTRICT COURT
MAR 27 2020
CENTRAL DISTRICT OF CALIFORNIA
BY [signature] DEPUTY

UNITED STATES DISTRICT COURT
CENTRAL DISTRICT OF CALIFORNIA

UNITED STATES OF AMERICA, PLAINTIFF
v.
Keith Middlebrook, DEFENDANT.
CASE NUMBER: 20-1341M

DECLARATION RE PASSPORT AND OTHER TRAVEL DOCUMENTS

I, Keith Middlebrook (Defendant/Material Witness), declare that
☐ I have never been issued any passport or other travel document by any country. I will not apply for a passport or other travel document during the pendency of this case.
☐ I have been issued a passport or other travel document(s). I will surrender my passport and all other travel document(s) issued to me to the U.S. Pretrial Services Agency by the deadline imposed. I will not apply for a passport or other travel document during the pendency of this case.
☒ I am unable to locate my passport(s) or other travel document(s). If I locate any passport or other travel document issued to me, I will immediately surrender it to the U.S. Pretrial Services Agency. I will not apply for a passport or other travel document during the pendency of this case.
☐ My passport and all other travel documents issued to me are in the possession of federal authorities. If any such document is returned to me during the pendency of this case, I will immediately surrender it to the U.S. Pretrial Services Agency. I will not apply for a passport or other travel document during the pendency of this case.

I declare under penalty of perjury that the foregoing is true and correct.
Executed this 27th day of March, 2020
at Los Angeles, California
(City and State)
/s/ Keith Middlebrook
Signature of Defendant/Material Witness

If the declarant is not an English speaker, include the following:
I, ________, am fluent in written and spoken English and ________ languages. I accurately translated this form from English into ________ to declarant on this date.
Date: ________
Interpreter

CR-37 (05/15) DECLARATION RE PASSPORT AND OTHER TRAVEL DOCUMENTS


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gov.uscourts.cacd.777632.11.0.pdf
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2a9360b8bc5e31f04a9405bc64c411d2f7142da08b41cc54ba7a2721fd00de63
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gov.uscourts.cacd.777632.11.0.pdf
Original
archive.org
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