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9/27/04 AFFIDAVIT OF PROBABLE CAUSE: Page IN THE DISTRICT COURT OF THE SECOND JUDICIAL DISTRICT OF THE STATE OF IDAHO, IN AND FOR THE COUNTY OF LATAH STATE OF IDAHO, ) Plaintiff, ) ) Case No. V. ) ) AFFIDAVIT OF ) PROBABLE CAUSE Defendant. ) ) STATE OF IDAHO, ) : COUNTY OF LATAH ) I, being duly sworn, do hereby state the following information is true and correct to the best of my knowledge and belief: That I am an agent/employee of which is located in Latah County, Idaho; That on the day of 20__, in Latah County, Idaho, as an agent/employee of I ---PAGE BREAK--- 9/27/04 AFFIDAVIT OF PROBABLE CAUSE: Page accepted the following described bank check from the maker: check account with the bank of payable Initial The check was presented as a valid and immediately negotiable instrument; Initial Neither I nor any other authorized agent made any agreement to “hold” the check; That I identified the maker of the check by (check all that apply): Taking I.D. in the form of a driver’s license, numbered The maker’s date of birth is ; Physically identifying the maker as someone known to me and whose physical description is: Male Female Ht. Build Hair Color/Length Other distinguishing characteristics: Taking the following To my knowledge the maker’s current address or location is ---PAGE BREAK--- 9/27/04 AFFIDAVIT OF PROBABLE CAUSE: Page The check was rejected by the bank on which it was written as having insufficient funds or no funds for payment; Initial The check is being submitted for criminal prosecution and not for the purpose of collecting a debt; Initial Neither I nor any other authorized agent made any agreement with the maker of the check to defer its payment after being informed the check was rejected as not paid by the bank; Initial Neither I nor any other authorized agent will accept any restitution for this check directly from the maker, and if the maker should attempt to make direct restitution or should contact us that I will refer the maker to the City of Moscow Prosecuting Attorney's Office; I am available and willing to testify truthfully as a witness if requested by the City of Moscow Prosecuting Attorney's Office. contacted or (Name) (Title) attempted to contact the maker regarding this check on the following dates with the following results: Date(s): Phone: (Telephone number) (Address) Other: ---PAGE BREAK--- 9/27/04 AFFIDAVIT OF PROBABLE CAUSE: Page I understand this affidavit provides the facts to start a criminal prosecution, and I acknowledge I have read the entire affidavit, and I believe all statements contained in it are true and accurate. Affiant SUBSCRIBED AND SWORN to before me this day of , 20 . NOTARY PUBLIC FOR IDAHO Residing in . My commission expires .