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STATE OF NEW YORK    COUNTY OF ____________________________________________________________

___________________________COURT _______________________________OF _________________________

                                  The People of the State of New York

                                                       Against                                                                   ACCUSATORY INSTRUMENT

__________________________________________________________                      FELONY COMPLAINT

 __________________________________________________________________________________________, Residing at

______________________________________________________________________________, by this Felony Complaint

makes written accusation as follows:

    That _______________________________________________________________, on the _________

Day of ________________20__________, at _________________________________________________________

In the ____________________________of ___________________________________________________________

County of _________________________________________________________________________, New York, did

Commit the offense of ___________________________________________________________________________

a felony in violation of Section ______of the____________________________    Law of the State of New York, in that (s)he did, at the aforesaid time and place:

The facts upon which this Felony Complaint is based are as follows: