FIFTH DISTRICT COURT

ANYWHERE, UTAH
ORDER FOR ISSUANCE OF WRIT FOR HABEAS CORPUS
WINSTON SHROUT, Petitioner
c/o Box 123, Anywhere, Utah
vs.
JOHN SMITH, Respondent
123 Main Str., Anywhere, Utah
Judge: _________________________ Case Number: __________________
On this _________ day of _______________ month, 2004, Winston Shrout presented a verified Petition
for Writ for Habeas Corpus, and on examination of the petition, the court orders that such Writ be issued.
It is therefore ordered that John Smith, Respondent, of 123 Main Str. Anywhere, Utah, produce a return on
the writ, verified true, correct, and complete, and not misleading, before this court at the location of the
Hall of Justice, 220 North 200 East, Anywhere, Utah, on the ________ day of ___________ month, 2004,
to show cause if any be had for lawful cause for restraint of liberty against Winston Shrout, his property
and concerns.
Let the writ issue accordingly.
____________________________________
Judge

________
date