884.18—Civilian authority's acknowledgment of transfer of custody and agreement to notify member's commander.
1. A warrant for the arrest of (name, rank, and SSN), hereinafter referred to as the “member,” and who is charged with (offenses) has been issued by (civilian authority) and in execution, thereof, I accept his or her custody.
2. In consideration of the delivery of member at (location) to me for trial upon the above charge, pursuant to the authority vested in me as (position), I hereby agree to the following:
a. The commander (name, rank, unit, telephone), will be advised of the disposition of the charges.
b. The member will be immediately returned to the custody of the military upon completion of the trial, if acquitted; or upon satisfying the sentence imposed, if convicted; or upon other disposition of the case.
c. The member's return will be to (location) or to such other place as may be designated by the Department of the Air Force.
3. The member's return will not be required if the member's commander has indicated that return is not appropriate. Instead of actual delivery, transportation for the member may be arranged so long as it is without expense to the United States or to the member.
4. Pending disposition of the charges, the member will remain in the custody of [name of agency and location], unless released on bail or the member's own recognizance, in which event [Air Force unit, activity, or recruiting office nearest place of trial] will be notified.
[Signature Element]