Commitment by ............... for imprisonment for ............... sentence, fine and costs. State of West Virginia, County of .......... ss:
To the sheriff or any constable of said county, and to the jailer of said county:
Whereas, ............... was this day convicted of the crime of ............... and was sentenced to confinement in the county jail for the period of ..... days, or months, from this date, and to pay the State a fine of $ ..... and costs incurred, amounting to the sum of $ ..... itemized on the back hereof, and to labor on the roads and bridges under the control of the county court, or in the preparation of road materials, until said fine and costs are paid, as provided in article fifteen, chapter seventeen of the Code.
You (the said sheriff or constable), are hereby commanded, in the name of the said State, to receive and confine the said ............... in said jail, and to see that the said ............... labors according to law until his sentence, fine and costs have been satisfied, or until he is discharged according to law.
Given under my hand and seal this ..... day of ..... , 19 ...... ......................................... Clerk of court or justice of peace.