The following form, or one in substance the same, shall be deemed to be a sufficient commitment:

Georgia, __________ County.

_____________________ (name of the defendant) having been arrested on a warrant for the offense of ______________ and brought before me, after hearing evidence it is ordered that he be committed for trial for the offense of ______________. The jailer of said county (or any other county, if necessary) is required to receive and safely keep him until discharged by due process of law.

Witness my hand and seal, this ______ day of ______________, ____.

_______________________ Judicial officer (Seal)