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HC 4567(9FJ2) STATE OF MIHNESOTA � <br /> � UNIFORM CITATION NO. COUN7v OF HENr+eVIN <br /> � DISTRICT COURT . <br /> ((��'+ The issuing officer states that the person <br /> 3 9 4—0 4 0 8 6 4 j� named below committed the ottense descnbed � <br /> ��..���, in violation of the sechon indicateC. <br /> I '_TYPE�.:..- :.�.DE6REE . �{qpED AREA'FdR�'�°�"', 12 MO. �COURT • <br /> ��T� 0�G 4-. �„oFflcE us�o�rcar� `��� � � '°: .., ❑ <br /> _.��_, <br /> DRNER'S LICENSE NUMBER STATE <br /> ` � i i I � <br /> � � ' l ; ' 1 " I � <br /> � <br /> I NAME—V+ST,FIRST,MIDDLE/MAIDEN <br /> 1 <br /> � S � ;L 'f� E '2m � N N � ,R ;�Z'L' ;S� I <br /> i � : <br /> i , <br /> IADDRESS�8 CITY <br /> � _-{ (� 5' (3 (Z 0 W nJ � c� s o ' <br /> STATE ZIP CODE <br /> w �, �y �-z � �,�r- r�.� � m 'rv � ���S�3�9 � 1 <br /> DATE OF BIRTH EYES HEIGHT WEIGHT SEX : ... <br /> i <br /> MO. � DAY VEAR . � � ' . � <br /> I � ( <br /> ! VIOLATION INFORMATION � <br /> ' DATE OF OFFENSE TIME METER NUMBER �, <br /> 0b 2t � Z: o � ' � � ' <br /> �. VEHICLE LICENSE PLATE STATE YEAii MAKE MOOE� <br /> �� COLOR LOCATION 8 CITV <br /> b 5- [3 2 ;o �.�, r.�: '2' c� 5;o <br /> � 2,o nl o �fln N 5�S'3 � � � � �� � <br /> ;, <br /> , STATUTE OR ORDINANCE NO. DESCFIPTION <br /> � O2 o nr o � �S� � ��� S 'T �:o �;2;�+��� ic <br /> i <br /> � v rv � � c e :r ',v' P �e.;���'d � <br /> � - � � Com Code C'i.DIV. ACTIVITY Spec Agcy <br /> i c, � u E ��- , c�.c � y o 3 <br /> jEndanger Llfe Accident Unsafe Commerclal Hazardous ��, <br /> i� �Or Property � �Conditions �Vehicle �Material i <br /> I BADGE NUMBEF ORI NUMBEfi . <br /> i' �SI M � OZ � �I SOo � ' <br /> ', If you fail fo respond to this citation within 7 days, increased penalties will i <br /> i be assessed and a warrant may be issued for your arrest. If a warrant is <br /> ; issued,a penalty oi 530.00 will be added fo the fine. <br /> � <br /> � : � � <br /> � <br /> , � � <br /> i <br /> � <br /> � � � � i <br /> � COURT COPY-DO NOT WRITE ON REVERSE ; <br /> i <br /> i - <br />