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<br /> � � - � � � HC s567(9�90) STATE OF MINNESOTA � - . . . � . -
<br /> UNIFORM CITATION NO. COUNTV OF HENNEPIN i
<br /> ..� _,;i _ DISTRICT COURT
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<br /> UJ 1— 0 4 3 2 2 6 3��� The issuing oHicer states that the person � "
<br /> named below committed the ottense described
<br /> - in violahon of the section indicateo I
<br /> � TVPE � DEGREE ' ' :12 MO. �.COlIaT °t -., . .
<br /> , _ . . . . . �p�j���!!��--�� ..,�..�. SHADEDAREAPOR ..� :,. a�. _..„ .t..: I ... .
<br /> . . . . ,. . _ • Ul• �(7'. �.:��� - � OFFICEUSEONLY ����� ..� .» , . ' . - ' -_.�. '.. -
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<br /> � � . _ ' � � � � . STATE _ . .
<br /> . . � .� - - � � . .. � DRIVER'S LICENSE NUb18ER � ' �- � .
<br /> -.. - - " . ' -' NAME—IAST,FIRST,�MIODIE/MAIDEN � - - . � � . � -
<br /> . - - _- L R N G E �ZMA N �� �� A � L � _ _�
<br /> -- �- ,. . ADORESS 8 CITY � . �._. . .. - . �
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<br /> - . . _ . . STATE ZIP CODE � _ . _
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<br /> �. , , DATE OF BIfiTH EYES HEIGHT WEIGHT SEX _
<br /> _ _ ' M0. � DAY , VEAR . ' ' , 1 M � — _ . �
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<br /> - VIOLATION INFORMA710N ( -
<br /> DATE OF OFFENSE TIME METER NUMBER f -
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<br /> - ' � � � �O -1 1 �U �� 0 i 4 I . .. , . _
<br /> . �� � � � � - VEHICLE LICENSE PLATE STATE �EAR MAKE MODEL t _ .
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<br /> - ' � " COLOR LOCATION 8 CITV �-,- � -' -
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<br /> . � . - � � . � . � Com CoCe CT.DIV ACTIVITV Spec Agcy �� � �
<br /> . 1 1 1 ' 1 _ {_ .
<br /> , $ y � ' � � ' -
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<br /> � Endan er Life Unsate Commercial riazardous - ��
<br /> 9 �Accldent ❑Conditions �Vehide �Mete�lal } �
<br /> . . . . . � � � �Or Property I � - - .
<br /> ' � - - BADGE NUMBER ORI NUMBER 1���.. _ �
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<br /> _ � ;5,$ � � ! O Z �7 l 5:� :� ' _ _
<br /> _ If you la/l to respond to ihls cltat/on wlthin 7 days, increased penaltles wlll
<br /> ' be assessed and e warrant may be Issued lor your arrest H a warrant ls __
<br /> ' lssued,a pena/ty of 330.00 wil/be added to the llne. _ '
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<br /> • � � COURT COPY-DO NOT WRITE ON REVE�25E
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