|
^ ��--��"��"��"""'�"'�"' DISiRICTCOUAT � UNIFORMCITATIONNO. couNtrovNeNaEviN
<br /> � UISTqICT COUHT
<br /> 3 8 7- � �.,.,��o o«�s��y,�.�,h.� �� �- / —
<br /> :..:::::.: °�°��„m�«����,������a.u��� _'(j'(7 �0 2 3 7 9 2 :. ::. rne;55���0 0�,,�� states tnat tns Derson�.�
<br /> 0 2 3 7 91:::�:::�'. IM sletlon In01Ca�ed. v v/ �:�:;�j�}�: Celovr commitlecl tt�o ollense 6escriDeO in riolation ol
<br /> . . . . . ... IM 6e[tiOn in0�eateC. '
<br /> ? ::.
<br /> .,x °�'121�W
<br /> �TYPE .. ��:OE4REE � a "��.,,YSNADCD ARfA FON:.:'. � ,�,` COURT� .
<br /> , • P T C P A1 Q �:� � -_''OFFICEUSEONIY � � N�E ,.:;�.".DEQREE � SNADEDAREAFOR .'::._ 72td0. � CpURT
<br /> , -1>r , �`Q . Q P Y P A1 G OFFICEUSE ONLV
<br /> � j ORNER'SUCENSENUMBER STATE � ❑ � �
<br /> I DRIVEH'S LICENSE NUMBER STATE
<br /> � � I � � � � ' j � j i ' � � ! ' , �
<br /> NAME—�AST,FIRST,MIDDLElMAIDEN � �
<br /> • NAME—LAST,FIRST,MIDOLElMA EN
<br /> � - �NI E I � l. e�s� I � � � ; � � iEi � � � ; j j
<br /> I � � � � I ( ; ! ' ' ! i
<br /> �
<br /> ' ADDRESS 6 CITY � I I � I 1 � � � �
<br /> i . AODRESS6CITY � ��
<br /> i
<br /> 3� 53�6 � L � r� t ' �� Vi � I I � 3;5� �� � ' , ' A J' , '
<br /> I � ' i � STA7E ZIPCODE � , � ', , `
<br /> � i I � , i ; i I � i ( � i �. I ., STATE ZIPCADE�
<br /> A.,� 'Z�C�IT`AI I � � �
<br /> � n� ,� S s �3,� � 1�1a �z�a��T�a� � � , � 5'S",3 :
<br /> DATEOFBIRTH EYES HEIGHT WE16HT SEX OATEOFBIRTH EY S MEIGHT WEIGHT SEX
<br /> MO �' OAY � YEAR I ' t I ' �
<br /> i i i I� ( MO. DAY I YEAR '� �' 1
<br /> o � � Z 5 4,c� i I ' `
<br /> . VIOlATIONINFOANATION � �
<br /> ' DATEOFOFFENSE TINE METERNUMBER VtOLAT10NINFOIIMATION '
<br /> � � �� i DATEOFOFFENSE TIME METERNUMBER
<br /> I ! I � �OI �1 � � OO � I � � � � � ! , ; ;
<br /> ' � � �31C�igl ! ID: i ' ;
<br /> VEMICLE LICENSE PLATE STATE YEAR MAKE MODEL VEHIC LICENSE VLATE STA7E EAR MANE bt O D E I
<br /> ! � j I ! I , � � I � , i . � � I I '
<br /> ; � � , , ,
<br /> � ; � � � ,
<br /> co�oa �ocnrioN a an
<br /> i � � � i � I i ; � � . COLOR IOCATION 6 Cltt . .
<br /> �� ' i 3 :S;3�L) L � �r � �A�v E; � � ��, �G �. :L� f� � � v
<br /> p v' o'n.o' � � i ; i � ' � i ' ! I i ; � � r � � �
<br /> � I � � p :� : ��h , , ; . ,
<br /> 63.�.itltf-0a ORDINANCE N0. � DESCRIPTION �
<br /> c` . ,�o' i � i � I , f . y �'f1MfOfL�MOi1DINANCE NO. . �I ; OESGRIPTION
<br /> y 9 = ' �' ' ' ' , r'' _ �?' ,��Z� v 'b LZ � r a �
<br /> , i ; ; , � � ,
<br /> � o -�-!o ��.,a � ��; ;o F' ' k 3 � f ; � , . (�
<br /> � � � ' j , � Com Code CT.DIV. ACTIVITV � �+�+ � �'� ���4 ' D' • C' C� .
<br /> 3 Q , � ' � ' � � � � ; � � ComCoCe CT.CiV, aCTlVi7V -
<br /> W = r; L � O3 = V�E �h ; ,
<br /> � y � E'� b� ; � , �G; ���'S y o ;
<br /> < � < � ENDANGER LIFE �qCCIDENT � UNSAFE Q � ENDANGER LiFE UNSAFE
<br /> � o' OR PROPERTY CONDITtONS = ❑ACCIDENT
<br /> o OR PROPERTY �CONDITIONS
<br /> ¢ r � BADGENUMOER OR�NUMBER ! T BADGENUMBER ORINUMBER
<br /> < t
<br /> � � �
<br /> p � . . , , . � . . ,
<br /> i �j
<br /> ' e SOII MIN � � 'L�71F 5,�.d i ; I� S� ) M � :O Z+ 7 � ;50 O
<br /> I agree to responC to this citation an0 understand Ihat if I fail to do so within 7 days,increased I agree to respond to this citation and undorstand that il I fait to do so within 7 tlays,increased
<br /> penalties will be assessed and a warrani wlll be issued for my arrest.If a warrant is issued,a p e n a i t i e s w i l t b e a s s e s s e d a n d a warran t wi l l be issue d for my arrest.if a warrant i;issued,a
<br /> p e n a l t y o t S 3 0 wi l l be a 0 de d to t he line.
<br /> pe1 OEFENDANT'SSIGNATURE PCtldllyO�S30Wi11b08dd@dtOthBflllO.
<br /> De� • . . , � . .
<br /> DEFENDANT'S S16NATURE
<br /> DEI � ' i I � � ! I ; I i , � � , � , I � '
<br /> ; � ' � ;
<br /> � i i ; I ; i ' I � � � i
<br /> i ' � , ! ' � , � i �
<br /> � ' � i I i ! � , � i I i � , � , , I ; ,
<br /> � � � � i � I � , � j � i j � � , I '; , ;
<br /> , � i � � f � � I � � � � ; i ' � • I � j � � j � � � ;
<br /> F� � ' ' ' ' � I i ; � � i , , � � �
<br /> ��� COURT COPY-DO NOT WRITE ON E2EVERSE � COURT COPY-DO NOT WRITE ON REVERSE
<br /> ♦ S� ,
<br /> - _ ---�_.
<br /> ' ---- —...-LT.vn��»tiUl'Y-------- . ----- —
<br /> --
<br /> �-------- --------- — -- --- ---
<br /> ,
<br />
|