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<br /> UNIfORM CITATION NO. ��"'t"�""���"�"' UNIFORM CITATION NO. ��D 5 RICi COuqTVIN
<br /> DISTRICT COUNT 4
<br /> � (�(� �:. The Usuinp ollicer stabs IMt I�a p�rson naeneC
<br /> o rson
<br /> � The 168uinp oNiter atatea lluf ihs person name0 �?{T(_O� ��� � .:'.;':♦.,:.: pNpw ComrMtteA tns otiMse dateriOeG in violation d
<br /> � 388—0 4 9 7 3 7 ��:��::�::: ���,��Ma,.�..�,��,�,�e„�,o, �,�, ...
<br /> � ........ tAe asctlon Indlc�te0. . ..:. the secNon InOicalad.
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<br /> { „r � �r' � F ��OEQREE t s+"`. , �Pi �
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<br /> � �.� .kr� s.+R^:�4•. `.�' '�r✓T' �'�.. �.4�S
<br /> � ORIVER'SLICENSENUMBER STATE �`
<br /> ORIVER'S LICENSE NUMBER STATE ,
<br /> 1 � � i � i i � i � � j ' � i � j � '
<br /> � NAME—UST,FIRST,MIDOIEIMAIDEN � NAME—IASi,FIRSt,MIODIEIMAIDEN
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<br /> � ADDRESS t GTY � ADDRESS 6 CITY
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<br /> � � STATE ZIPCODE � � STATE ZIPCODE �
<br /> � I� 'z�T'b; ' ; ! � SS , rJ�;A ';��zA� ;� � � ; M s �
<br /> DATE OF BIRTH EYES HEIGMT WEIOMT SEX DATE OF BIRTM EYES HEIGHi WEN3MT SE%
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<br /> • �: •' TION INFORYATION t -•- ' "-VIOlAi10N INFORMATION
<br /> ' DATEOFOFFENSE TIME METERPIUMBER OFOFFENSE TIME METERNUMBER
<br /> 0_ ... :� i . � I., I e �. �' 1 � .
<br /> I , � i ' I � � � , , 1
<br /> YEMICLE LICENSE PIATE STATE YEAH MAKE MOOEL
<br /> ` VEHICLEUCENSEPLATE� STATE YEAR NAKE MODEL
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<br /> COIOR � LOCATION Q CIT/ ' CO.OR IOCATION 8 CIiY
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<br /> STATUTEORORDINANCENO. DE8CRIPTION � STAMEORORO�NANCENO. DESCRIPTION .
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<br /> = tr ' � } ` � ' � 'wti '� �o ► ' � = o� r ' ; i ;q � ! ; � !
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<br /> p - ComCoM CT.DIV. ,ACTIViTY i ¢ I � ( ComCoCe CT.DIV. ACTIVIT/ � : .
<br /> = 1'� �G � i a� s 0� � ' ' ' � i i � � � ' g' ' ; ' �
<br /> V i � I W � � i
<br /> < �ENDANGER LIFE �ACCIDENT � UNSAFE < �ENDANGER LIFE �ACCiDENT � UNSAFE
<br /> o' OR PROPERTY CONDITIONS o' OR PROPERTY CONDITIONS
<br /> > � BADGEN MBER ORINUMBER
<br /> BADGENUMBER ORINUMBER ,
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<br /> ,� } ,�� N p , ' b'Ui ; i ! ' ; 8 "" " ;o'Z+ I o '6' ; '
<br /> I ayree to respond to thia citalion and underatandlthat i}I fall to do ao withfn 7 daya,increased I agree to respond to thia citation and understand that if I fail to do so wlthin 7 daya,increased
<br /> penalties wlll be assessed and a warrant will be�sswd for my arnst.ll a warcant ia issued,a penaltlea will be assessed and a wanant will be issued for my arrest.If a warranl ls issued,a
<br /> penalty of t30 will be added to the fine. penalty of t30 will be added to the fine.
<br /> DEFENDANT$SIGNATURE DEFENDANTS SIGNATURE
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<br /> COURT COPY-DO NOT WRITE ON REVERSE COURT COPY-DO NOT WRITE ON REVERSE
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