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WISCONSIN CITATION AND COMPLAINT(NON TRAFFIC) <br /> Ordinance/Alcohollfobacco/Harassment •Deposit Permitted ❑ cash (For Court Use Only) <br /> • P 215 5 5 0 Sporting Event Safety/Drug Paraphernalia l 00 UW Rule Violations juvenile $ ❑ card <br /> You Are Notified To Appear Defendant Name Last First MI <br /> • Is this a mandatory appearance? ❑yes X no FA ���k`/ <br /> Street Address `Po'st Ice State Zip Code <br /> (Read the reverse side of this citation for court information.) (7 0 r (�, D <br /> yv <br /> do <br /> I h d r 3 59 <br /> on 01/33/ 00 g at I 0:00 pm Driver License Numb or Other I.D.(specify) State Exp.Yr. <br /> D Co +/ Circuit Court <br /> i //ft rE)r' 9 Date of Birth Sex Race Height Weight Hair Eyes <br /> M r\ , V i 70 3 Defendant Violated: \(Check only 1 violation.)11125.07(4)(a) ❑254.92(2) ❑961.573(2) <br /> Ordinance No. I 0,a'S/ J(a) Adopting State ❑125.07(4)(b) ❑947.013(1m) ❑961.574(2) <br /> Statute: ❑125.085(3)(b) ❑167.32 ❑961.575(2) <br /> Plaintiff: ❑City ❑Village ❑Town ,County ❑UWS ❑125.09(2) ❑ <br /> OF: Dcf,, <br /> Description of Violation: YJ_ <br /> ❑State of Wisconsin ❑ Board of Regents rat ;lute„ fo 0L_/*:A �o' ;nr. /II���'Q,r s I <br /> At: (� Name&Address of Parent/Guardian/Legal Custodian <br /> Week Day Month-Day-Year Time ❑AM CS 0 c t.1 E 1 o� �?zt (if minor defendant) <br /> —09O{ /'� RPM City/Vllage <br /> 1-i RPM 0cAr Vern �CJI' <br /> Citation Served: ❑ Personally WI Mailed to defendant's last known address <br /> ❑Left with person residing at defendant's residence: Name Age <br /> Pri tOfficerN a Department I.D.No. Date Citation Issued Telephone Number of Parent/Guardian/ <br /> ata5 Jk J 1X2 Legal Custodian <br /> GF-1 116,04/02 //�i,` COURT COPY <br /> • <br /> • <br /> • <br /> • <br />