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WISCONSIN CITATION AND COMPLAINT(NON TRAFFIC) <br /> Ordinance/Alcohol/Tobacco/Harassment •Deposit Permitted <br /> 21554 ,9 Sporting Event Safety/Dru Paraphernalia (❑ cash (For Court Use Only) <br /> P UW Rule Violations ❑Juvenile $3 1' •0Q 1 <br /> ❑ card <br /> You Are Notified To Appear Defendagt Narpe-Last Fit MI <br /> Is this a mandatory appearance? Oyes Qno Street Address pn Post Office �� State Zip Code <br /> (Read the reverse side of this citation for court information.) LO\\ CH-// / 0 8 Po cl 'k5D,, / <br /> on /0"17--0 1 at el: CO pm® Driver License Number or Other I.D.(specify) State Exp.Yr. <br /> ()An e.- Co f f1 Circuit Court <br /> S S MN,'" to„ �'f Date of Birth Sex Race Height Weight Hair Eyes <br /> F. <br /> Aj .:,s , vi.� 5370 Defendant Violated: Check only'I violation.)❑125.07(4)(a) ❑254.92(2) ❑961.573(2) <br /> Ordinance No. i 0.�5(s (0.) State Adopting ❑125.07(4)(b) ❑947.013(1 m) ❑961.574(2) <br /> Statute: 0 125.085(3)(b) 0 167.32 0 961.575(2) <br /> Plaintiff: ❑City ❑ Village ❑Town .County <br /> OF: (� ❑UWS El 125.09(2) ❑ <br /> h °..i1 e- Description of Violation: <br /> ❑State of Wisconsin El /Board of Regents F-,:),,,,re__ 4-6 cory'y W 1 1 f` 1 0, r-5�d)( ) <br /> • At:r} r� Name&Address of Parent/Guardian/Legal Custodian <br /> Week Day Month-Day-Year Time ❑AM �I j a erg /l (if minor defendant) <br /> County CityNillage� / <br /> Wet I o-/_ Qg 3:DQ..QPM none 6 <br /> - 6'oom.'n- ,Ode <br /> Citation Served: ❑ Personally IK Mailed to defendant's last known address <br /> ❑Lett with person residing at defendant's residence: Name Age <br /> Print Officer Name Department I.D.No. Date Citation Issued Telephone Number of Parent/Guardian/ <br /> 44 OC Legal Custodian <br /> GF-116,04/02 COURT COPY <br />