charged in this citation, the court is authorized to enter a conviction and render judgment against me for the amount of my appearance bond in satisfaction of the penalty and surcharge plus court cost.

You hereby are given notice that within a reasonable time but no later than the date scheduled for yourinitial appearance a citation/complaint sworn under oath will be filed with the district court clerk of thecounty in which this citation was issued.

Speed

IA Code:

State of Iowa

this

Road Work Zone

Weight

Agency

City

Zone

Court Costs

1. I hereby swear and affirm that the information provided by me on this citation is true under penalty of providing false information.

My signature below is not a plea of guilty, but acknowledges all of the following:

PLAINTIFF

4. I hereby give my unsecured appearance bond in the amount of

ICIS Sec #:

Subscribed and sworn to me by

at

Fed/Adm Code:

NOTICE: Providing false identification information is a violation of Section 719.1A ofthe Code of Iowa and is punishable as a simple misdemeanor.

Law Enforcement Agency -

Violation

DL State

In the Court at

Located in the county and state aforesaid and did then and there commit the following offense:

Fatal Accident

DL Rest.

Dated

Court Date: If you must appear in court or if you choose to appear to answer to a charge which does not

day of

Zip Code

Form 420001E 1/07

DOB

Local Ord.

Height

require an appearance, report to the above named court on:

Court Appearance Required (805.10)

VS.

Name

DL/State IDViewed?

Race

Sex

The following applies to simple misdemeanors only:

The undersigned states that on or about

Sec #:

Upon a public highway at

CDLReq?

Year

dollars and enter my written appearance. I agree that if I fail to appear in person or by counsel to defend against the offense

DL End.

DL#

Address

IOWA UNIFORM CITATION AND COMPLAINT

I swear that the foregoing complaint is true and correct. , Iowa

ICC# Lic. Plate #/REG

I.D. No.

Reference #:

Signature ofDefendant

City of:

Dispatch /Case #:

20

US DOT#

DL Class

State

2. I promise to appear in said court at said time and place. I understand that a person who willfully fails to appear in court as specified by this citation may be subject to arrest and/or loss of driving privileges.

First

defendant did unlawfully: Operate Motor Vehicle/Boat

State

Scheduled Violation/Fine

Suffix

Criminal SurchargeSerious P.I.

in

Notary/other

Reason:

3. If a court appearance is not required, I may enter a plea of guilty prior to the designated appearance date by delivery in person, or by agent, or by mail to the court specified by this citation.

Civil Damage Assessment Other

County of:

Officer'sSignature

Total Fine/Costs

HazMat End Req?

Officer'sSignature

Non-scheduled Violation

X

ICIS Ord.

at

Defendant, Last

at

COMPLAINT

Pass EndReq?

Co. Enf. Surcharge

Middle

Notary/otherSignature

Dated

S81 EYER 150311 181642 4

*+S81EYER1503111816424+*

Citation #:

SAC COUNTY SHERIFF'S OFFICE

SAC - 81

SAC COUNTY COURTHOUSE 100 NW STATE STREET SUITE 12 SAC CITY IA 50583

202CC4220LEMASTER EVAN JOHN 11/20/1991YES

W NEthnicity50109-0000GRANGER IA2101 LOCUST ST APT 5

5' 10"IA B MALEC NONE

03/11/2015 6:16 PM 2002 GLD DODGE -DODG

STA 4D

2015 NOIA208YII

US 71/KARR AVE

5565$40.00

$14.00

$5.0015SPEEDING 55 OR < (6 THRU 10 OVER)RADAR (74)

$60.00

321.285 321.285-B$119.00

81-9

03/11/2015

03/11/2015

8:30 AM04/13/2015

$148.50

SAC CITY - 6717MEYER, JONATHAN

MARCH, 201511

OTHERSAC COUNTY SHERIFF'S OFFICE

NOT GUILTY

Driver's LicenseRecommendation

OTHER DISPOSITION

Other

Susp.

Yr.

BAIL CASH DEPOSIT

DATE: Continued to:

Incarceration in

VERDICT

WARRANT ISSUED

Iowa

DISMISSED

TESTIMONY - JUDGE'S NOTES: (Other Orders)

Revo

Mo.

Signature, person giving bail

TO THE COURT: The following are witnesses who can give testimony relating to the facts of this alleged violation. Please subpoena prosecuting witness:

COST $

ABSTRACT OF COURT RECORD

Address

JURY TRIAL

Days:

DOCKET NO.

REASON

CASE NO.

School

CASE NO.

STATE:

Days

Name

FORFEIT BOND

The court Therefore Enters in Following Order This Date

REASON

Phone

PLEA

LICENSE NO.

NOT GUILTY

Citation #:

GUILTY

Signature, person taking bailDate

DATE:

NO JURY TRIAL orPROCEEDING

GUILTY

DATE:

None

Day

COURT NO.

FINED $ SURCHARGE $ Continued to:

S81 EYER 150311 181642 4

FILED 03/12/2015 08:02AMCLERK DISTRICT COURTSAC COUNTY IOWA

charged in this citation, the court is authorized to enter a conviction and render judgment against me for the amount of my appearance bond in satisfaction of the penalty and surcharge plus court cost.

You hereby are given notice that within a reasonable time but no later than the date scheduled for yourinitial appearance a citation/complaint sworn under oath will be filed with the district court clerk of thecounty in which this citation was issued.

Speed

IA Code:

State of Iowa

this

Road Work Zone

Weight

Agency

City

Zone

Court Costs

1. I hereby swear and affirm that the information provided by me on this citation is true under penalty of providing false information.

My signature below is not a plea of guilty, but acknowledges all of the following:

PLAINTIFF

4. I hereby give my unsecured appearance bond in the amount of

ICIS Sec #:

Subscribed and sworn to me by

at

Fed/Adm Code:

NOTICE: Providing false identification information is a violation of Section 719.1A ofthe Code of Iowa and is punishable as a simple misdemeanor.

Law Enforcement Agency -

Violation

DL State

In the Court at

Located in the county and state aforesaid and did then and there commit the following offense:

Fatal Accident

DL Rest.

Dated

Court Date: If you must appear in court or if you choose to appear to answer to a charge which does not

day of

Zip Code

Form 420001E 1/07

DOB

Local Ord.

Height

require an appearance, report to the above named court on:

Court Appearance Required (805.10)

VS.

Name

DL/State IDViewed?

Race

Sex

The following applies to simple misdemeanors only:

The undersigned states that on or about

Sec #:

Upon a public highway at

CDLReq?

Year

dollars and enter my written appearance. I agree that if I fail to appear in person or by counsel to defend against the offense

DL End.

DL#

Address

IOWA UNIFORM CITATION AND COMPLAINT

I swear that the foregoing complaint is true and correct. , Iowa

ICC# Lic. Plate #/REG

I.D. No.

Reference #:

Signature ofDefendant

City of:

Dispatch /Case #:

20

US DOT#

DL Class

State

2. I promise to appear in said court at said time and place. I understand that a person who willfully fails to appear in court as specified by this citation may be subject to arrest and/or loss of driving privileges.

First

defendant did unlawfully: Operate Motor Vehicle/Boat

State

Scheduled Violation/Fine

Suffix

Criminal SurchargeSerious P.I.

in

Notary/other

Reason:

3. If a court appearance is not required, I may enter a plea of guilty prior to the designated appearance date by delivery in person, or by agent, or by mail to the court specified by this citation.

Civil Damage Assessment Other

County of:

Officer'sSignature

Total Fine/Costs

HazMat End Req?

Officer'sSignature

Non-scheduled Violation

X

ICIS Ord.

at

Defendant, Last

at

COMPLAINT

Pass EndReq?

Co. Enf. Surcharge

Middle

Notary/otherSignature

Dated

S81 EYER 150311 153443 3

*+S81EYER1503111534433+*

Citation #:

SAC COUNTY SHERIFF'S OFFICE

SAC - 81

SAC COUNTY COURTHOUSE 100 NW STATE STREET SUITE 12 SAC CITY IA 50583

028BB3276MEYERS PATRICIA EDITH 2/22/1963YES

W NEthnicity50315-0000DES MOINES IA716 SE HACKLEY AVE

5' 04"IA NONE FEMALEC NONE

03/11/2015 3:34 PM 2014 GRY TOYOTA -TOYT

CAM 4D

2016 NOIACUW218

STATE 175/330TH ST

5565$40.00

$14.00

$5.0015SPEEDING 55 OR < (6 THRU 10 OVER)RADAR (76)

$60.00

321.285 321.285-B$119.00

81-9

03/11/2015

03/11/2015

8:30 AM04/13/2015

$148.50

SAC CITY - 6717MEYER, JONATHAN

MARCH, 201511

OTHERSAC COUNTY SHERIFF'S OFFICE

NOT GUILTY

Driver's LicenseRecommendation

OTHER DISPOSITION

Other

Susp.

Yr.

BAIL CASH DEPOSIT

DATE: Continued to:

Incarceration in

VERDICT

WARRANT ISSUED

Iowa

DISMISSED

TESTIMONY - JUDGE'S NOTES: (Other Orders)

Revo

Mo.

Signature, person giving bail

TO THE COURT: The following are witnesses who can give testimony relating to the facts of this alleged violation. Please subpoena prosecuting witness:

COST $

ABSTRACT OF COURT RECORD

Address

JURY TRIAL

Days:

DOCKET NO.

REASON

CASE NO.

School

CASE NO.

STATE:

Days

Name

FORFEIT BOND

The court Therefore Enters in Following Order This Date

REASON

Phone

PLEA

LICENSE NO.

NOT GUILTY

Citation #:

GUILTY

Signature, person taking bailDate

DATE:

NO JURY TRIAL orPROCEEDING

GUILTY

DATE:

None

Day

COURT NO.

FINED $ SURCHARGE $ Continued to:

S81 EYER 150311 153443 3

FILED 03/12/2015 08:03AMCLERK DISTRICT COURTSAC COUNTY IOWA

charged in this citation, the court is authorized to enter a conviction and render judgment against me for the amount of my appearance bond in satisfaction of the penalty and surcharge plus court cost.

You hereby are given notice that within a reasonable time but no later than the date scheduled for yourinitial appearance a citation/complaint sworn under oath will be filed with the district court clerk of thecounty in which this citation was issued.

Speed

IA Code:

State of Iowa

this

Road Work Zone

Weight

Agency

City

Zone

Court Costs

1. I hereby swear and affirm that the information provided by me on this citation is true under penalty of providing false information.

My signature below is not a plea of guilty, but acknowledges all of the following:

PLAINTIFF

4. I hereby give my unsecured appearance bond in the amount of

ICIS Sec #:

Subscribed and sworn to me by

at

Fed/Adm Code:

NOTICE: Providing false identification information is a violation of Section 719.1A ofthe Code of Iowa and is punishable as a simple misdemeanor.

Law Enforcement Agency -

Violation

DL State

In the Court at

Located in the county and state aforesaid and did then and there commit the following offense:

Fatal Accident

DL Rest.

Dated

Court Date: If you must appear in court or if you choose to appear to answer to a charge which does not

day of

Zip Code

Form 420001E 1/07

DOB

Local Ord.

Height

require an appearance, report to the above named court on:

Court Appearance Required (805.10)

VS.

Name

DL/State IDViewed?

Race

Sex

The following applies to simple misdemeanors only:

The undersigned states that on or about

Sec #:

Upon a public highway at

CDLReq?

Year

dollars and enter my written appearance. I agree that if I fail to appear in person or by counsel to defend against the offense

DL End.

DL#

Address

IOWA UNIFORM CITATION AND COMPLAINT

I swear that the foregoing complaint is true and correct. , Iowa

ICC# Lic. Plate #/REG

I.D. No.

Reference #:

Signature ofDefendant

City of:

Dispatch /Case #:

20

US DOT#

DL Class

State

2. I promise to appear in said court at said time and place. I understand that a person who willfully fails to appear in court as specified by this citation may be subject to arrest and/or loss of driving privileges.

First

defendant did unlawfully: Operate Motor Vehicle/Boat

State

Scheduled Violation/Fine

Suffix

Criminal SurchargeSerious P.I.

in

Notary/other

Reason:

3. If a court appearance is not required, I may enter a plea of guilty prior to the designated appearance date by delivery in person, or by agent, or by mail to the court specified by this citation.

Civil Damage Assessment Other

County of:

Officer'sSignature

Total Fine/Costs

HazMat End Req?

Officer'sSignature

Non-scheduled Violation

X

ICIS Ord.

at

Defendant, Last

at

COMPLAINT

Pass EndReq?

Co. Enf. Surcharge

Middle

Notary/otherSignature

Dated

T01 T404 150310 144853 2

*+T01T4041503101448532+*

Citation #:

MOTOR VEHICLE ENFORCEMENT

SAC - 81

SAC COUNTY COURTHOUSE 100 NW STATE STREET SUITE 12 SAC CITY IA 50583

007250333LEE MICHAEL ALAN 3/18/1977YES

W NEthnicity29609-0900GREENVILLE SC71 CRESTVIEW DR

6' 01"SC 210 LBSNONE MALED NONE

03/10/2015 2:20 PM 2013 WHI CHEVROLET - CHEV

SILVERADO TR/ST

2015 NOSCP45554700596960

US 71/KARR AVE

$50.00

$17.50393.100B

N/A13GAS CANS IN THE BACK OF THE TRUCK ONE WITH APPROX 1 G OF IT

UPSIDEDOWN NOT SEC$60.00

321.449 321.449-A$127.50

T404

03/10/2015

03/10/2015

8:30 AM03/23/2015

$161.25

EARLY - 2200HANSEN, JEFFREY

MARCH, 201512

OTHERMOTOR VEHICLE ENFORCEMENT

NOT GUILTY

Driver's LicenseRecommendation

OTHER DISPOSITION

Other

Susp.

Yr.

BAIL CASH DEPOSIT

DATE: Continued to:

Incarceration in

VERDICT

WARRANT ISSUED

Iowa

DISMISSED

TESTIMONY - JUDGE'S NOTES: (Other Orders)

Revo

Mo.

Signature, person giving bail

TO THE COURT: The following are witnesses who can give testimony relating to the facts of this alleged violation. Please subpoena prosecuting witness:

COST $

ABSTRACT OF COURT RECORD

Address

JURY TRIAL

Days:

DOCKET NO.

REASON

CASE NO.

School

CASE NO.

STATE:

Days

Name

FORFEIT BOND

The court Therefore Enters in Following Order This Date

REASON

Phone

PLEA

LICENSE NO.

NOT GUILTY

Citation #:

GUILTY

Signature, person taking bailDate

DATE:

NO JURY TRIAL orPROCEEDING

GUILTY

DATE:

None

Day

COURT NO.

FINED $ SURCHARGE $ Continued to:

T01 T404 150310 144853 2

FILED 03/12/2015 04:30PMCLERK DISTRICT COURTSAC COUNTY IOWA

charged in this citation, the court is authorized to enter a conviction and render judgment against me for the amount of my appearance bond in satisfaction of the penalty and surcharge plus court cost.

You hereby are given notice that within a reasonable time but no later than the date scheduled for yourinitial appearance a citation/complaint sworn under oath will be filed with the district court clerk of thecounty in which this citation was issued.

Speed

IA Code:

State of Iowa

this

Road Work Zone

Weight

Agency

City

Zone

Court Costs

1. I hereby swear and affirm that the information provided by me on this citation is true under penalty of providing false information.

My signature below is not a plea of guilty, but acknowledges all of the following:

PLAINTIFF

4. I hereby give my unsecured appearance bond in the amount of

ICIS Sec #:

Subscribed and sworn to me by

at

Fed/Adm Code:

NOTICE: Providing false identification information is a violation of Section 719.1A ofthe Code of Iowa and is punishable as a simple misdemeanor.

Law Enforcement Agency -

Violation

DL State

In the Court at

Located in the county and state aforesaid and did then and there commit the following offense:

Fatal Accident

DL Rest.

Dated

Court Date: If you must appear in court or if you choose to appear to answer to a charge which does not

day of

Zip Code

Form 420001E 1/07

DOB

Local Ord.

Height

require an appearance, report to the above named court on:

Court Appearance Required (805.10)

VS.

Name

DL/State IDViewed?

Race

Sex

The following applies to simple misdemeanors only:

The undersigned states that on or about

Sec #:

Upon a public highway at

CDLReq?

Year

dollars and enter my written appearance. I agree that if I fail to appear in person or by counsel to defend against the offense

DL End.

DL#

Address

IOWA UNIFORM CITATION AND COMPLAINT

I swear that the foregoing complaint is true and correct. , Iowa

ICC# Lic. Plate #/REG

I.D. No.

Reference #:

Signature ofDefendant

City of:

Dispatch /Case #:

20

US DOT#

DL Class

State

2. I promise to appear in said court at said time and place. I understand that a person who willfully fails to appear in court as specified by this citation may be subject to arrest and/or loss of driving privileges.

First

defendant did unlawfully: Operate Motor Vehicle/Boat

State

Scheduled Violation/Fine

Suffix

Criminal SurchargeSerious P.I.

in

Notary/other

Reason:

3. If a court appearance is not required, I may enter a plea of guilty prior to the designated appearance date by delivery in person, or by agent, or by mail to the court specified by this citation.

Civil Damage Assessment Other

County of:

Officer'sSignature

Total Fine/Costs

HazMat End Req?

Officer'sSignature

Non-scheduled Violation

X

ICIS Ord.

at

Defendant, Last

at

COMPLAINT

Pass EndReq?

Co. Enf. Surcharge

Middle

Notary/otherSignature

Dated

T01 T404 150310 144909 3

*+T01T4041503101449093+*

Citation #:

MOTOR VEHICLE ENFORCEMENT

SAC - 81

SAC COUNTY COURTHOUSE 100 NW STATE STREET SUITE 12 SAC CITY IA 50583

007250333LEE MICHAEL ALAN 3/18/1977YES

W NEthnicity29609-0900GREENVILLE SC71 CRESTVIEW DR

6' 01"SC 210 LBSNONE MALED NONE

03/10/2015 2:20 PM 2013 WHI CHEVROLET - CHEV

SILVERADO TR/ST

2015 NOSCP45554700596960

US 71/KARR AVE

$20.00

$7.00392.2RG

N/A13DRIVER NOT CARRYING REG PAPER FOR THE TRAILER

$60.00

321.32 321.32$87.00

T404

03/10/2015

03/10/2015

8:30 AM03/23/2015

$100.50

EARLY - 2200HANSEN, JEFFREY

MARCH, 201512

OTHERMOTOR VEHICLE ENFORCEMENT

NOT GUILTY

Driver's LicenseRecommendation

OTHER DISPOSITION

Other

Susp.

Yr.

BAIL CASH DEPOSIT

DATE: Continued to:

Incarceration in

VERDICT

WARRANT ISSUED

Iowa

DISMISSED

TESTIMONY - JUDGE'S NOTES: (Other Orders)

Revo

Mo.

Signature, person giving bail

TO THE COURT: The following are witnesses who can give testimony relating to the facts of this alleged violation. Please subpoena prosecuting witness:

COST $

ABSTRACT OF COURT RECORD

Address

JURY TRIAL

Days:

DOCKET NO.

REASON

CASE NO.

School

CASE NO.

STATE:

Days

Name

FORFEIT BOND

The court Therefore Enters in Following Order This Date

REASON

Phone

PLEA

LICENSE NO.

NOT GUILTY

Citation #:

GUILTY

Signature, person taking bailDate

DATE:

NO JURY TRIAL orPROCEEDING

GUILTY

DATE:

None

Day

COURT NO.

FINED $ SURCHARGE $ Continued to:

T01 T404 150310 144909 3

FILED 03/12/2015 04:30PMCLERK DISTRICT COURTSAC COUNTY IOWA

charged in this citation, the court is authorized to enter a conviction and render judgment against me for the amount of my appearance bond in satisfaction of the penalty and surcharge plus court cost.

You hereby are given notice that within a reasonable time but no later than the date scheduled for yourinitial appearance a citation/complaint sworn under oath will be filed with the district court clerk of thecounty in which this citation was issued.

Speed

IA Code:

State of Iowa

this

Road Work Zone

Weight

Agency

City

Zone

Court Costs

1. I hereby swear and affirm that the information provided by me on this citation is true under penalty of providing false information.

My signature below is not a plea of guilty, but acknowledges all of the following:

PLAINTIFF

4. I hereby give my unsecured appearance bond in the amount of

ICIS Sec #:

Subscribed and sworn to me by

at

Fed/Adm Code:

NOTICE: Providing false identification information is a violation of Section 719.1A ofthe Code of Iowa and is punishable as a simple misdemeanor.

Law Enforcement Agency -

Violation

DL State

In the Court at

Located in the county and state aforesaid and did then and there commit the following offense:

Fatal Accident

DL Rest.

Dated

Court Date: If you must appear in court or if you choose to appear to answer to a charge which does not

day of

Zip Code

Form 420001E 1/07

DOB

Local Ord.

Height

require an appearance, report to the above named court on:

Court Appearance Required (805.10)

VS.

Name

DL/State IDViewed?

Race

Sex

The following applies to simple misdemeanors only:

The undersigned states that on or about

Sec #:

Upon a public highway at

CDLReq?

Year

dollars and enter my written appearance. I agree that if I fail to appear in person or by counsel to defend against the offense

DL End.

DL#

Address

IOWA UNIFORM CITATION AND COMPLAINT

I swear that the foregoing complaint is true and correct. , Iowa

ICC# Lic. Plate #/REG

I.D. No.

Reference #:

Signature ofDefendant

City of:

Dispatch /Case #:

20

US DOT#

DL Class

State

2. I promise to appear in said court at said time and place. I understand that a person who willfully fails to appear in court as specified by this citation may be subject to arrest and/or loss of driving privileges.

First

defendant did unlawfully: Operate Motor Vehicle/Boat

State

Scheduled Violation/Fine

Suffix

Criminal SurchargeSerious P.I.

in

Notary/other

Reason:

3. If a court appearance is not required, I may enter a plea of guilty prior to the designated appearance date by delivery in person, or by agent, or by mail to the court specified by this citation.

Civil Damage Assessment Other

County of:

Officer'sSignature

Total Fine/Costs

HazMat End Req?

Officer'sSignature

Non-scheduled Violation

X

ICIS Ord.

at

Defendant, Last

at

COMPLAINT

Pass EndReq?

Co. Enf. Surcharge

Middle

Notary/otherSignature

Dated

T01 T404 150310 144945 4

*+T01T4041503101449454+*

Citation #:

MOTOR VEHICLE ENFORCEMENT

SAC - 81

SAC COUNTY COURTHOUSE 100 NW STATE STREET SUITE 12 SAC CITY IA 50583

007250333LEE MICHAEL ALAN 3/18/1977YES

W NEthnicity29609-0900GREENVILLE SC71 CRESTVIEW DR

6' 01"SC 210 LBSNONE MALED NONE

03/10/2015 2:20 PM 2013 WHI CHEVROLET - CHEV

SILVERADO TR/ST

2015 NOSCP45554700596960

US 71/KARR AVE

$50.00

$17.50393.43

N/A13INOP BREAKAWAY DEVICE FOR THE TRAILER

$60.00

321.449 321.449-A$127.50

T404

03/10/2015

03/10/2015

8:30 AM03/23/2015

$161.25

EARLY - 2200HANSEN, JEFFREY

MARCH, 201512

OTHERMOTOR VEHICLE ENFORCEMENT

NOT GUILTY

Driver's LicenseRecommendation

OTHER DISPOSITION

Other

Susp.

Yr.

BAIL CASH DEPOSIT

DATE: Continued to:

Incarceration in

VERDICT

WARRANT ISSUED

Iowa

DISMISSED

TESTIMONY - JUDGE'S NOTES: (Other Orders)

Revo

Mo.

Signature, person giving bail

TO THE COURT: The following are witnesses who can give testimony relating to the facts of this alleged violation. Please subpoena prosecuting witness:

COST $

ABSTRACT OF COURT RECORD

Address

JURY TRIAL

Days:

DOCKET NO.

REASON

CASE NO.

School

CASE NO.

STATE:

Days

Name

FORFEIT BOND

The court Therefore Enters in Following Order This Date

REASON

Phone

PLEA

LICENSE NO.

NOT GUILTY

Citation #:

GUILTY

Signature, person taking bailDate

DATE:

NO JURY TRIAL orPROCEEDING

GUILTY

DATE:

None

Day

COURT NO.

FINED $ SURCHARGE $ Continued to:

T01 T404 150310 144945 4

FILED 03/12/2015 04:30PMCLERK DISTRICT COURTSAC COUNTY IOWA

charged in this citation, the court is authorized to enter a conviction and render judgment against me for the amount of my appearance bond in satisfaction of the penalty and surcharge plus court cost.

You hereby are given notice that within a reasonable time but no later than the date scheduled for yourinitial appearance a citation/complaint sworn under oath will be filed with the district court clerk of thecounty in which this citation was issued.

Speed

IA Code:

State of Iowa

this

Road Work Zone

Weight

Agency

City

Zone

Court Costs

1. I hereby swear and affirm that the information provided by me on this citation is true under penalty of providing false information.

My signature below is not a plea of guilty, but acknowledges all of the following:

PLAINTIFF

4. I hereby give my unsecured appearance bond in the amount of

ICIS Sec #:

Subscribed and sworn to me by

at

Fed/Adm Code:

NOTICE: Providing false identification information is a violation of Section 719.1A ofthe Code of Iowa and is punishable as a simple misdemeanor.

Law Enforcement Agency -

Violation

DL State

In the Court at

Located in the county and state aforesaid and did then and there commit the following offense:

Fatal Accident

DL Rest.

Dated

Court Date: If you must appear in court or if you choose to appear to answer to a charge which does not

day of

Zip Code

Form 420001E 1/07

DOB

Local Ord.

Height

require an appearance, report to the above named court on:

Court Appearance Required (805.10)

VS.

Name

DL/State IDViewed?

Race

Sex

The following applies to simple misdemeanors only:

The undersigned states that on or about

Sec #:

Upon a public highway at

CDLReq?

Year

dollars and enter my written appearance. I agree that if I fail to appear in person or by counsel to defend against the offense

DL End.

DL#

Address

IOWA UNIFORM CITATION AND COMPLAINT

I swear that the foregoing complaint is true and correct. , Iowa

ICC# Lic. Plate #/REG

I.D. No.

Reference #:

Signature ofDefendant

City of:

Dispatch /Case #:

20

US DOT#

DL Class

State

2. I promise to appear in said court at said time and place. I understand that a person who willfully fails to appear in court as specified by this citation may be subject to arrest and/or loss of driving privileges.

First

defendant did unlawfully: Operate Motor Vehicle/Boat

State

Scheduled Violation/Fine

Suffix

Criminal SurchargeSerious P.I.

in

Notary/other

Reason:

3. If a court appearance is not required, I may enter a plea of guilty prior to the designated appearance date by delivery in person, or by agent, or by mail to the court specified by this citation.

Civil Damage Assessment Other

County of:

Officer'sSignature

Total Fine/Costs

HazMat End Req?

Officer'sSignature

Non-scheduled Violation

X

ICIS Ord.

at

Defendant, Last

at

COMPLAINT

Pass EndReq?

Co. Enf. Surcharge

Middle

Notary/otherSignature

Dated

T01 T404 150311 075701 8

*+T01T4041503110757018+*

Citation #:

MOTOR VEHICLE ENFORCEMENT

SAC - 81

SAC COUNTY COURTHOUSE 100 NW STATE STREET SUITE 12 SAC CITY IA 50583

G59078374HUTFLESS DENNIS W 1/23/1964YES

W NEthnicity68022-0000ELKHORN NE20706 PARKER ST

6' 00"NE 230 LBSB MALEA TX

03/11/2015 7:40 AM 2009 RED FREIGHTLINER - F

TT/ST

2015 YES NO NONE14352000336067 241522

US 71/330TH ST

5565$40.00

$14.00392.2-SLLS3

N/A15SPEED WB HWY 175 JUST E OF M50 AS 68 IN A 55 ZONE

$60.00

321.285 321.285-B$114.00

T404

03/11/2015

03/11/2015

8:30 AM03/23/2015

$141.00

EARLY - 2200HANSEN, JEFFREY

MARCH, 201512

OTHERMOTOR VEHICLE ENFORCEMENT

NOT GUILTY

Driver's LicenseRecommendation

OTHER DISPOSITION

Other

Susp.

Yr.

BAIL CASH DEPOSIT

DATE: Continued to:

Incarceration in

VERDICT

WARRANT ISSUED

Iowa

DISMISSED

TESTIMONY - JUDGE'S NOTES: (Other Orders)

Revo

Mo.

Signature, person giving bail

TO THE COURT: The following are witnesses who can give testimony relating to the facts of this alleged violation. Please subpoena prosecuting witness:

COST $

ABSTRACT OF COURT RECORD

Address

JURY TRIAL

Days:

DOCKET NO.

REASON

CASE NO.

School

CASE NO.

STATE:

Days

Name

FORFEIT BOND

The court Therefore Enters in Following Order This Date

REASON

Phone

PLEA

LICENSE NO.

NOT GUILTY

Citation #:

GUILTY

Signature, person taking bailDate

DATE:

NO JURY TRIAL orPROCEEDING

GUILTY

DATE:

None

Day

COURT NO.

FINED $ SURCHARGE $ Continued to:

T01 T404 150311 075701 8

FILED 03/12/2015 04:30PMCLERK DISTRICT COURTSAC COUNTY IOWA

charged in this citation, the court is authorized to enter a conviction and render judgment against me for the amount of my appearance bond in satisfaction of the penalty and surcharge plus court cost.

You hereby are given notice that within a reasonable time but no later than the date scheduled for yourinitial appearance a citation/complaint sworn under oath will be filed with the district court clerk of thecounty in which this citation was issued.

Speed

IA Code:

State of Iowa

this

Road Work Zone

Weight

Agency

City

Zone

Court Costs

1. I hereby swear and affirm that the information provided by me on this citation is true under penalty of providing false information.

My signature below is not a plea of guilty, but acknowledges all of the following:

PLAINTIFF

4. I hereby give my unsecured appearance bond in the amount of

ICIS Sec #:

Subscribed and sworn to me by

at

Fed/Adm Code:

NOTICE: Providing false identification information is a violation of Section 719.1A ofthe Code of Iowa and is punishable as a simple misdemeanor.

Law Enforcement Agency -

Violation

DL State

In the Court at

Located in the county and state aforesaid and did then and there commit the following offense:

Fatal Accident

DL Rest.

Dated

Court Date: If you must appear in court or if you choose to appear to answer to a charge which does not

day of

Zip Code

Form 420001E 1/07

DOB

Local Ord.

Height

require an appearance, report to the above named court on:

Court Appearance Required (805.10)

VS.

Name

DL/State IDViewed?

Race

Sex

The following applies to simple misdemeanors only:

The undersigned states that on or about

Sec #:

Upon a public highway at

CDLReq?

Year

dollars and enter my written appearance. I agree that if I fail to appear in person or by counsel to defend against the offense

DL End.

DL#

Address

IOWA UNIFORM CITATION AND COMPLAINT

I swear that the foregoing complaint is true and correct. , Iowa

ICC# Lic. Plate #/REG

I.D. No.

Reference #:

Signature ofDefendant

City of:

Dispatch /Case #:

20

US DOT#

DL Class

State

2. I promise to appear in said court at said time and place. I understand that a person who willfully fails to appear in court as specified by this citation may be subject to arrest and/or loss of driving privileges.

First

defendant did unlawfully: Operate Motor Vehicle/Boat

State

Scheduled Violation/Fine

Suffix

Criminal SurchargeSerious P.I.

in

Notary/other

Reason:

3. If a court appearance is not required, I may enter a plea of guilty prior to the designated appearance date by delivery in person, or by agent, or by mail to the court specified by this citation.

Civil Damage Assessment Other

County of:

Officer'sSignature

Total Fine/Costs

HazMat End Req?

Officer'sSignature

Non-scheduled Violation

X

ICIS Ord.

at

Defendant, Last

at

COMPLAINT

Pass EndReq?

Co. Enf. Surcharge

Middle

Notary/otherSignature

Dated

T01 T404 150311 141459 1

*+T01T4041503111414591+*

Citation #:

MOTOR VEHICLE ENFORCEMENT

SAC - 81

SAC COUNTY COURTHOUSE 100 NW STATE STREET SUITE 12 SAC CITY IA 50583

641ZZ6417SUNDE ROBERT ALLEN 3/3/1945YES

W NEthnicity50436-0000FOREST CITY IA136 WESTGATE DR

5' 10"IA 195 LBSNONE MALEA N

03/11/2015 1:58 PM 2004 GRY PETERBILT - PTRB

TT/ST

2015 YES NO NOIASE168400561638

STATE 175/330TH ST

$50.00

$17.50392.16

N/A13DRIVER WAS NOT WEARING HIS SEATBELT WHILE TRAVELING ON HWY

175$60.00

321.445 321.445$127.50

T404

03/11/2015

03/11/2015

8:30 AM03/23/2015

$161.25

EARLY - 2200HANSEN, JEFFREY

MARCH, 201512

OTHERMOTOR VEHICLE ENFORCEMENT

NOT GUILTY

Driver's LicenseRecommendation

OTHER DISPOSITION

Other

Susp.

Yr.

BAIL CASH DEPOSIT

DATE: Continued to:

Incarceration in

VERDICT

WARRANT ISSUED

Iowa

DISMISSED

TESTIMONY - JUDGE'S NOTES: (Other Orders)

Revo

Mo.

Signature, person giving bail

TO THE COURT: The following are witnesses who can give testimony relating to the facts of this alleged violation. Please subpoena prosecuting witness:

COST $

ABSTRACT OF COURT RECORD

Address

JURY TRIAL

Days:

DOCKET NO.

REASON

CASE NO.

School

CASE NO.

STATE:

Days

Name

FORFEIT BOND

The court Therefore Enters in Following Order This Date

REASON

Phone

PLEA

LICENSE NO.

NOT GUILTY

Citation #:

GUILTY

Signature, person taking bailDate

DATE:

NO JURY TRIAL orPROCEEDING

GUILTY

DATE:

None

Day

COURT NO.

FINED $ SURCHARGE $ Continued to:

T01 T404 150311 141459 1

FILED 03/12/2015 04:31PMCLERK DISTRICT COURTSAC COUNTY IOWA

charged in this citation, the court is authorized to enter a conviction and render judgment against me for the amount of my appearance bond in satisfaction of the penalty and surcharge plus court cost.

You hereby are given notice that within a reasonable time but no later than the date scheduled for yourinitial appearance a citation/complaint sworn under oath will be filed with the district court clerk of thecounty in which this citation was issued.

Speed

IA Code:

State of Iowa

this

Road Work Zone

Weight

Agency

City

Zone

Court Costs

1. I hereby swear and affirm that the information provided by me on this citation is true under penalty of providing false information.

My signature below is not a plea of guilty, but acknowledges all of the following:

PLAINTIFF

4. I hereby give my unsecured appearance bond in the amount of

ICIS Sec #:

Subscribed and sworn to me by

at

Fed/Adm Code:

NOTICE: Providing false identification information is a violation of Section 719.1A ofthe Code of Iowa and is punishable as a simple misdemeanor.

Law Enforcement Agency -

Violation

DL State

In the Court at

Located in the county and state aforesaid and did then and there commit the following offense:

Fatal Accident

DL Rest.

Dated

Court Date: If you must appear in court or if you choose to appear to answer to a charge which does not

day of

Zip Code

Form 420001E 1/07

DOB

Local Ord.

Height

require an appearance, report to the above named court on:

Court Appearance Required (805.10)

VS.

Name

DL/State IDViewed?

Race

Sex

The following applies to simple misdemeanors only:

The undersigned states that on or about

Sec #:

Upon a public highway at

CDLReq?

Year

dollars and enter my written appearance. I agree that if I fail to appear in person or by counsel to defend against the offense

DL End.

DL#

Address

IOWA UNIFORM CITATION AND COMPLAINT

I swear that the foregoing complaint is true and correct. , Iowa

ICC# Lic. Plate #/REG

I.D. No.

Reference #:

Signature ofDefendant

City of:

Dispatch /Case #:

20

US DOT#

DL Class

State

2. I promise to appear in said court at said time and place. I understand that a person who willfully fails to appear in court as specified by this citation may be subject to arrest and/or loss of driving privileges.

First

defendant did unlawfully: Operate Motor Vehicle/Boat

State

Scheduled Violation/Fine

Suffix

Criminal SurchargeSerious P.I.

in

Notary/other

Reason:

3. If a court appearance is not required, I may enter a plea of guilty prior to the designated appearance date by delivery in person, or by agent, or by mail to the court specified by this citation.

Civil Damage Assessment Other

County of:

Officer'sSignature

Total Fine/Costs

HazMat End Req?

Officer'sSignature

Non-scheduled Violation

X

ICIS Ord.

at

Defendant, Last

at

COMPLAINT

Pass EndReq?

Co. Enf. Surcharge

Middle

Notary/otherSignature

Dated

T01 T404 150311 141738 2

*+T01T4041503111417382+*

Citation #:

MOTOR VEHICLE ENFORCEMENT

SAC - 81

SAC COUNTY COURTHOUSE 100 NW STATE STREET SUITE 12 SAC CITY IA 50583

641ZZ6417SUNDE ROBERT ALLEN 3/3/1945YES

W NEthnicity50436-0000FOREST CITY IA136 WESTGATE DR

5' 10"IA 195 LBSNONE MALEA N

03/11/2015 1:58 PM 2004 GRY PETERBILT - PTRB

TT/ST

2015 YES NO NOIASE168400561638

STATE 175/330TH ST

$50.00

$17.50393.95A

N/A13DISCHARGED FIRE EXTINGUISHER IN THE TRUCK

$60.00

321.449 321.449-A$127.50

T404

03/11/2015

03/11/2015

8:30 AM03/23/2015

$161.25

EARLY - 2200HANSEN, JEFFREY

MARCH, 201512

OTHERMOTOR VEHICLE ENFORCEMENT

NOT GUILTY

Driver's LicenseRecommendation

OTHER DISPOSITION

Other

Susp.

Yr.

BAIL CASH DEPOSIT

DATE: Continued to:

Incarceration in

VERDICT

WARRANT ISSUED

Iowa

DISMISSED

TESTIMONY - JUDGE'S NOTES: (Other Orders)

Revo

Mo.

Signature, person giving bail

TO THE COURT: The following are witnesses who can give testimony relating to the facts of this alleged violation. Please subpoena prosecuting witness:

COST $

ABSTRACT OF COURT RECORD

Address

JURY TRIAL

Days:

DOCKET NO.

REASON

CASE NO.

School

CASE NO.

STATE:

Days

Name

FORFEIT BOND

The court Therefore Enters in Following Order This Date

REASON

Phone

PLEA

LICENSE NO.

NOT GUILTY

Citation #:

GUILTY

Signature, person taking bailDate

DATE:

NO JURY TRIAL orPROCEEDING

GUILTY

DATE:

None

Day

COURT NO.

FINED $ SURCHARGE $ Continued to:

T01 T404 150311 141738 2

FILED 03/12/2015 04:31PMCLERK DISTRICT COURTSAC COUNTY IOWA

charged in this citation, the court is authorized to enter a conviction and render judgment against me for the amount of my appearance bond in satisfaction of the penalty and surcharge plus court cost.

You hereby are given notice that within a reasonable time but no later than the date scheduled for yourinitial appearance a citation/complaint sworn under oath will be filed with the district court clerk of thecounty in which this citation was issued.

Speed

IA Code:

State of Iowa

this

Road Work Zone

Weight

Agency

City

Zone

Court Costs

1. I hereby swear and affirm that the information provided by me on this citation is true under penalty of providing false information.

My signature below is not a plea of guilty, but acknowledges all of the following:

PLAINTIFF

4. I hereby give my unsecured appearance bond in the amount of

ICIS Sec #:

Subscribed and sworn to me by

at

Fed/Adm Code:

NOTICE: Providing false identification information is a violation of Section 719.1A ofthe Code of Iowa and is punishable as a simple misdemeanor.

Law Enforcement Agency -

Violation

DL State

In the Court at

Located in the county and state aforesaid and did then and there commit the following offense:

Fatal Accident

DL Rest.

Dated

Court Date: If you must appear in court or if you choose to appear to answer to a charge which does not

day of

Zip Code

Form 420001E 1/07

DOB

Local Ord.

Height

require an appearance, report to the above named court on:

Court Appearance Required (805.10)

VS.

Name

DL/State IDViewed?

Race

Sex

The following applies to simple misdemeanors only:

The undersigned states that on or about

Sec #:

Upon a public highway at

CDLReq?

Year

dollars and enter my written appearance. I agree that if I fail to appear in person or by counsel to defend against the offense

DL End.

DL#

Address

IOWA UNIFORM CITATION AND COMPLAINT

I swear that the foregoing complaint is true and correct. , Iowa

ICC# Lic. Plate #/REG

I.D. No.

Reference #:

Signature ofDefendant

City of:

Dispatch /Case #:

20

US DOT#

DL Class

State

2. I promise to appear in said court at said time and place. I understand that a person who willfully fails to appear in court as specified by this citation may be subject to arrest and/or loss of driving privileges.

First

defendant did unlawfully: Operate Motor Vehicle/Boat

State

Scheduled Violation/Fine

Suffix

Criminal SurchargeSerious P.I.

in

Notary/other

Reason:

3. If a court appearance is not required, I may enter a plea of guilty prior to the designated appearance date by delivery in person, or by agent, or by mail to the court specified by this citation.

Civil Damage Assessment Other

County of:

Officer'sSignature

Total Fine/Costs

HazMat End Req?

Officer'sSignature

Non-scheduled Violation

X

ICIS Ord.

at

Defendant, Last

at

COMPLAINT

Pass EndReq?

Co. Enf. Surcharge

Middle

Notary/otherSignature

Dated

T01 T404 150312 091020 6

*+T01T4041503120910206+*

Citation #:

MOTOR VEHICLE ENFORCEMENT

SAC - 81

SAC COUNTY COURTHOUSE 100 NW STATE STREET SUITE 12 SAC CITY IA 50583

860ZZ7988BEERENDS LARRY LAVERN 2/19/1962YES

W NEthnicity50009-0000ALTOONA IA853 RED HAWK WAY SE

6' 01"IA 260 LBSNONE MALEA LNT

03/12/2015 8:45 AM 2013 WHI INTERNATIONAL - I

PK

2015 YES NO NOIA292ZZL01067095

US 71/KARR AVE

$50.00

$17.50396.17C

N/A13NO ANNUAL INSPECTION ON TRUCK LAST ONE EXP 8/14

$60.00

321.449 321.449-A$127.50

T404

03/12/2015

03/12/2015

8:30 AM03/30/2015

$161.25

EARLY - 2200HANSEN, JEFFREY

MARCH, 201512

OTHERMOTOR VEHICLE ENFORCEMENT

NOT GUILTY

Driver's LicenseRecommendation

OTHER DISPOSITION

Other

Susp.

Yr.

BAIL CASH DEPOSIT

DATE: Continued to:

Incarceration in

VERDICT

WARRANT ISSUED

Iowa

DISMISSED

TESTIMONY - JUDGE'S NOTES: (Other Orders)

Revo

Mo.

Signature, person giving bail

TO THE COURT: The following are witnesses who can give testimony relating to the facts of this alleged violation. Please subpoena prosecuting witness:

COST $

ABSTRACT OF COURT RECORD

Address

JURY TRIAL

Days:

DOCKET NO.

REASON

CASE NO.

School

CASE NO.

STATE:

Days

Name

FORFEIT BOND

The court Therefore Enters in Following Order This Date

REASON

Phone

PLEA

LICENSE NO.

NOT GUILTY

Citation #:

GUILTY

Signature, person taking bailDate

DATE:

NO JURY TRIAL orPROCEEDING

GUILTY

DATE:

None

Day

COURT NO.

FINED $ SURCHARGE $ Continued to:

T01 T404 150312 091020 6

FILED 03/12/2015 04:31PMCLERK DISTRICT COURTSAC COUNTY IOWA

charged in this citation, the court is authorized to enter a conviction and render judgment against me for the amount of my appearance bond in satisfaction of the penalty and surcharge plus court cost.

You hereby are given notice that within a reasonable time but no later than the date scheduled for yourinitial appearance a citation/complaint sworn under oath will be filed with the district court clerk of thecounty in which this citation was issued.

Speed

IA Code:

State of Iowa

this

Road Work Zone

Weight

Agency

City

Zone

Court Costs

1. I hereby swear and affirm that the information provided by me on this citation is true under penalty of providing false information.

My signature below is not a plea of guilty, but acknowledges all of the following:

PLAINTIFF

4. I hereby give my unsecured appearance bond in the amount of

ICIS Sec #:

Subscribed and sworn to me by

at

Fed/Adm Code:

NOTICE: Providing false identification information is a violation of Section 719.1A ofthe Code of Iowa and is punishable as a simple misdemeanor.

Law Enforcement Agency -

Violation

DL State

In the Court at

Located in the county and state aforesaid and did then and there commit the following offense:

Fatal Accident

DL Rest.

Dated

Court Date: If you must appear in court or if you choose to appear to answer to a charge which does not

day of

Zip Code

Form 420001E 1/07

DOB

Local Ord.

Height

require an appearance, report to the above named court on:

Court Appearance Required (805.10)

VS.

Name

DL/State IDViewed?

Race

Sex

The following applies to simple misdemeanors only:

The undersigned states that on or about

Sec #:

Upon a public highway at

CDLReq?

Year

dollars and enter my written appearance. I agree that if I fail to appear in person or by counsel to defend against the offense

DL End.

DL#

Address

IOWA UNIFORM CITATION AND COMPLAINT

I swear that the foregoing complaint is true and correct. , Iowa

ICC# Lic. Plate #/REG

I.D. No.

Reference #:

Signature ofDefendant

City of:

Dispatch /Case #:

20

US DOT#

DL Class

State

2. I promise to appear in said court at said time and place. I understand that a person who willfully fails to appear in court as specified by this citation may be subject to arrest and/or loss of driving privileges.

First

defendant did unlawfully: Operate Motor Vehicle/Boat

State

Scheduled Violation/Fine

Suffix

Criminal SurchargeSerious P.I.

in

Notary/other

Reason:

3. If a court appearance is not required, I may enter a plea of guilty prior to the designated appearance date by delivery in person, or by agent, or by mail to the court specified by this citation.

Civil Damage Assessment Other

County of:

Officer'sSignature

Total Fine/Costs

HazMat End Req?

Officer'sSignature

Non-scheduled Violation

X

ICIS Ord.

at

Defendant, Last

at

COMPLAINT

Pass EndReq?

Co. Enf. Surcharge

Middle

Notary/otherSignature

Dated

T01 T404 150312 095926 8

*+T01T4041503120959268+*

Citation #:

MOTOR VEHICLE ENFORCEMENT

SAC - 81

SAC COUNTY COURTHOUSE 100 NW STATE STREET SUITE 12 SAC CITY IA 50583

726XX7422BRITTAIN CHARLES GENE 6/27/1953YES

W NEthnicity51536-0000HANCOCK IA48293 PINOAK RD

5' 08"IA 150 LBSB MALEA LN

03/12/2015 9:14 AM 1996 PLE FREIGHTLINER - F

TT/ST

2015 YES NO NOIAPW518300911872 766063

US 71/KARR AVE

$50.00

$17.50396.3A1

N/A13TRUCK WOULD NOT MAINTAIN AIR WHEN BRAKES RELEASE AND APPLIED

SEE COMMENTS$60.00

321.449 321.449-A$127.50

T404

03/12/2015

03/12/2015

8:30 AM03/30/2015

$161.25

EARLY - 2200HANSEN, JEFFREY

MARCH, 201512

OTHERMOTOR VEHICLE ENFORCEMENT

NOT GUILTY

Driver's LicenseRecommendation

OTHER DISPOSITION

Other

Susp.

Yr.

BAIL CASH DEPOSIT

DATE: Continued to:

Incarceration in

VERDICT

WARRANT ISSUED

Iowa

DISMISSED

TESTIMONY - JUDGE'S NOTES: (Other Orders)

Revo

Mo.

Signature, person giving bail

TO THE COURT: The following are witnesses who can give testimony relating to the facts of this alleged violation. Please subpoena prosecuting witness:

COST $

ABSTRACT OF COURT RECORD

Address

JURY TRIAL

Days:

DOCKET NO.

REASON

CASE NO.

School

CASE NO.

STATE:

Days

Name

FORFEIT BOND

The court Therefore Enters in Following Order This Date

REASON

Phone

PLEA

LICENSE NO.

NOT GUILTY

Citation #:

GUILTY

Signature, person taking bailDate

DATE:

NO JURY TRIAL orPROCEEDING

GUILTY

DATE:

None

Day

COURT NO.

FINED $ SURCHARGE $ Continued to:

T01 T404 150312 095926 8

FILED 03/12/2015 04:31PMCLERK DISTRICT COURTSAC COUNTY IOWA

charged in this citation, the court is authorized to enter a conviction and render judgment against me for the amount of my appearance bond in satisfaction of the penalty and surcharge plus court cost.

You hereby are given notice that within a reasonable time but no later than the date scheduled for yourinitial appearance a citation/complaint sworn under oath will be filed with the district court clerk of thecounty in which this citation was issued.

Speed

IA Code:

State of Iowa

this

Road Work Zone

Weight

Agency

City

Zone

Court Costs

1. I hereby swear and affirm that the information provided by me on this citation is true under penalty of providing false information.

My signature below is not a plea of guilty, but acknowledges all of the following:

PLAINTIFF

4. I hereby give my unsecured appearance bond in the amount of

ICIS Sec #:

Subscribed and sworn to me by

at

Fed/Adm Code:

NOTICE: Providing false identification information is a violation of Section 719.1A ofthe Code of Iowa and is punishable as a simple misdemeanor.

Law Enforcement Agency -

Violation

DL State

In the Court at

Located in the county and state aforesaid and did then and there commit the following offense:

Fatal Accident

DL Rest.

Dated

Court Date: If you must appear in court or if you choose to appear to answer to a charge which does not

day of

Zip Code

Form 420001E 1/07

DOB

Local Ord.

Height

require an appearance, report to the above named court on:

Court Appearance Required (805.10)

VS.

Name

DL/State IDViewed?

Race

Sex

The following applies to simple misdemeanors only:

The undersigned states that on or about

Sec #:

Upon a public highway at

CDLReq?

Year

dollars and enter my written appearance. I agree that if I fail to appear in person or by counsel to defend against the offense

DL End.

DL#

Address

IOWA UNIFORM CITATION AND COMPLAINT

I swear that the foregoing complaint is true and correct. , Iowa

ICC# Lic. Plate #/REG

I.D. No.

Reference #:

Signature ofDefendant

City of:

Dispatch /Case #:

20

US DOT#

DL Class

State

2. I promise to appear in said court at said time and place. I understand that a person who willfully fails to appear in court as specified by this citation may be subject to arrest and/or loss of driving privileges.

First

defendant did unlawfully: Operate Motor Vehicle/Boat

State

Scheduled Violation/Fine

Suffix

Criminal SurchargeSerious P.I.

in

Notary/other

Reason:

3. If a court appearance is not required, I may enter a plea of guilty prior to the designated appearance date by delivery in person, or by agent, or by mail to the court specified by this citation.

Civil Damage Assessment Other

County of:

Officer'sSignature

Total Fine/Costs

HazMat End Req?

Officer'sSignature

Non-scheduled Violation

X

ICIS Ord.

at

Defendant, Last

at

COMPLAINT

Pass EndReq?

Co. Enf. Surcharge

Middle

Notary/otherSignature

Dated

T01 T404 150312 100202 9

*+T01T4041503121002029+*

Citation #:

MOTOR VEHICLE ENFORCEMENT

SAC - 81

SAC COUNTY COURTHOUSE 100 NW STATE STREET SUITE 12 SAC CITY IA 50583

726XX7422BRITTAIN CHARLES GENE 6/27/1953YES

W NEthnicity51536-0000HANCOCK IA48293 PINOAK RD

5' 08"IA 150 LBSB MALEA LN

03/12/2015 9:14 AM 1996 PLE FREIGHTLINER - F

TT/ST

2015 YES NO NOIAPW518300911872 766063

US 71/KARR AVE

$50.00

$17.50396.3A1BOS

N/A1320% OF TRACTOR BRAKES OUT OF ADJUSTMENT

$60.00

321.449 321.449-A$127.50

T404

03/12/2015

03/12/2015

8:30 AM03/30/2015

$161.25

EARLY - 2200HANSEN, JEFFREY

MARCH, 201512

OTHERMOTOR VEHICLE ENFORCEMENT

NOT GUILTY

Driver's LicenseRecommendation

OTHER DISPOSITION

Other

Susp.

Yr.

BAIL CASH DEPOSIT

DATE: Continued to:

Incarceration in

VERDICT

WARRANT ISSUED

Iowa

DISMISSED

TESTIMONY - JUDGE'S NOTES: (Other Orders)

Revo

Mo.

Signature, person giving bail

TO THE COURT: The following are witnesses who can give testimony relating to the facts of this alleged violation. Please subpoena prosecuting witness:

COST $

ABSTRACT OF COURT RECORD

Address

JURY TRIAL

Days:

DOCKET NO.

REASON

CASE NO.

School

CASE NO.

STATE:

Days

Name

FORFEIT BOND

The court Therefore Enters in Following Order This Date

REASON

Phone

PLEA

LICENSE NO.

NOT GUILTY

Citation #:

GUILTY

Signature, person taking bailDate

DATE:

NO JURY TRIAL orPROCEEDING

GUILTY

DATE:

None

Day

COURT NO.

FINED $ SURCHARGE $ Continued to:

T01 T404 150312 100202 9

FILED 03/12/2015 04:31PMCLERK DISTRICT COURTSAC COUNTY IOWA

charged in this citation, the court is authorized to enter a conviction and render judgment against me for the amount of my appearance bond in satisfaction of the penalty and surcharge plus court cost.

You hereby are given notice that within a reasonable time but no later than the date scheduled for yourinitial appearance a citation/complaint sworn under oath will be filed with the district court clerk of thecounty in which this citation was issued.

Speed

IA Code:

State of Iowa

this

Road Work Zone

Weight

Agency

City

Zone

Court Costs

1. I hereby swear and affirm that the information provided by me on this citation is true under penalty of providing false information.

My signature below is not a plea of guilty, but acknowledges all of the following:

PLAINTIFF

4. I hereby give my unsecured appearance bond in the amount of

ICIS Sec #:

Subscribed and sworn to me by

at

Fed/Adm Code:

NOTICE: Providing false identification information is a violation of Section 719.1A ofthe Code of Iowa and is punishable as a simple misdemeanor.

Law Enforcement Agency -

Violation

DL State

In the Court at

Located in the county and state aforesaid and did then and there commit the following offense:

Fatal Accident

DL Rest.

Dated

Court Date: If you must appear in court or if you choose to appear to answer to a charge which does not

day of

Zip Code

Form 420001E 1/07

DOB

Local Ord.

Height

require an appearance, report to the above named court on:

Court Appearance Required (805.10)

VS.

Name

DL/State IDViewed?

Race

Sex

The following applies to simple misdemeanors only:

The undersigned states that on or about

Sec #:

Upon a public highway at

CDLReq?

Year

dollars and enter my written appearance. I agree that if I fail to appear in person or by counsel to defend against the offense

DL End.

DL#

Address

IOWA UNIFORM CITATION AND COMPLAINT

I swear that the foregoing complaint is true and correct. , Iowa

ICC# Lic. Plate #/REG

I.D. No.

Reference #:

Signature ofDefendant

City of:

Dispatch /Case #:

20

US DOT#

DL Class

State

2. I promise to appear in said court at said time and place. I understand that a person who willfully fails to appear in court as specified by this citation may be subject to arrest and/or loss of driving privileges.

First

defendant did unlawfully: Operate Motor Vehicle/Boat

State

Scheduled Violation/Fine

Suffix

Criminal SurchargeSerious P.I.

in

Notary/other

Reason:

3. If a court appearance is not required, I may enter a plea of guilty prior to the designated appearance date by delivery in person, or by agent, or by mail to the court specified by this citation.

Civil Damage Assessment Other

County of:

Officer'sSignature

Total Fine/Costs

HazMat End Req?

Officer'sSignature

Non-scheduled Violation

X

ICIS Ord.

at

Defendant, Last

at

COMPLAINT

Pass EndReq?

Co. Enf. Surcharge

Middle

Notary/otherSignature

Dated

T01 T404 150312 105707 2

*+T01T4041503121057072+*

Citation #:

MOTOR VEHICLE ENFORCEMENT

SAC - 81

SAC COUNTY COURTHOUSE 100 NW STATE STREET SUITE 12 SAC CITY IA 50583

651AH2310COWAN JOSHUA MICHAEL 12/3/1994YES

W NEthnicity52060-0000MAQUOKETA IA802 S MAIN ST

6' 05"IA 300 LBSK MALEA NONE

03/12/2015 10:10 AM 1995 BGE FREIGHTLINER - F

TT/ST

2015 YES NO NOIADB722302110450 735811

US 71/KARR AVE

$50.00

$17.50393.75A3

N/A13FLAT TIRE TESTED 33PSI NEEDS HALF OF 105 PSI TO BE LEGAL

$60.00

321.449 321.449-A$127.50

T404

03/12/2015

03/12/2015

8:30 AM03/30/2015

$161.25

EARLY - 2200HANSEN, JEFFREY

MARCH, 201512

OTHERMOTOR VEHICLE ENFORCEMENT

NOT GUILTY

Driver's LicenseRecommendation

OTHER DISPOSITION

Other

Susp.

Yr.

BAIL CASH DEPOSIT

DATE: Continued to:

Incarceration in

VERDICT

WARRANT ISSUED

Iowa

DISMISSED

TESTIMONY - JUDGE'S NOTES: (Other Orders)

Revo

Mo.

Signature, person giving bail

TO THE COURT: The following are witnesses who can give testimony relating to the facts of this alleged violation. Please subpoena prosecuting witness:

COST $

ABSTRACT OF COURT RECORD

Address

JURY TRIAL

Days:

DOCKET NO.

REASON

CASE NO.

School

CASE NO.

STATE:

Days

Name

FORFEIT BOND

The court Therefore Enters in Following Order This Date

REASON

Phone

PLEA

LICENSE NO.

NOT GUILTY

Citation #:

GUILTY

Signature, person taking bailDate

DATE:

NO JURY TRIAL orPROCEEDING

GUILTY

DATE:

None

Day

COURT NO.

FINED $ SURCHARGE $ Continued to:

T01 T404 150312 105707 2

FILED 03/12/2015 04:31PMCLERK DISTRICT COURTSAC COUNTY IOWA

charged in this citation, the court is authorized to enter a conviction and render judgment against me for the amount of my appearance bond in satisfaction of the penalty and surcharge plus court cost.

You hereby are given notice that within a reasonable time but no later than the date scheduled for yourinitial appearance a citation/complaint sworn under oath will be filed with the district court clerk of thecounty in which this citation was issued.

Speed

IA Code:

State of Iowa

this

Road Work Zone

Weight

Agency

City

Zone

Court Costs

1. I hereby swear and affirm that the information provided by me on this citation is true under penalty of providing false information.

My signature below is not a plea of guilty, but acknowledges all of the following:

PLAINTIFF

4. I hereby give my unsecured appearance bond in the amount of

ICIS Sec #:

Subscribed and sworn to me by

at

Fed/Adm Code:

NOTICE: Providing false identification information is a violation of Section 719.1A ofthe Code of Iowa and is punishable as a simple misdemeanor.

Law Enforcement Agency -

Violation

DL State

In the Court at

Located in the county and state aforesaid and did then and there commit the following offense:

Fatal Accident

DL Rest.

Dated

Court Date: If you must appear in court or if you choose to appear to answer to a charge which does not

day of

Zip Code

Form 420001E 1/07

DOB

Local Ord.

Height

require an appearance, report to the above named court on:

Court Appearance Required (805.10)

VS.

Name

DL/State IDViewed?

Race

Sex

The following applies to simple misdemeanors only:

The undersigned states that on or about

Sec #:

Upon a public highway at

CDLReq?

Year

dollars and enter my written appearance. I agree that if I fail to appear in person or by counsel to defend against the offense

DL End.

DL#

Address

IOWA UNIFORM CITATION AND COMPLAINT

I swear that the foregoing complaint is true and correct. , Iowa

ICC# Lic. Plate #/REG

I.D. No.

Reference #:

Signature ofDefendant

City of:

Dispatch /Case #:

20

US DOT#

DL Class

State

2. I promise to appear in said court at said time and place. I understand that a person who willfully fails to appear in court as specified by this citation may be subject to arrest and/or loss of driving privileges.

First

defendant did unlawfully: Operate Motor Vehicle/Boat

State

Scheduled Violation/Fine

Suffix

Criminal SurchargeSerious P.I.

in

Notary/other

Reason:

3. If a court appearance is not required, I may enter a plea of guilty prior to the designated appearance date by delivery in person, or by agent, or by mail to the court specified by this citation.

Civil Damage Assessment Other

County of:

Officer'sSignature

Total Fine/Costs

HazMat End Req?

Officer'sSignature

Non-scheduled Violation

X

ICIS Ord.

at

Defendant, Last

at

COMPLAINT

Pass EndReq?

Co. Enf. Surcharge

Middle

Notary/otherSignature

Dated

T01 T404 150312 105830 3

*+T01T4041503121058303+*

Citation #:

MOTOR VEHICLE ENFORCEMENT

SAC - 81

SAC COUNTY COURTHOUSE 100 NW STATE STREET SUITE 12 SAC CITY IA 50583

651AH2310COWAN JOSHUA MICHAEL 12/3/1994YES

W NEthnicity52060-0000MAQUOKETA IA802 S MAIN ST

6' 05"IA 300 LBSK MALEA NONE

03/12/2015 10:10 AM 1995 BGE FREIGHTLINER - F

TT/ST

2015 YES NO NOIADB722302110450 735811

US 71/KARR AVE

$50.00

$17.50393.95A

N/A13DISCHARGED FIRE EXTINGUISHER IN THE TRUCK

$60.00

321.449 321.449-A$127.50

T404

03/12/2015

03/12/2015

8:30 AM03/30/2015

$161.25

EARLY - 2200HANSEN, JEFFREY

MARCH, 201512

OTHERMOTOR VEHICLE ENFORCEMENT

NOT GUILTY

Driver's LicenseRecommendation

OTHER DISPOSITION

Other

Susp.

Yr.

BAIL CASH DEPOSIT

DATE: Continued to:

Incarceration in

VERDICT

WARRANT ISSUED

Iowa

DISMISSED

TESTIMONY - JUDGE'S NOTES: (Other Orders)

Revo

Mo.

Signature, person giving bail

TO THE COURT: The following are witnesses who can give testimony relating to the facts of this alleged violation. Please subpoena prosecuting witness:

COST $

ABSTRACT OF COURT RECORD

Address

JURY TRIAL

Days:

DOCKET NO.

REASON

CASE NO.

School

CASE NO.

STATE:

Days

Name

FORFEIT BOND

The court Therefore Enters in Following Order This Date

REASON

Phone

PLEA

LICENSE NO.

NOT GUILTY

Citation #:

GUILTY

Signature, person taking bailDate

DATE:

NO JURY TRIAL orPROCEEDING

GUILTY

DATE:

None

Day

COURT NO.

FINED $ SURCHARGE $ Continued to:

T01 T404 150312 105830 3

FILED 03/12/2015 04:31PMCLERK DISTRICT COURTSAC COUNTY IOWA

charged in this citation, the court is authorized to enter a conviction and render judgment against me for the amount of my appearance bond in satisfaction of the penalty and surcharge plus court cost.

You hereby are given notice that within a reasonable time but no later than the date scheduled for yourinitial appearance a citation/complaint sworn under oath will be filed with the district court clerk of thecounty in which this citation was issued.

Speed

IA Code:

State of Iowa

this

Road Work Zone

Weight

Agency

City

Zone

Court Costs

1. I hereby swear and affirm that the information provided by me on this citation is true under penalty of providing false information.

My signature below is not a plea of guilty, but acknowledges all of the following:

PLAINTIFF

4. I hereby give my unsecured appearance bond in the amount of

ICIS Sec #:

Subscribed and sworn to me by

at

Fed/Adm Code:

NOTICE: Providing false identification information is a violation of Section 719.1A ofthe Code of Iowa and is punishable as a simple misdemeanor.

Law Enforcement Agency -

Violation

DL State

In the Court at

Located in the county and state aforesaid and did then and there commit the following offense:

Fatal Accident

DL Rest.

Dated

Court Date: If you must appear in court or if you choose to appear to answer to a charge which does not

day of

Zip Code

Form 420001E 1/07

DOB

Local Ord.

Height

require an appearance, report to the above named court on:

Court Appearance Required (805.10)

VS.

Name

DL/State IDViewed?

Race

Sex

The following applies to simple misdemeanors only:

The undersigned states that on or about

Sec #:

Upon a public highway at

CDLReq?

Year

dollars and enter my written appearance. I agree that if I fail to appear in person or by counsel to defend against the offense

DL End.

DL#

Address

IOWA UNIFORM CITATION AND COMPLAINT

I swear that the foregoing complaint is true and correct. , Iowa

ICC# Lic. Plate #/REG

I.D. No.

Reference #:

Signature ofDefendant

City of:

Dispatch /Case #:

20

US DOT#

DL Class

State

2. I promise to appear in said court at said time and place. I understand that a person who willfully fails to appear in court as specified by this citation may be subject to arrest and/or loss of driving privileges.

First

defendant did unlawfully: Operate Motor Vehicle/Boat

State

Scheduled Violation/Fine

Suffix

Criminal SurchargeSerious P.I.

in

Notary/other

Reason:

3. If a court appearance is not required, I may enter a plea of guilty prior to the designated appearance date by delivery in person, or by agent, or by mail to the court specified by this citation.

Civil Damage Assessment Other

County of:

Officer'sSignature

Total Fine/Costs

HazMat End Req?

Officer'sSignature

Non-scheduled Violation

X

ICIS Ord.

at

Defendant, Last

at

COMPLAINT

Pass EndReq?

Co. Enf. Surcharge

Middle

Notary/otherSignature

Dated

T01 T404 150312 125912 6

*+T01T4041503121259126+*

Citation #:

MOTOR VEHICLE ENFORCEMENT

SAC - 81

SAC COUNTY COURTHOUSE 100 NW STATE STREET SUITE 12 SAC CITY IA 50583

758YY6316HESSE KORY WILLIAM 8/5/1986YES

W NEthnicity50629-0000FAIRBANK IA3129 236TH ST

6' 00"IA 170 LBSB MALEA N

03/12/2015 12:20 PM 1995 WHI FREIGHTLINER - F

DS

2015 YES NO NOIABL135901588614 595019

US 71/KARR AVE

$50.00

$17.50395.8K2

N/A13DRIVER WAS NOT KEEPING LOG ON TRIP TODAY WHICH WAS 200.8 M AND

NO PRIOR 7$60.00

321.449 321.449-C$127.50

T404

03/12/2015

03/12/2015

8:30 AM03/30/2015

$161.25

EARLY - 2200HANSEN, JEFFREY

MARCH, 201512

OTHERMOTOR VEHICLE ENFORCEMENT

NOT GUILTY

Driver's LicenseRecommendation

OTHER DISPOSITION

Other

Susp.

Yr.

BAIL CASH DEPOSIT

DATE: Continued to:

Incarceration in

VERDICT

WARRANT ISSUED

Iowa

DISMISSED

TESTIMONY - JUDGE'S NOTES: (Other Orders)

Revo

Mo.

Signature, person giving bail

TO THE COURT: The following are witnesses who can give testimony relating to the facts of this alleged violation. Please subpoena prosecuting witness:

COST $

ABSTRACT OF COURT RECORD

Address

JURY TRIAL

Days:

DOCKET NO.

REASON

CASE NO.

School

CASE NO.

STATE:

Days

Name

FORFEIT BOND

The court Therefore Enters in Following Order This Date

REASON

Phone

PLEA

LICENSE NO.

NOT GUILTY

Citation #:

GUILTY

Signature, person taking bailDate

DATE:

NO JURY TRIAL orPROCEEDING

GUILTY

DATE:

None

Day

COURT NO.

FINED $ SURCHARGE $ Continued to:

T01 T404 150312 125912 6

FILED 03/12/2015 04:31PMCLERK DISTRICT COURTSAC COUNTY IOWA

charged in this citation, the court is authorized to enter a conviction and render judgment against me for the amount of my appearance bond in satisfaction of the penalty and surcharge plus court cost.

You hereby are given notice that within a reasonable time but no later than the date scheduled for yourinitial appearance a citation/complaint sworn under oath will be filed with the district court clerk of thecounty in which this citation was issued.

Speed

IA Code:

State of Iowa

this

Road Work Zone

Weight

Agency

City

Zone

Court Costs

1. I hereby swear and affirm that the information provided by me on this citation is true under penalty of providing false information.

My signature below is not a plea of guilty, but acknowledges all of the following:

PLAINTIFF

4. I hereby give my unsecured appearance bond in the amount of

ICIS Sec #:

Subscribed and sworn to me by

at

Fed/Adm Code:

NOTICE: Providing false identification information is a violation of Section 719.1A ofthe Code of Iowa and is punishable as a simple misdemeanor.

Law Enforcement Agency -

Violation

DL State

In the Court at

Located in the county and state aforesaid and did then and there commit the following offense:

Fatal Accident

DL Rest.

Dated

Court Date: If you must appear in court or if you choose to appear to answer to a charge which does not

day of

Zip Code

Form 420001E 1/07

DOB

Local Ord.

Height

require an appearance, report to the above named court on:

Court Appearance Required (805.10)

VS.

Name

DL/State IDViewed?

Race

Sex

The following applies to simple misdemeanors only:

The undersigned states that on or about

Sec #:

Upon a public highway at

CDLReq?

Year

dollars and enter my written appearance. I agree that if I fail to appear in person or by counsel to defend against the offense

DL End.

DL#

Address

IOWA UNIFORM CITATION AND COMPLAINT

I swear that the foregoing complaint is true and correct. , Iowa

ICC# Lic. Plate #/REG

I.D. No.

Reference #:

Signature ofDefendant

City of:

Dispatch /Case #:

20

US DOT#

DL Class

State

2. I promise to appear in said court at said time and place. I understand that a person who willfully fails to appear in court as specified by this citation may be subject to arrest and/or loss of driving privileges.

First

defendant did unlawfully: Operate Motor Vehicle/Boat

State

Scheduled Violation/Fine

Suffix

Criminal SurchargeSerious P.I.

in

Notary/other

Reason:

3. If a court appearance is not required, I may enter a plea of guilty prior to the designated appearance date by delivery in person, or by agent, or by mail to the court specified by this citation.

Civil Damage Assessment Other

County of:

Officer'sSignature

Total Fine/Costs

HazMat End Req?

Officer'sSignature

Non-scheduled Violation

X

ICIS Ord.

at

Defendant, Last

at

COMPLAINT

Pass EndReq?

Co. Enf. Surcharge

Middle

Notary/otherSignature

Dated

T01 T404 150312 135117 8

*+T01T4041503121351178+*

Citation #:

MOTOR VEHICLE ENFORCEMENT

SAC - 81

SAC COUNTY COURTHOUSE 100 NW STATE STREET SUITE 12 SAC CITY IA 50583

X224243642008BYERS MARK EUGENE 7/12/1951YES

W NEthnicity55912AUSTIN MN604 8TH AVE SW

6' 00"MN 240 LBSNONEA NONE

03/12/2015 1:30 PM 2013 WHI VOLVO -VOLV

TT/ST

2015 YES NO NOMNPAM026200589319 686027

US 71/KARR AVE

$50.00

$17.50393.75F

N/A13AX 1 TIRE RATING WAS 12,350 WEIGHED 13340 OVER 990LBS

$60.00

321.449 321.449-A$127.50

T404

03/12/2015

03/12/2015

8:30 AM03/30/2015

$161.25

EARLY - 2200HANSEN, JEFFREY

MARCH, 201512

OTHERMOTOR VEHICLE ENFORCEMENT

NOT GUILTY

Driver's LicenseRecommendation

OTHER DISPOSITION

Other

Susp.

Yr.

BAIL CASH DEPOSIT

DATE: Continued to:

Incarceration in

VERDICT

WARRANT ISSUED

Iowa

DISMISSED

TESTIMONY - JUDGE'S NOTES: (Other Orders)

Revo

Mo.

Signature, person giving bail

TO THE COURT: The following are witnesses who can give testimony relating to the facts of this alleged violation. Please subpoena prosecuting witness:

COST $

ABSTRACT OF COURT RECORD

Address

JURY TRIAL

Days:

DOCKET NO.

REASON

CASE NO.

School

CASE NO.

STATE:

Days

Name

FORFEIT BOND

The court Therefore Enters in Following Order This Date

REASON

Phone

PLEA

LICENSE NO.

NOT GUILTY

Citation #:

GUILTY

Signature, person taking bailDate

DATE:

NO JURY TRIAL orPROCEEDING

GUILTY

DATE:

None

Day

COURT NO.

FINED $ SURCHARGE $ Continued to:

T01 T404 150312 135117 8

FILED 03/12/2015 04:31PMCLERK DISTRICT COURTSAC COUNTY IOWA