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    01/07

    C O M P L M N T

    I O W A U N I F O R M C I T A T IO N A N D C O M P L A I N T

    SAC  C I T Y   P O L IC E   D E P T .

    • s ta te o f Iowa

    0  000̂ 7  o f :

    j ity

      of:

    SAC

    S A C

     C I T Y

    81

    N 2  0005324

    In t f ie Court at ^

    v s :   p ,

    N a m e .

    S A C   G O . C O U R T H O U S E , S A G C I T Y , lA  50583

    Q C S ^ \^^f  T ^ J i   L< ~

    Defendan t . Las t  3 I  =lrst  M i dd l e

    A d d r e s s .

    fnda nt , Las t A F i rs

    3 o c . 5 .  t j f v tS^

    C i t y .

    D L # .

    . s ta te

    . State

    C

    DO B

    R a c e .

    . DL Rest.

    o

    W / B / l / A / U

    DL /S ta te ID V i ewed? Y e s D

    Ethn .  tfO S e x H t . ^ r - o S . w , . 

    Tt ie unders igned states t t iat on or about   0 ^  / / / . ^ at ^ l * f ^ J g l J i

    H o f o n H c n t H i H i i n i a u u f i i l l v ^ M o . , D a y Y r.

    N o D

    • AM

    M

    defendant did unlawful ly :

    Ope rate Motor Vehic le/Boat (descr ibe)

    C D L R e q ? Y e s n N o D P ass. E nd . R eq? Y e s D N o D H azM at E nd . R e q ? Y e s D N o D

    Reg#   ^ t   î

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    A B S T R A C T   O F C O E R R E C O R D

    COURT NO.

    DOCKET  N ( ).„

    LICENSE N0.,_

    FORFErr

      BOND

    JURY  T R I A L

    n

    NO JURY •UR.IAL

    or PROCEEDING  •

    OFHER DiSPOSrnON.

    CASE NO,.

    CASE NO,

    S T A T l ;  •  I O W A

    OTHER

    B A I L

      CASH

      DEPOSIT

    ,^ ^  PLEA  .. -

    • G U I L T Y

    NOT G U I L T Y

    VERDICT

    G U I L I T

    NOT G U I L T Y

    DISMISSED

    The Court Therefore Eniei's In F o l i o w i i ig Oixler  Fhis Date.

    o Day Yr.

    FINED  ..

    C R I M I N A L  SURCHARGE S

    COUN'TY  ENFORCEMENT- SURCH AR ,G E S COSTS S...

    Incarceration in

    Davs;

    None School

    Drivers License

    Recommendation .„.„ ...JJ

    D A T E :  C ontini cd..i£i:

    SlIS Davs

    Revo

    Contimtcd to:

    REASON

    REASON

    D A T E :

    WAR R A N T ISSUED

    T E S T I M O N Y  - JUDGES NOTES: (Other Orders)

    X

    Date Signature, peison  giviru.; hail  Signature, person taking hail

    swear

     that  (lifc forgoing  ci ta i ioi i

     is true and correct.  /O

    Signature Agency

    Subscribed and sworn to before mc by  ivvf̂ '^^^^^^ip  f r e i at

    y   o ..y (dfi J l, .L H-^ - l i) l

    T O  T H E  C O U R T ;  T l ie  f o l l o w i n g

      are witnesses who can give testimony relating to

    the facts of this alleged violation Please subpoena prosecuting witness:

    Tit le

    Name Address Phone

    1

    E-FILED 2015 MAR 16 1:26 PM SAC - CLERK OF DISTRICT COURT

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    E-FILED 2015 MAR 16 2:31 AM SAC - CLERK OF DISTRICT COURT

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    E-FILED 2015 MAR 16 2:31 AM SAC - CLERK OF DISTRICT COURT

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    E-FILED 2015 MAR 16 2:30 AM SAC - CLERK OF DISTRICT COURT

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    E-FILED 2015 MAR 16 2:30 AM SAC - CLERK OF DISTRICT COURT

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    chargedinthiscitation,thecourtisauthorizedtoenteraconvictionandrenderjudgmentagainstmefortheamountofmyappearancebondinsatisfactionofthepenaltyandsurchargepluscourtcost.

    You hereby are given notice that within a reasonable time but no later than the date scheduled for your

    initial appearance a citation/complaint sworn under oath will be filed with the district court clerk of the

    county in which this citation was issued.

    Speed

    IACode:

    State of Iowa

    this

    Road Work Zone

    Weight

     Agency

    City

    Zone

    Court Costs

    1.Iherebyswearandaffirmthattheinformationprovidedbymeonthiscitationistrueunderpenaltyofprovidingfalseinformation.

    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 

    ICISSec#:

    Subscribed and sworn to me by

    at

    Fed/AdmCode:

    NOTICE:ProvidingfalseidentificationinformationisaviolationofSection719.1Aof theCodeofIowaandispunishableasasimplemisdemeanor.

    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

    Form420001E1/07

    DOB

    Local Ord.

    Height

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

    Court Appearance Required (805.10)

    VS.

    Name

    DL/StateIDViewed?

    Race

    Sex

    The following applies to simple misdemeanors only:

    The undersigned states that on or about

    Sec #:

    Upon a public highway at

    CDLReq?

    Year 

    dollarsandentermywrittenappearance.IagreethatifIfailtoappearinpersonorbycounseltodefendagainsttheoffense

    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#:

    Signatureof Defendant

    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

    HazMatEndReq?

    Officer'sSignature

    Non-scheduled Violation

    X

    ICISOrd.

    at

    Defendant, Last

    at

    COMPLAINT

    PassEndReq?

    Co. Enf. Surcharge

    Middle

    Notary/other Signature

    Dated

    S81 RMAN 15 313 231229 7

    Citation #:

    SAC COUNTY SHERIFF'S OFFICE

    SAC - 81

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

    751AJ2693BELT TREY ROBERT 8/10/1999YES

    NEthnicity51450-0000CARNARVON IA310 370TH ST

    5' 10"IA 7 MALEC NONE

    03/13/2015 11:12 PM 2008 BLK CHEVROL

     

    IMP 4D

    2015 NOIACZN257

    STATE 39/FOX AVE5565$40.00

    $14.00

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

    $60.00

    321.285 321.285-B$119.00

    81-6

    03/13/2015

    03/13/2015

    8:30 AM04/06/2015

    $148.50

    SAC CITY - 6717HATTERMAN, JOHN

    MARCH, 201513

    NOTARYSAC 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 or 

    PROCEEDING

    GUILTY

    DATE:

    None

    Day

    COURT NO.

    FINED $ SURCHARGE $ Continued to:

    S81 RMAN 15 313 231229 7

    FILED 03/16/2015 08:03AM

    CLERK DISTRICT COURT

    SAC COUNTY IOWA

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    chargedinthiscitation,thecourtisauthorizedtoenteraconvictionandrenderjudgmentagainstmefortheamountofmyappearancebondinsatisfactionofthepenaltyandsurchargepluscourtcost.

    You hereby are given notice that within a reasonable time but no later than the date scheduled for your

    initial appearance a citation/complaint sworn under oath will be filed with the district court clerk of the

    county in which this citation was issued.

    Speed

    IACode:

    State of Iowa

    this

    Road Work Zone

    Weight

     Agency

    City

    Zone

    Court Costs

    1.Iherebyswearandaffirmthattheinformationprovidedbymeonthiscitationistrueunderpenaltyofprovidingfalseinformation.

    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 

    ICISSec#:

    Subscribed and sworn to me by

    at

    Fed/AdmCode:

    NOTICE:ProvidingfalseidentificationinformationisaviolationofSection719.1Aof theCodeofIowaandispunishableasasimplemisdemeanor.

    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

    Form420001E1/07

    DOB

    Local Ord.

    Height

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

    Court Appearance Required (805.10)

    VS.

    Name

    DL/StateIDViewed?

    Race

    Sex

    The following applies to simple misdemeanors only:

    The undersigned states that on or about

    Sec #:

    Upon a public highway at

    CDLReq?

    Year 

    dollarsandentermywrittenappearance.IagreethatifIfailtoappearinpersonorbycounseltodefendagainsttheoffense

    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#:

    Signatureof Defendant

    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

    HazMatEndReq?

    Officer'sSignature

    Non-scheduled Violation

    X

    ICISOrd.

    at

    Defendant, Last

    at

    COMPLAINT

    PassEndReq?

    Co. Enf. Surcharge

    Middle

    Notary/other Signature

    Dated

    S81 RMAN 15 313 231458 8

    Citation #:

    SAC COUNTY SHERIFF'S OFFICE

    SAC - 81

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

    751AJ2693BELT TREY ROBERT 8/10/1999YES

    NEthnicity51450-0000CARNARVON IA310 370TH ST

    5' 10"IA 7 MALEC NONE

    03/13/2015 11:12 PM 2008 BLK CHEVROL

     

    IMP 4D

    2015 NOIACZN257

    STATE 39/FOX AVE$50.00

    $17.50

    $5.0015VIOL OF CONDITIONS OF RESTRICTED LICENSE

    $60.00

    321.193 321.193$132.50

    81-6

    03/13/2015

    03/13/2015

    8:30 AM04/06/2015

    $168.75

    SAC CITY - 6717HATTERMAN, JOHN

    MARCH, 201513

    NOTARYSAC 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 or 

    PROCEEDING

    GUILTY

    DATE:

    None

    Day

    COURT NO.

    FINED $ SURCHARGE $ Continued to:

    S81 RMAN 15 313 231458 8

    FILED 03/16/2015 08:03AM

    CLERK DISTRICT COURT

    SAC COUNTY IOWA

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    chargedinthiscitation,thecourtisauthorizedtoenteraconvictionandrenderjudgmentagainstmefortheamountofmyappearancebondinsatisfactionofthepenaltyandsurchargepluscourtcost.

    You hereby are given notice that within a reasonable time but no later than the date scheduled for your

    initial appearance a citation/complaint sworn under oath will be filed with the district court clerk of the

    county in which this citation was issued.

    Speed

    IACode:

    State of Iowa

    this

    Road Work Zone

    Weight

     Agency

    City

    Zone

    Court Costs

    1.Iherebyswearandaffirmthattheinformationprovidedbymeonthiscitationistrueunderpenaltyofprovidingfalseinformation.

    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 

    ICISSec#:

    Subscribed and sworn to me by

    at

    Fed/AdmCode:

    NOTICE:ProvidingfalseidentificationinformationisaviolationofSection719.1Aof theCodeofIowaandispunishableasasimplemisdemeanor.

    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

    Form420001E1/07

    DOB

    Local Ord.

    Height

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

    Court Appearance Required (805.10)

    VS.

    Name

    DL/StateIDViewed?

    Race

    Sex

    The following applies to simple misdemeanors only:

    The undersigned states that on or about

    Sec #:

    Upon a public highway at

    CDLReq?

    Year 

    dollarsandentermywrittenappearance.IagreethatifIfailtoappearinpersonorbycounseltodefendagainsttheoffense

    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#:

    Signatureof Defendant

    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

    HazMatEndReq?

    Officer'sSignature

    Non-scheduled Violation

    X

    ICISOrd.

    at

    Defendant, Last

    at

    COMPLAINT

    PassEndReq?

    Co. Enf. Surcharge

    Middle

    Notary/other Signature

    Dated

    S81 RMAN 15 314 2 1146 9

    Citation #:

    SAC COUNTY SHERIFF'S OFFICE

    SAC - 81

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

    H13625288REATH JACK   8/28/1997YES

    B NEthnicity68134-0000OMAHA NE3111 MAPLEWOOD BLVD APT

    6' 00"NE NONE MALEO NONE

    03/14/2015 8:11 PM 2002 MAR CHEVROL

     

    IMPALA 4D

    NO

    ESTHER AVE AND 310TH ST5579$120.00

    $42.00

    $5.0015SPEEDING 55 OR < (20 MPH OVER + $5.00 EA. MILE)

    $60.00

    321.285 321.285-E$227.00

    81-6

    03/14/2015

    03/14/2015

    8:30 AM04/06/2015

    $310.50

    SAC CITY - 6717HATTERMAN, JOHN

    MARCH, 201514

    NOTARYSAC 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 or 

    PROCEEDING

    GUILTY

    DATE:

    None

    Day

    COURT NO.

    FINED $ SURCHARGE $ Continued to:

    S81 RMAN 15 314 2 1146 9

    FILED 03/16/2015 08:03AM

    CLERK DISTRICT COURT

    SAC COUNTY IOWA

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    11/22

    chargedinthiscitation,thecourtisauthorizedtoenteraconvictionandrenderjudgmentagainstmefortheamountofmyappearancebondinsatisfactionofthepenaltyandsurchargepluscourtcost.

    You hereby are given notice that within a reasonable time but no later than the date scheduled for your

    initial appearance a citation/complaint sworn under oath will be filed with the district court clerk of the

    county in which this citation was issued.

    Speed

    IACode:

    State of Iowa

    this

    Road Work Zone

    Weight

     Agency

    City

    Zone

    Court Costs

    1.Iherebyswearandaffirmthattheinformationprovidedbymeonthiscitationistrueunderpenaltyofprovidingfalseinformation.

    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 

    ICISSec#:

    Subscribed and sworn to me by

    at

    Fed/AdmCode:

    NOTICE:ProvidingfalseidentificationinformationisaviolationofSection719.1Aof theCodeofIowaandispunishableasasimplemisdemeanor.

    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

    Form420001E1/07

    DOB

    Local Ord.

    Height

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

    Court Appearance Required (805.10)

    VS.

    Name

    DL/StateIDViewed?

    Race

    Sex

    The following applies to simple misdemeanors only:

    The undersigned states that on or about

    Sec #:

    Upon a public highway at

    CDLReq?

    Year 

    dollarsandentermywrittenappearance.IagreethatifIfailtoappearinpersonorbycounseltodefendagainsttheoffense

    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#:

    Signatureof Defendant

    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

    HazMatEndReq?

    Officer'sSignature

    Non-scheduled Violation

    X

    ICISOrd.

    at

    Defendant, Last

    at

    COMPLAINT

    PassEndReq?

    Co. Enf. Surcharge

    Middle

    Notary/other Signature

    Dated

    S81 URNS 15 315 165348 7

    Citation #:

    SAC COUNTY SHERIFF'S OFFICE

    SAC - 81

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

    063BB0378BETTIN MADISON QUINN 8/4/1997YES

    NEthnicity51458-0000ODEBOLT IA614 W 4TH ST

    5' 00"IA NONE FEMALEC NONE

    03/15/2015 4:53 PM 2014 SIL CHEVROL

     

    SLV PK  

    2016 NOIABHB005

    PERKINS AVE AND D036/255TH ST5570$80.00

    $28.00

    $5.0015SPEEDING 55 OR < (11 THRU 15 OVER)

    $60.00

    321.285 321.285-C$173.00

    81-7

    03/15/2015

    03/15/2015

    8:30 AM04/13/2015

    $229.50

    SAC CITY - 6717BURNS, JOEL

    MARCH, 201515

    NOTARYSAC 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 or 

    PROCEEDING

    GUILTY

    DATE:

    None

    Day

    COURT NO.

    FINED $ SURCHARGE $ Continued to:

    S81 URNS 15 315 165348 7

    FILED 03/16/2015 08:03AM

    CLERK DISTRICT COURT

    SAC COUNTY IOWA

  • 8/9/2019 March 16, 2015.pdf

    12/22

    DEFEND NT COPY Citat ion #:

    T T142 15 311 2 2334 4

    F o r m 4 2 0 0 0 1 E 1/07

    P L A I N T I F F :

    I O W A   U N I F O R M   C I T A T I O N A N D   C O M P L A I N T

    L a w   E n f o r c e m e n t A g e n c y -  M O T O R V E H I C L E  E N F O R C E M E N T

    Reference  tt

    i C o u n t y of:  S a c - 81

    ^ : S ta te of l owa

    In the Court at  SA C C O U N T Y C O U R T H O U S E  100 NW S T A T E  STR E E T S U I TE 12

    V S .

    I C i t y of:

    City  SA C CITY

    State  LA  Zip

    ;

    50583

    N a m e

    O C A S I O R U B E N

    D e f e n d a n t , L a s t  j.-  First

    A d d r e s s  12E A S T  B I D W E L L A V E .

    D L   S ta te  N J

    Midd le Su f f i x

    C i t y  J E R S E Y   C I T Y

    n l J

    ,  011176760009622

    DL#

    Date of B i r th 0 9 / 2 8 / 1 9 6 2

    D L   C l a s s  A D L   E n d 'H. M

    S t a t e  N J .  Z i p C o d e   • 0 7 3 0 5 - 4 2 1 7   R a c e  W Ethn ic i t y  N

    D L   R e s .  1 M H e i g h t  5' 07 W e i g h t 3 3 0 L B S  Sex  M A L E

    T h e u n d e r s i g n e d s t a t e s that on or a b o u t  •  0 3 / 1 1 / 2 0 1 5  at  8 : 0 0 P M d e f e n d a n t  did u n l a w f u l ly : O p e r a t e M o t o r ^ e b j c l e / B o a t   2012 M A R

    y

    - ^ F R H T

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      ' ^ ' '  ' • • • i s V  .

    r T / S T

    U S   D OT # 0 0 06 9 85 2 u n i «  i  n u ^ j / D ^ T > 7A o m e»*„i.„  i \ w i h i s  CDL V r c '  ' P a s s E n d  \sr\

    1

    ;  '_,>-__, _  _-,  vr»

    ICC# 140125

    , L i e .. P l a te # / R E G P Z 6 9 7 0

    $100.00

    U p o n a  pub l i c h ighw ay at  U S   7 1 / K A R R   A V E

    S c h e d u l e d V i o l a t i o n / F i n e

    C r i m i n a l S u r c h a r g e

    C o .  E n f . S u r c h a r g e

    C o u r t C o s t s

    T o t a l F i n e / C o s t s

    S t a t e  LA Y e a r  2015

    C D L

    , '  Y E S

      ;

      ' ^

    S

    q

    =

    E n d

    .  N O _ H a z M a t E rid R e q

    i?  NO

    S 3 5 . 0 0

    R e a s o n

    L o c a t e d  in he coun ty and s ta te a fo r e sa id and  did t hen and the r e com mi t  the f o l low ing o f fense :

    i C o u r t A p p e a r a n c e R e q u i r e d ( 8 0 5   10)  I'  ; R o a d W o r k Z o n e N o n - s c h e d u l e d V i o l a t io n S p e e d

    C iv i l  D a m a g e A s s e s s m e n t

    Z o n e

    S e r i o u s P.I.

    :  F a t a A c c i d e n t

    O t h e r

    N /A   • - „ . .

    Violation  F A I L U R E  T O O B E Y  T R A F F I C C O N T R O L D E V I CE  ( O P E N S C A L E  SIGN)

    _ Lflj^^\

     

    (^$195.00  ^ y 6 e c «  321.256  ICIS Sec  321.256

    L o c a l  O r d .

    F e d / A d m C o d e 3 9 2 . 2 C

    l A C o d e :  20 13

    IC IS Or d .

    O f f i c e r ' s

    S i g n a t u r e

    I.D  No 7] 42

    C o u r t D a t e :  If you must appear in court or if you choose to appear to angwer to a charge

    which  doesQQU eqtr tTe

    -

    anappearance,  re^or t te- tS^bove namedegurtoh:

    Dated .03/11/2015

    —  03/3tW2015--

    a

    -8:36-A-ftfr-

    NOTICE:  Providing false identification information is a violation of Section  719.1  A  of the Code o?To wa-.anaVjiLr̂ ishable as a simplê jmsdemeanor,

    Y o u   hereby are given notice that wthin a reasonable time but no later than the date scheduled for your initial appearance a citation/com plaint sworn under oa th will be tiled wth the

    district court clerk of the county in which this citation wa s issue d.

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

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

    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.

    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.  ,,

    Th e  following applies to simple misdemeanors only:

    4._ hereby give my unsecured appearance bond in the amount of . S262.50 dollars and enter written appearance.  I agree that if I fail to appear in person or by counsel to

    defend against the offense 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.  ,

    ,.  ~

    v

      ;.

    4

      ., .  Dated  If you require the assistance of  auxiliary aids or services to participate in court because of a

    f ,

     fjf'tfjYi  •  t C - '

     '  disability, immediately call the AD A district coordinator in the.county which the citation was

    ' '• •  .  03/11/2015 issu ed, or if you are hearing impaired, call Relay lowa TTY at  1-800-735-2942.

    D e f e n d a n t

    Signature

    T01 T142  150311  202334 4

    IF   PLE AD I N G   G U I L T y   DETACPKAND  R EMIT WITH   P A Y M E N T  O R P A Y  ONLINE; A T   W W W . IO W A C O U R T S . G O V

    A T

    ^ C H E C K S P A Y A B L E  T O :   C L E R K  O F i

    Citat ion #:

    s  C S T l B M I T  P A Y M E N T  T O : S A C C O U N T Y C O U R T H O U S E  100 NW S T A T E  STR E E T S U I TE 12

    •T4U_T142_-1503I1  2023 34 4

    C i ty S A C C I T Y S t a t e  L\ Zip  5 0 5 8 3

    ISSUING  L A W   ENFORCEMENT AGENCY M o t o r V e h i c l e E n f o r c e m e n t

    Reference #:

    N a m e  O C A S I O R U B E N

    DL #  011176760009622

    D a t e  of B i r t h 0 9 / 2 8 / 1 9 6 2

    D e f e n d a n t , L a s t  •  F i r s t

    Address  12 EA ST B I D W E L L  A V E .

    Midd le Su f f i x

    C i t y  J E R S E Y   C I T Y

    D L   State  NJ  DL  Class A

    The undersigned states

     that

     on or about 03/11/2015  at

    D L E n d .  HN D L R e s .  IM

    S t a t e  N J  < H p C o d e 0 7 3 0 5- 4 2 17   R a c e  W

    H e i g h t  5 ' 0 7 '  W e i g h t  330

    E t h n i c i t y

    Sex   M A L E

    20:00 defendant did unlawfully: Operate Motor Veh icle/Boat

    U S  DOT#  00069852  ICC#  140125

    L i e .  Plate #/REG PZ6970

    State  LA  Yea r 2015

    Upon  a public highway at  U S   71 / k A R R   A V E

    C D L

    R e q ?

    r m g l l i m u x

    TT/ST

    Y E S

    P a s s   E n d

    R e q ?

    N O   HazMat End Req? NO

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

    Violation  F A I L U R E  T O  O B E Y  T R A F F I C C O N T R O L D E V I C E  ( O P E N  S C A L E  SI Sec #: 321.256  ICIS Sec  321.256  LocalO rd ICIS Ord.

    S c h e d u l e d  F i n e S 1 0 0 . 0 0

    B o n d A m o u n t S 2 62 .5 0

    C r i m i n a l S u r c h a r g e S 35 .0 0 C o . E n f . S u r c h a r g e  N / A

    Court Costs  $60.00 To tal F in e /C o st s .5195.00

    ; R o a d W o r k Z o n e C o u r t A p p e a r a n c e R e q u i r e d ( 8 0 5  10)  C o u r t D a t e - 0 3 / 3 0 / 2 0 1 5 S p e e d

    Z o n e F e d / A d m  C o d e .  3 9 2 . 2 C

    •  l A C o d e : 20 13

    PPE R NCE PLE OF GUILTY  S

    I,  the undersigned, do hereby enter my appearance on the complaint of the offense charged on this citation.  I have been informed of my right to a trial, that my

    signature to  this plea of guilty will have the sam e effect as a judgment of court and this record will be sent to  the Department of Transportation of this state (or of the "

    state of my residence).  I do hereby  P L EA D  GUILTY   .to said offense as charged and agree to the penalty prescribed for my offense. Amou nt to pay: $195 .00

    : IF   Y O U A R E   REQUIRED   TO  POST   BAIL TO OBTAIN  RELEASE

    A .  If you desire to enter a plea of guilty, the officer may release you from custody upon observing you mail the citation, admission of guilt  and minimum fine,  •

    '• surcharge, wth court costs to a traffic  violations office in an env elope furnished by the officer.  • •

    B .  Ifyou choose to plead NOT GUILTY,  the officer may release you from custody by observing you mail the citation, and one and one half times the minimum fine,

    surcharge, wth  court costs, or in  lieu of one and one half times the fine and costs a guaranteed arrest bond certificate together wth  signing the following statement:

    I agree that  either (1) I wi l l appear pursuant to  this citation or (2) if  I do not so appear, the amount deposited as ba i l wi l l be for feited."

    Signa t i

    D e f e n d a n t

    ur o V? A l o

    Officer:  PEREZ, WILLIAM

    I.D. No. T142

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    13/22

    chargedinthiscitation,thecourtisauthorizedtoenteraconvictionandrenderjudgmentagainstmefortheamountofmyappearancebondinsatisfactionofthepenaltyandsurchargepluscourtcost.

    You hereby are given notice that within a reasonable time but no later than the date scheduled for your

    initial appearance a citation/complaint sworn under oath will be filed with the district court clerk of the

    county in which this citation was issued.

    Speed

    IACode:

    State of Iowa

    this

    Road Work Zone

    Weight

     Agency

    City

    Zone

    Court Costs

    1.Iherebyswearandaffirmthattheinformationprovidedbymeonthiscitationistrueunderpenaltyofprovidingfalseinformation.

    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 

    ICISSec#:

    Subscribed and sworn to me by

    at

    Fed/AdmCode:

    NOTICE:ProvidingfalseidentificationinformationisaviolationofSection719.1Aof theCodeofIowaandispunishableasasimplemisdemeanor.

    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

    Form420001E1/07

    DOB

    Local Ord.

    Height

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

    Court Appearance Required (805.10)

    VS.

    Name

    DL/StateIDViewed?

    Race

    Sex

    The following applies to simple misdemeanors only:

    The undersigned states that on or about

    Sec #:

    Upon a public highway at

    CDLReq?

    Year 

    dollarsandentermywrittenappearance.IagreethatifIfailtoappearinpersonorbycounseltodefendagainsttheoffense

    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#:

    Signatureof Defendant

    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

    HazMatEndReq?

    Officer'sSignature

    Non-scheduled Violation

    X

    ICISOrd.

    at

    Defendant, Last

    at

    COMPLAINT

    PassEndReq?

    Co. Enf. Surcharge

    Middle

    Notary/other Signature

    Dated

    S81 BACK 15 316 112222 7

    Citation #:

    SAC COUNTY SHERIFF'S OFFICE

    SAC - 81

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

    615AH3100NASH BRITTANY NICOLE 10/14/1995YES

    NEthnicity50010-0000AMES IA1725 BURNETT AVE

    5' 08"IA NONE FEMALEC NONE

    03/16/2015 11:22 AM 1999 GRN AUDI - AA6 4D

    2010 NOIA945WQC

    PERKINS AVE AND US 206575$40.00

    $14.00

    $5.0015SPEEDING > 55 (6 THRU 10 OVER)

    $60.00

    321.285 321.285-G$119.00

    81-5

    03/16/2015

    03/16/2015

    8:30 AM04/20/2015

    $148.50

    SAC CITY - 6717CUDABACK, TORY

    MARCH, 201516

    NOTARYSAC 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 or 

    PROCEEDING

    GUILTY

    DATE:

    None

    Day

    COURT NO.

    FINED $ SURCHARGE $ Continued to:

    S81 BACK 15 316 112222 7

    FILED 03/16/2015 12:17PM

    CLERK DISTRICT COURT

    SAC COUNTY IOWA

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    14/22

    chargedinthiscitation,thecourtisauthorizedtoenteraconvictionandrenderjudgmentagainstmefortheamountofmyappearancebondinsatisfactionofthepenaltyandsurchargepluscourtcost.

    You hereby are given notice that within a reasonable time but no later than the date scheduled for your

    initial appearance a citation/complaint sworn under oath will be filed with the district court clerk of the

    county in which this citation was issued.

    Speed

    IACode:

    State of Iowa

    this

    Road Work Zone

    Weight

     Agency

    City

    Zone

    Court Costs

    1.Iherebyswearandaffirmthattheinformationprovidedbymeonthiscitationistrueunderpenaltyofprovidingfalseinformation.

    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 

    ICISSec#:

    Subscribed and sworn to me by

    at

    Fed/AdmCode:

    NOTICE:ProvidingfalseidentificationinformationisaviolationofSection719.1Aof theCodeofIowaandispunishableasasimplemisdemeanor.

    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

    Form420001E1/07

    DOB

    Local Ord.

    Height

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

    Court Appearance Required (805.10)

    VS.

    Name

    DL/StateIDViewed?

    Race

    Sex

    The following applies to simple misdemeanors only:

    The undersigned states that on or about

    Sec #:

    Upon a public highway at

    CDLReq?

    Year 

    dollarsandentermywrittenappearance.IagreethatifIfailtoappearinpersonorbycounseltodefendagainsttheoffense

    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#:

    Signatureof Defendant

    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

    HazMatEndReq?

    Officer'sSignature

    Non-scheduled Violation

    X

    ICISOrd.

    at

    Defendant, Last

    at

    COMPLAINT

    PassEndReq?

    Co. Enf. Surcharge

    Middle

    Notary/other Signature

    Dated

    T 1 T142 15 311 1522 7 9

    *+T01T1421503111522079+*

    Citation #:

    MOTOR VEHICLE ENFORCEMENT

    SAC - 81

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

    D0944118ROJAS SOPHIE DANIELLE 9/30/1975YES

    NEthnicity64110KANSAS CITY MO6121 HOLMES

    5' 07"MO 137 LBSB FEMALEF NONE

    03/11/2015 3:22 PM 2013 GRY TOYOTA - RAV4 SUV

    2013 NOMOSL5D9Y

    N028/DAKOTA AVE

    6585$90.00

    $31.50

    N/A15SPEEDING 87 MPH IN 65 MPH ZONE (RADAR 87 MPH)

    $60.00

    321.285 321.285-I$181.50

    T142

    03/11/2015

    03/11/2015

    8:30 AM03/30/2015

    $242.25

    EARLY - 2200PEREZ, WILLIAM

    MARCH, 201516

    OTHER MOTOR 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 or PROCEEDING

    GUILTY

    DATE:

    None

    Day

    COURT NO.

    FINED $ SURCHARGE $ Continued to:

    T 1 T142 15 311 1522 7 9

    FILED 03/16/2015 03:30PM

    CLERK DISTRICT COURT

    SAC COUNTY IOWA

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    15/22

    chargedinthiscitation,thecourtisauthorizedtoenteraconvictionandrenderjudgmentagainstmefortheamountofmyappearancebondinsatisfactionofthepenaltyandsurchargepluscourtcost.

    You hereby are given notice that within a reasonable time but no later than the date scheduled for your

    initial appearance a citation/complaint sworn under oath will be filed with the district court clerk of the

    county in which this citation was issued.

    Speed

    IACode:

    State of Iowa

    this

    Road Work Zone

    Weight

     Agency

    City

    Zone

    Court Costs

    1.Iherebyswearandaffirmthattheinformationprovidedbymeonthiscitationistrueunderpenaltyofprovidingfalseinformation.

    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 

    ICISSec#:

    Subscribed and sworn to me by

    at

    Fed/AdmCode:

    NOTICE:ProvidingfalseidentificationinformationisaviolationofSection719.1Aof theCodeofIowaandispunishableasasimplemisdemeanor.

    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

    Form420001E1/07

    DOB

    Local Ord.

    Height

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

    Court Appearance Required (805.10)

    VS.

    Name

    DL/StateIDViewed?

    Race

    Sex

    The following applies to simple misdemeanors only:

    The undersigned states that on or about

    Sec #:

    Upon a public highway at

    CDLReq?

    Year 

    dollarsandentermywrittenappearance.IagreethatifIfailtoappearinpersonorbycounseltodefendagainsttheoffense

    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#:

    Signatureof Defendant

    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

    HazMatEndReq?

    Officer'sSignature

    Non-scheduled Violation

    X

    ICISOrd.

    at

    Defendant, Last

    at

    COMPLAINT

    PassEndReq?

    Co. Enf. Surcharge

    Middle

    Notary/other Signature

    Dated

    T 1 T142 15 311 165944

    *+T01T1421503111659440+*

    Citation #:

    MOTOR VEHICLE ENFORCEMENT

    SAC - 81

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

    Y195242828415KRAUSE THOMAS JAMES 12/18/1983YES

    NEthnicity56501DETROIT LAKES MN20450 COUNTY HIGHWAY

    5' 11"MN 260 LBSB MALEA NONE

    03/11/2015 4:05 PM 2004 PLE PETERBIL

     

    TT/ST

    2015 YES NO NOMNPAB134900075296 160820

    US 71/KARR AVE

    $50.00

    $17.50393.9TS

    N/A13INOPERATIVE LEFT & RIGHT TURN SIGNALS

    $60.00

    321.449 321.449-A$127.50

    T142

    03/11/2015

    03/11/2015

    8:30 AM03/30/2015

    $161.25

    EARLY - 2200PEREZ, WILLIAM

    MARCH, 201516

    OTHER MOTOR 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 or PROCEEDING

    GUILTY

    DATE:

    None

    Day

    COURT NO.

    FINED $ SURCHARGE $ Continued to:

    T 1 T142 15 311 165944

    FILED 03/16/2015 03:30PM

    CLERK DISTRICT COURT

    SAC COUNTY IOWA

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    16/22

    chargedinthiscitation,thecourtisauthorizedtoenteraconvictionandrenderjudgmentagainstmefortheamountofmyappearancebondinsatisfactionofthepenaltyandsurchargepluscourtcost.

    You hereby are given notice that within a reasonable time but no later than the date scheduled for your

    initial appearance a citation/complaint sworn under oath will be filed with the district court clerk of the

    county in which this citation was issued.

    Speed

    IACode:

    State of Iowa

    this

    Road Work Zone

    Weight

     Agency

    City

    Zone

    Court Costs

    1.Iherebyswearandaffirmthattheinformationprovidedbymeonthiscitationistrueunderpenaltyofprovidingfalseinformation.

    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 

    ICISSec#:

    Subscribed and sworn to me by

    at

    Fed/AdmCode:

    NOTICE:ProvidingfalseidentificationinformationisaviolationofSection719.1Aof theCodeofIowaandispunishableasasimplemisdemeanor.

    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

    Form420001E1/07

    DOB

    Local Ord.

    Height

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

    Court Appearance Required (805.10)

    VS.

    Name

    DL/StateIDViewed?

    Race

    Sex

    The following applies to simple misdemeanors only:

    The undersigned states that on or about

    Sec #:

    Upon a public highway at

    CDLReq?

    Year 

    dollarsandentermywrittenappearance.IagreethatifIfailtoappearinpersonorbycounseltodefendagainsttheoffense

    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#:

    Signatureof Defendant

    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

    HazMatEndReq?

    Officer'sSignature

    Non-scheduled Violation

    X

    ICISOrd.

    at

    Defendant, Last

    at

    COMPLAINT

    PassEndReq?

    Co. Enf. Surcharge

    Middle

    Notary/other Signature

    Dated

    T 1 T142 15 311 183412 2

    *+T01T1421503111834122+*

    Citation #:

    MOTOR VEHICLE ENFORCEMENT

    SAC - 81

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

    890ZZ2865SIMONS PHILLIP ROSS 2/9/1986YES

    NEthnicity51301-0000SPENCER IA4225 210TH AVE

    6' 00"IA 170 LBSNONE MALEA LN

    03/11/2015 6:20 PM 2007

    HI INTERNA

     

    TT/ST

    2015 YES NO NOIADD322002562993

    RAILROAD ST AND 4TH AVE

    $50.00

    $17.50392.16

    N/A13FAILING TO USE SEAT BELT WHILE OPERATING CMV

    $60.00

    321.445 321.445$127.50

    T142

    03/11/2015

    03/11/2015

    8:30 AM03/30/2015

    $161.25

    EARLY - 2200PEREZ, WILLIAM

    MARCH, 201516

    OTHER MOTOR 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 or PROCEEDING

    GUILTY

    DATE:

    None

    Day

    COURT NO.

    FINED $ SURCHARGE $ Continued to:

    T 1 T142 15 311 183412 2

    FILED 03/16/2015 03:30PM

    CLERK DISTRICT COURT

    SAC COUNTY IOWA

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    17/22

    chargedinthiscitation,thecourtisauthorizedtoenteraconvictionandrenderjudgmentagainstmefortheamountofmyappearancebondinsatisfactionofthepenaltyandsurchargepluscourtcost.

    You hereby are given notice that within a reasonable time but no later than the date scheduled for your

    initial appearance a citation/complaint sworn under oath will be filed with the district court clerk of the

    county in which this citation was issued.

    Speed

    IACode:

    State of Iowa

    this

    Road Work Zone

    Weight

     Agency

    City

    Zone

    Court Costs

    1.Iherebyswearandaffirmthattheinformationprovidedbymeonthiscitationistrueunderpenaltyofprovidingfalseinformation.

    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 

    ICISSec#:

    Subscribed and sworn to me by

    at

    Fed/AdmCode:

    NOTICE:ProvidingfalseidentificationinformationisaviolationofSection719.1Aof theCodeofIowaandispunishableasasimplemisdemeanor.

    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

    Form420001E1/07

    DOB

    Local Ord.

    Height

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

    Court Appearance Required (805.10)

    VS.

    Name

    DL/StateIDViewed?

    Race

    Sex

    The following applies to simple misdemeanors only:

    The undersigned states that on or about

    Sec #:

    Upon a public highway at

    CDLReq?

    Year 

    dollarsandentermywrittenappearance.IagreethatifIfailtoappearinpersonorbycounseltodefendagainsttheoffense

    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#:

    Signatureof Defendant

    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

    HazMatEndReq?

    Officer'sSignature

    Non-scheduled Violation

    X

    ICISOrd.

    at

    Defendant, Last

    at

    COMPLAINT

    PassEndReq?

    Co. Enf. Surcharge

    Middle

    Notary/other Signature

    Dated

    T 1 T142 15 316 91 19 3

    *+T01T1421503160910193+*

    Citation #:

    MOTOR VEHICLE ENFORCEMENT

    SAC - 81

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

    942022402FISHER MITCHELL AYNE 1/11/1977YES

    NEthnicity80705-0000LOG LNE VLG CO103 POPLAR DR 

    6' 01"CO 180 LBSNONE MALEA M

    03/16/2015 9:00 AM 2000 BLK FRH TT/ST

    2014 YES NO NOCO566-XAL02317650 791195

    US 71/KARR AVE

    $50.00

    $17.50392.16

    N/A13FAILING TO USE SEAT BELT WHILE OPERATING CMV

    $60.00

    321.445 321.445$127.50

    T142

    03/16/2015

    03/16/2015

    8:30 AM03/30/2015

    $161.25

    EARLY - 2200PEREZ, WILLIAM

    MARCH, 201516

    OTHER MOTOR 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 or PROCEEDING

    GUILTY

    DATE:

    None

    Day

    COURT NO.

    FINED $ SURCHARGE $ Continued to:

    T 1 T142 15 316 91 19 3

    FILED 03/16/2015 03:31PM

    CLERK DISTRICT COURT

    SAC COUNTY IOWA

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    18/22

    chargedinthiscitation,thecourtisauthorizedtoenteraconvictionandrenderjudgmentagainstmefortheamountofmyappearancebondinsatisfactionofthepenaltyandsurchargepluscourtcost.

    You hereby are given notice that within a reasonable time but no later than the date scheduled for your

    initial appearance a citation/complaint sworn under oath will be filed with the district court clerk of the

    county in which this citation was issued.

    Speed

    IACode:

    State of Iowa

    this

    Road Work Zone

    Weight

     Agency

    City

    Zone

    Court Costs

    1.Iherebyswearandaffirmthattheinformationprovidedbymeonthiscitationistrueunderpenaltyofprovidingfalseinformation.

    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 

    ICISSec#:

    Subscribed and sworn to me by

    at

    Fed/AdmCode:

    NOTICE:ProvidingfalseidentificationinformationisaviolationofSection719.1Aof theCodeofIowaandispunishableasasimplemisdemeanor.

    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

    Form420001E1/07

    DOB

    Local Ord.

    Height

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

    Court Appearance Required (805.10)

    VS.

    Name

    DL/StateIDViewed?

    Race

    Sex

    The following applies to simple misdemeanors only:

    The undersigned states that on or about

    Sec #:

    Upon a public highway at

    CDLReq?

    Year 

    dollarsandentermywrittenappearance.IagreethatifIfailtoappearinpersonorbycounseltodefendagainsttheoffense

    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#:

    Signatureof Defendant

    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

    HazMatEndReq?

    Officer'sSignature

    Non-scheduled Violation

    X

    ICISOrd.

    at

    Defendant, Last

    at

    COMPLAINT

    PassEndReq?

    Co. Enf. Surcharge

    Middle

    Notary/other Signature

    Dated

    T 1 T142 15 316 92641 4

    *+T01T1421503160926414+*

    Citation #:

    MOTOR VEHICLE ENFORCEMENT

    SAC - 81

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

    942022402FISHER MITCHELL AYNE 1/11/1977YES

    NEthnicity80705-0000LOG LNE VLG CO103 POPLAR DR 

    6' 01"CO 180 LBSNONE MALEA M

    03/16/2015 9:00 AM 2000 BLK FRH TT/ST

    2014 YES NO NOCO566-XAL02317650 791195

    US 71/KARR AVE

    $50.00

    $17.50396.3A1BOS

    N/A13BRAKES OUT OF SERVICE: 2 OF 10 BRAKES OUT OF ADJUSTMENT (AXLE 4 &

    $60.00

    321.449 321.449-A$127.50

    T142

    03/16/2015

    03/16/2015

    8:30 AM03/30/2015

    $161.25

    EARLY - 2200PEREZ, WILLIAM

    MARCH, 201516

    OTHER MOTOR 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 or PROCEEDING

    GUILTY

    DATE:

    None

    Day

    COURT NO.

    FINED $ SURCHARGE $ Continued to:

    T 1 T142 15 316 92641 4

    FILED 03/16/2015 03:31PM

    CLERK DISTRICT COURT

    SAC COUNTY IOWA

  • 8/9/2019 March 16, 2015.pdf

    19/22

    chargedinthiscitation,thecourtisauthorizedtoenteraconvictionandrenderjudgmentagainstmefortheamountofmyappearancebondinsatisfactionofthepenaltyandsurchargepluscourtcost.

    You hereby are given notice that within a reasonable time but no later than the date scheduled for your

    initial appearance a citation/complaint sworn under oath will be filed with the district court clerk of the

    county in which this citation was issued.

    Speed

    IACode:

    State of Iowa

    this

    Road Work Zone

    Weight

     Agency

    City

    Zone

    Court Costs

    1.Iherebyswearandaffirmthattheinformationprovidedbymeonthiscitationistrueunderpenaltyofprovidingfalseinformation.

    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 

    ICISSec#:

    Subscribed and sworn to me by

    at

    Fed/AdmCode:

    NOTICE:ProvidingfalseidentificationinformationisaviolationofSection719.1Aof theCodeofIowaandispunishableasasimplemisdemeanor.

    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

    Form420001E1/07

    DOB

    Local Ord.

    Height

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

    Court Appearance Required (805.10)

    VS.

    Name

    DL/StateIDViewed?

    Race

    Sex

    The following applies to simple misdemeanors only:

    The undersigned states that on or about

    Sec #:

    Upon a public highway at

    CDLReq?

    Year 

    dollarsandentermywrittenappearance.IagreethatifIfailtoappearinpersonorbycounseltodefendagainsttheoffense

    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#:

    Signatureof Defendant

    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

    HazMatEndReq?

    Officer'sSignature

    Non-scheduled Violation

    X

    ICISOrd.

    at

    Defendant, Last

    at

    COMPLAINT

    PassEndReq?

    Co. Enf. Surcharge

    Middle

    Notary/other Signature

    Dated

    T 1 T142 15 316 93847 7

    *+T01T1421503160938477+*

    Citation #:

    MOTOR VEHICLE ENFORCEMENT

    SAC - 81

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

    D00398219DALE ROBERT A 7/24/1961YES

    NEthnicity85367-6113YUMA AZ13202 E 42ND DR 

    5' 10"AZ 205 LBSB MALEA TXL

    03/16/2015 9:40 AM 2010 RED KEN TT/ST

    2015 YES NO NOIN102678700074432 103798

    US 71/KARR AVE

    $22.00

    $7.70392.2-SLLEWA1

    N/A13OW ON TANDEM AXLES 2 & 3 BY 1,520 LBS (35,520 LBS)

    $60.00

    321.463 321.463$89.70

    T142

    03/16/2015

    03/16/2015

    8:30 AM03/30/2015

    $104.55

    EARLY - 2200PEREZ, WILLIAM

    MARCH, 201516

    OTHER MOTOR 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 or PROCEEDING

    GUILTY

    DATE:

    None

    Day

    COURT NO.

    FINED $ SURCHARGE $ Continued to:

    T 1 T142 15 316 93847 7

    FILED 03/16/2015 03:31PM

    CLERK DISTRICT COURT

    SAC COUNTY IOWA

  • 8/9/2019 March 16, 2015.pdf

    20/22

    chargedinthiscitation,thecourtisauthorizedtoenteraconvictionandrenderjudgmentagainstmefortheamountofmyappearancebondinsatisfactionofthepenaltyandsurchargepluscourtcost.

    You hereby are given notice that within a reasonable time but no later than the date scheduled for your

    initial appearance a citation/complaint sworn under oath will be filed with the district court clerk of the

    county in which this citation was issued.

    Speed

    IACode:

    State of Iowa

    this

    Road Work Zone

    Weight

     Agency

    City

    Zone

    Court Costs

    1.Iherebyswearandaffirmthattheinformationprovidedbymeonthiscitationistrueunderpenaltyofprovidingfalseinformation.

    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 

    ICISSec#:

    Subscribed and sworn to me by

    at

    Fed/AdmCode:

    NOTICE:ProvidingfalseidentificationinformationisaviolationofSection719.1Aof theCodeofIowaandispunishableasasimplemisdemeanor.

    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

    Form420001E1/07

    DOB

    Local Ord.

    Height

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

    Court Appearance Required (805.10)

    VS.

    Name

    DL/StateIDViewed?

    Race

    Sex

    The following applies to simple misdemeanors only:

    The undersigned states that on or about

    Sec #:

    Upon a public highway at

    CDLReq?

    Year 

    dollarsandentermywrittenappearance.IagreethatifIfailtoappearinpersonorbycounseltodefendagainsttheoffense

    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#:

    Signatureof Defendant

    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

    HazMatEndReq?

    Officer'sSignature

    Non-scheduled Violation

    X

    ICISOrd.

    at

    Defendant, Last

    at

    COMPLAINT

    PassEndReq?

    Co. Enf. Surcharge

    Middle

    Notary/other Signature

    Dated

    T 1 T142 15 316 12 5 3

    *+T01T1421503161205030+*

    Citation #:

    MOTOR VEHICLE ENFORCEMENT

    SAC - 81

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

    K30016086372KETO DJODJI 12/31/1986YES

    B NEthnicity61265-0000MOLINE IL825 17TH STREET APT 406

    5' 09"IL 165 LBSB MALEA ****

    03/16/2015 11:40 AM 2006

    HI VOLVO - TT/ST

    2015 YES NO NOILP84934002407460 828350

    US 71/KARR AVE

    $100.00

    $35.00392.2C

    N/A13FAILURE TO OBEY TRAFFIC CONTROL DEVICE (OPEN SCALE SIGN)

    $60.00

    321.256 321.256$195.00

    T142

    03/16/2015

    03/16/2015

    8:30 AM03/30/2015

    $262.50

    EARLY - 2200PEREZ, WILLIAM

    MARCH, 201516

    OTHER MOTOR 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 or PROCEEDING

    GUILTY

    DATE:

    None

    Day

    COURT NO.

    FINED $ SURCHARGE $ Continued to:

    T 1 T142 15 316 12 5 3

    FILED 03/16/2015 03:31PM

    CLERK DISTRICT COURT

    SAC COUNTY IOWA

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    E-FILED 2015 MAR 16 2:30 AM SAC - CLERK OF DISTRICT COURT

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    22/22

    E-FILED 2015 MAR 16 2:30 AM SAC - CLERK OF DISTRICT COURT