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HomeMy WebLinkAboutCitation #53878 APT. ADOPTING WIS STATS Yes THE UNDERSIGNED FOR AND IN BEHALFOFTHE CITY OF OSHKOSH STATES UPON INFORMATION AND BELIEF . ORDINANCE ON :!ul:1 T'J DEFENDANT ~:l;; S ,AT l;,;n iJ~M/PM VIOLATE LAST FIRST ~',l:'~:;~ ADDRESS (HOME) CITY/STATE '~\;t.t""~~ SCHOOL ADDRESS/PLACE OF EMPLOYMENT/HOME PHONE BIRTH DATE STATE MARKS, SCARS, TATTOOS TYPE COLOR ON HWY/STREET - PRIVATE/PUBLIC PROPERTY PARENT/GUARDIAN PHONE YOU ARE HEREBY SUMMONED TO APPEAR IN THE ABOVE COURT ~,. 1,,*' ON A, '';'''.>i'''' \;.'.' i.~,"-~:", It;;i M M OSHKOSH POLICE DEPARTMENT LOCATED AT SAFETY BUILDING, RM. 194,420 JACKSON ST., OSHKOSH, WI 54903-2808 (RECORD COpy) it; .I~, : :t":.~~.;,~~ OFFICER'S SIGNATURE l'-" ..;.,;.. AGENCY RECORD o it drawn Agency - Reason o Denied by Prosecution - Reason o Dismissed - Reason PLEA: 0 NOT GUILTY FINDINGS: ~ONTEST ...rJ GUILTY TRIAL: DATE: o JURY o COURT BRANCH: SENTENCE: o o o o $ ~ 0 NOT GUILTY o DISMISSED COURT 2 3 4 5 6 WARRANT STATUS ORDERED: FINE AND/OR DAYS JAIL AND/OR DATE: DAYS IN JAIL FOR FAILURE TO PAY: SERVED: Driver's License Suspension For Failure To Pay INCIDENT REPORT: DATE: RETURN DATE: INCIDENT DICTATED YES NO ARREST REPORT DICTATED YES NO JALES DATE: SIGNATURE OF OFFICER DATE: DATE DATA ENTERED: A-c-- -.BML