HomeMy WebLinkAboutCitation #52027 - 02/17 to 3/17/04 CITY Of OSHKOSH, WISCONSIN ,luvenile Yes Incident No. Deposit
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Notified Yes $ ; . FOR COURT USE ONLY
� STATE OF WISCONSIN THE UNDERSIGNED FOR AND IN BEHALF OF THE
� CIRCUIT COURT CIN OF OSHKOSH STATES UPON INFORMATION AND BELIEF THAT SAID DEFENDANT DID
WINNEBAGO COUNTY
ORDINANCE ADOPTING WIS STATS
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ON , AT AM/PM VIOLATE _ TO WIT:
DEFENDANT LAST FIRST MIDD DESCRIBE VIOLATION
ADDRESS(HOME) rAPT. CI STATE ZIP CODE - -
� SCHOOL ADDRESS/PLACE OF EMPLOYMENT/ OME PHONE ' ' ' ' '
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� BIRTH DATE DRIVERS LICENSE STATE
SEX RACE HEIGHT WEIGHT HAIR EYES MARKS,SCARS,TATTOOS
VEH.PLATE EXP. STATE YEAR/MAKE Of VEH. TYPE COLOR ON HWY/STREET—PRIVATE/PUBLIC PROPERTY
PARENT/GUARDIAN ADDRESS PHONE AT.
YOU ARE HEREBY SUMMONED TO APPEAR IN THE ABOVE COURT '1Ninnebago County,C� of Oshkosh
ON , , AT�_AM/PM OSHKOSH POLICE DEPARTMENT
OFFICER'S SIGNATURE NUMBER
LOCATED AT SAFETY BUILDING,RM. 194,420 JACKSON ST.,OSHKOSH,WI 54903-2808
(RECORD COPY)
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AGENCY RECORD
DATE OF DISP SITIO STIPULATION
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G� a
❑Withdra n by Agency- Reason ❑Amended To:
❑Denied by Prosecution - Reason
❑ Dismissed- Reason
PLEA: ❑ NOT GUILTY FINDINGS: ❑ GUILTY O NOT GUILTY
❑ NO CONTEST
❑GUILTY IS ISS
TRIAL: DATE:
❑JURY ��
❑COURT BRANCH: 1 3 4 5 6
SENTENCE: WARRANT STATUS
❑ $ FINE AND/OR ORDERED: i'�i
❑ DAYS JAIL AND/OR DATE: / /
❑ DAYS IN JAIL FOR FAILURE TO PAY: SERVED:
❑ Driver's License Suspension For Failure To Pay DATE: / / �4
INCIDENT REPORT: RETURN
DATE �
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INCIDENT D TAT YES NO ARREST REPORT DICTATED YES NO
DATE: 7 � DATE: q
SIGNATii E OF OFFIC R DATE RMS JALES
DATA �
�� ENTERED: / / / /