C00001 .pdf

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Police Department
Summons
VIOLATOR

LAST NAME
LANE
CITY

DRIVERS LICENSE NO.

STATE
LC

OCCUPATION

MIDDLE

STATE

CLASS

CDL

ZIP CODE
RACE
WHITE

SEX
MALE

TELEPHONE
DATE OF BIRTH
03/06/1956

EMPLOYERS ADDRESS
MILE POST

S
VEHICLE LICENSE NO.
DATE
07/13/2013

TIME
16:31

ALLEGED SPEED

HEIGHT

TELEPHONE

LOCATION
PLUMERS SKYWAY
STATE
LC
WEATHER
CLEAR
SPEED LIMIT

COLOR
GREEN
TRAFFIC
NONE
RADAR
LASER

CONSTRUCTION ZONE
X NO
YES
YEAR MODEL
MAKE
TYPE
1969
CHEVELLE MUSSLE

WORKERS PRESENT
X NO
YES
COMM. VEH.
X NO
YES
ROAD SURFACE
SCHOOL ZONE
ACCIDENT
DRY
X NO
X NO
YES
YES
RADAR CAL
VEHICLE TOWED
X NO
X NO
YES
YES

VIOLATION(S)

SIGNATURE:

THIS IS NOT A PLEA OF GUILTY

C1300003

FIRST
COLE

RESIDENCE ADDRESS

I hereby promise to appear at the time and place designated
in this notice.

C00307130001

Case No.

X
WARNING
VEHICLE
YES
TYPE OF
CONSENT
SEARCH
SEARCH
X
CITATION
NO
PC
CONTRABAND
YES
TYPE OF
DRUGS
CURRENCY
FOUND
CONTRABAND
X
NO
WEAPONS
OTHER
WARNING(S) NO PENALTY ASSESSED FOR THE FOLLOWING OFFENSE(S)
1 ILLEGAL U-TURNS
REASON
FOR STOP

INC TO ARREST
INVENTORY

YOU ARE HEREBY NOTIFIED TO APPEAR BEFORE JUSTICE COURT OF:

ON
OR
BEFORE

ISSUED
By:

Haines

ID#
46

BADGE #

If you fail to appear in court as required by law, you may be denied the renewal of your driver’s license and assessed an additional fee .
A second or subsequent conviction of failure to maintain financial responsibility will result in the suspension of your driver’s license and motor
vehicle registration unless you file and maintain proof of financial responsibility with the Department of Public Safety for (1) one year from date of
conviction. The department may waive the requirement to file proof of financial responsibility if you file satisfactory evidence with the department
showing that at the time this citation was issued, the vehicle was covered by a liability insurance policy or that you were otherwise exempt from the
requirements to provide evidence of financial responsibility.

DIVISION
LCPD


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