Dispatch /

Case #:

COMPLAINT
Form 420001E 1/07
PLAINTIFF

Reference #:

Law Enforcement Agency -

MOTOR VEHICLE ENFORCEMENT

City of:

SAC CITY

SAC COUNTY COURTHOUSE 100 NW STATE STREET SUITE 12

SCHOCH

Name

IOWA UNIFORM CITATION AND COMPLAINT

County of: SAC - 81

State of Iowa
In the Court at
VS.

T01 T405 150323 115539 3

Citation #:

DUANE

Defendant, Last

FREDERICK

First

Address 817 S SHIAWASSEE ST

DL Class

03/23/2015

The undersigned states that on or about

US DOT# 00306396

ICC# 889139

$50.00
$17.50

Co. Enf. Surcharge

N/A

Court Costs

$60.00

Total Fine/Costs

$127.50

Court Appearance Required (805.10)

Reason:

Height

Serious P.I.

2000 WHI

Race W
48867-4317
5' 04"
Weight 300 LBS

Ethnicity N
Sex MALE

FORD FORD
Pass
End

TR-ST

CDL YES
NO
HazMat End Req? NO
Req?
Req?
Located in the county and state aforesaid and did then and there commit the following offense:

MI

State

Upon a public highway at US 71/KARR AVE

Criminal Surcharge

Zip Code

DL Rest. NONE

defendant did unlawfully: Operate Motor Vehicle/Boat

Lic. Plate #/REG CPR5269

Scheduled Violation/Fine

State MI

OWOSSO
DL End. NONE

at 11:00 AM

DOB 2/27/1945

Suffix

City

DL State MI

50583
DL/State ID
Viewed?
YES

S 200 155 261 151

DL#

Middle

IA

Year 2016

Road Work Zone

Fatal Accident

Non-scheduled Violation

Civil Damage Assessment

Speed

Other

Violation MEDICAL CARD EXPIRED 3-11-15

Sec #: 321.449

Zone

IA Code: 20 13

ICIS Sec #: 321.449-B

ICIS Ord.

Local Ord.

I.D. No. T405

Officer's
Signature

in

Fed/Adm Code: 391.45B

NOTICE: Providing false identification information is a violation of Section 719.1A of

the Code of Iowa and is punishable as a simple misdemeanor.

Dated 03/23/2015

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.

Court Date: If you must appear in court or if you choose to appear to answer to a charge which does not
require an appearance, report to the above named court on:
04/13/2015 at
8:30 AM
My signature below is not a plea of guilty, but acknowledges all of the following:
1. I 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.
The following applies to simple misdemeanors only:

$161.25
4. I hereby give my unsecured appearance bond in the amount of
dollars and enter my 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.

*+T01T4051503231155393+*
Dated

Signature of
Defendant

03/23/2015

I swear that the foregoing complaint is true and correct.

this

25

day of

Agency

Officer's
Signature

MOTOR VEHICLE ENFORCEMENT

ABSTRACT OF COURT RECORD

COURT NO.

CASE NO.

DOCKET NO.
LICENSE NO.

CASE NO.
STATE:

NO JURY TRIAL or
PROCEEDING

OTHER

T01 T405 150323 115539 3

TESTIMONY - JUDGE'S NOTES: (Other Orders)

Iowa

FILED 03/25/2015 10:30AM

CLERK DISTRICT COURT
SAC COUNTY IOWA

BAIL CASH DEPOSIT

VERDICT

GUILTY
NOT GUILTY

GUILTY
NOT GUILTY
Date

DISMISSED

Signature, person giving bail

Driver's License
Recommendation

OTHER DISPOSITION

None

School

Signature, person taking bail

Susp.

Revo

The court Therefore Enters in Following Order This Date

Mo.

FINED $
Incarceration in

SURCHARGE $

, Iowa

EARLY - 2200
Notary/other

Other

PLEA

at

Notary/other
Signature

Citation #:

FORFEIT BOND

JURY TRIAL

MCFARLAND, TIMOTHY
MARCH, 2015

Subscribed and sworn to me by

Day

COST $
Days:

Yr.

DATE:

Continued to:

REASON

DATE:

Continued to:

REASON

DATE:

WARRANT ISSUED

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

Days

Dispatch /
Case #:

COMPLAINT
Form 420001E 1/07
PLAINTIFF

Reference #:

Law Enforcement Agency -

MOTOR VEHICLE ENFORCEMENT

City of:

SAC CITY

SAC COUNTY COURTHOUSE 100 NW STATE STREET SUITE 12

SCHOCH

Name

IOWA UNIFORM CITATION AND COMPLAINT

County of: SAC - 81

State of Iowa
In the Court at
VS.

T01 T405 150323 115635 4

Citation #:

DUANE

Defendant, Last

FREDERICK

First

Address 817 S SHIAWASSEE ST

DL Class

03/23/2015

The undersigned states that on or about

US DOT# 00306396

ICC# 889139

$50.00
$17.50

Co. Enf. Surcharge

N/A

Court Costs

$60.00

Total Fine/Costs

$127.50

Court Appearance Required (805.10)

Reason:

Height

Serious P.I.

2000 WHI

Race W
48867-4317
5' 04"
Weight 300 LBS

Ethnicity N
Sex MALE

FORD FORD
Pass
End

TR-ST

CDL YES
NO
HazMat End Req? NO
Req?
Req?
Located in the county and state aforesaid and did then and there commit the following offense:

MI

State

Upon a public highway at US 71/KARR AVE

Criminal Surcharge

Zip Code

DL Rest. NONE

defendant did unlawfully: Operate Motor Vehicle/Boat

Lic. Plate #/REG CPR5269

Scheduled Violation/Fine

State MI

OWOSSO
DL End. NONE

at 11:00 AM

DOB 2/27/1945

Suffix

City

DL State MI

50583
DL/State ID
Viewed?
YES

S 200 155 261 151

DL#

Middle

IA

Year 2016

Road Work Zone

Fatal Accident

Non-scheduled Violation

Civil Damage Assessment

Speed

Other

Violation DISCHARGED FIRE EXTINGUISHER

Sec #: 321.449

Zone

IA Code: 20 13

ICIS Sec #: 321.449-A

ICIS Ord.

Local Ord.

I.D. No. T405

Officer's
Signature

in

Fed/Adm Code: 393.95A

NOTICE: Providing false identification information is a violation of Section 719.1A of

the Code of Iowa and is punishable as a simple misdemeanor.

Dated 03/23/2015

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.

Court Date: If you must appear in court or if you choose to appear to answer to a charge which does not
require an appearance, report to the above named court on:
04/13/2015 at
8:30 AM
My signature below is not a plea of guilty, but acknowledges all of the following:
1. I 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.
The following applies to simple misdemeanors only:

$161.25
4. I hereby give my unsecured appearance bond in the amount of
dollars and enter my 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.

*+T01T4051503231156354+*
Dated

Signature of
Defendant

03/23/2015

I swear that the foregoing complaint is true and correct.

this

25

day of

Agency

Officer's
Signature

MOTOR VEHICLE ENFORCEMENT

ABSTRACT OF COURT RECORD

COURT NO.

CASE NO.

DOCKET NO.
LICENSE NO.

CASE NO.
STATE:

NO JURY TRIAL or
PROCEEDING

OTHER

T01 T405 150323 115635 4

TESTIMONY - JUDGE'S NOTES: (Other Orders)

Iowa

FILED 03/25/2015 10:30AM

CLERK DISTRICT COURT
SAC COUNTY IOWA

BAIL CASH DEPOSIT

VERDICT

GUILTY
NOT GUILTY

GUILTY
NOT GUILTY
Date

DISMISSED

Signature, person giving bail

Driver's License
Recommendation

OTHER DISPOSITION

None

School

Signature, person taking bail

Susp.

Revo

The court Therefore Enters in Following Order This Date

Mo.

FINED $
Incarceration in

SURCHARGE $

, Iowa

EARLY - 2200
Notary/other

Other

PLEA

at

Notary/other
Signature

Citation #:

FORFEIT BOND

JURY TRIAL

MCFARLAND, TIMOTHY
MARCH, 2015

Subscribed and sworn to me by

Day

COST $
Days:

Yr.

DATE:

Continued to:

REASON

DATE:

Continued to:

REASON

DATE:

WARRANT ISSUED

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

Days

Dispatch /
Case #:

COMPLAINT
Form 420001E 1/07
PLAINTIFF

Law Enforcement Agency -

SAC COUNTY SHERIFF'S OFFICE

City of:

SAC CITY

SAC COUNTY COURTHOUSE 100 NW STATE STREET SUITE 12

CARMONA

Name

IOWA UNIFORM CITATION AND COMPLAINT

County of: SAC - 81

State of Iowa
In the Court at
VS.

S81 BACK 150325 104649 0

Citation #:

Reference #:

GERMAN

Defendant, Last

AUGUSTO

First

Address 10273 SCARBOROUGH RD

The undersigned states that on or about

US DOT#

DL Class

03/25/2015

$40.00

Criminal Surcharge

$14.00

Co. Enf. Surcharge

$5.00

Court Costs

$60.00

Total Fine/Costs

$119.00

Serious P.I.

2014 WHI

Ethnicity U
Sex MALE

Weight

HONDA HOND
Pass
End

CIVIC

4D

CDL NO
HazMat End Req?
Req?
Req?
Located in the county and state aforesaid and did then and there commit the following offense:

Court Appearance Required (805.10)

Reason:

Race W

55437

Height

State MN Year 2015

Upon a public highway at US 71/UNION AVE

Scheduled Violation/Fine

Zip Code

DL Rest. B

defendant did unlawfully: Operate Motor Vehicle/Boat

Lic. Plate #/REG 669MWG

ICC#

State MN

BLOOMINGTON
DL End. NONE

at 10:46 AM

DOB 11/3/1957

Suffix

City

DL State MN

50583
DL/State ID
Viewed?
YES

T960273672115

DL#

Middle

IA

Road Work Zone

Fatal Accident

Non-scheduled Violation

Civil Damage Assessment

Speed

Other

55

Zone

IA Code: 20 15

ICIS Sec #: 321.285-B

ICIS Ord.

Local Ord.

I.D. No. 81-5

Officer's
Signature

in

Fed/Adm Code:

Violation SPEEDING 55 OR < (6 THRU 10 OVER)

Sec #: 321.285

65

NOTICE: Providing false identification information is a violation of Section 719.1A of

the Code of Iowa and is punishable as a simple misdemeanor.

Dated 03/25/2015

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.

Court Date: If you must appear in court or if you choose to appear to answer to a charge which does not
require an appearance, report to the above named court on:
04/20/2015 at
8:30 AM
My signature below is not a plea of guilty, but acknowledges all of the following:
1. I 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.
The following applies to simple misdemeanors only:

$148.50
4. I hereby give my unsecured appearance bond in the amount of
dollars and enter my 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.

*+S81BACK1503251046490+*
Dated

Signature of
Defendant

03/25/2015

I swear that the foregoing complaint is true and correct.

this

25

day of

Agency

Officer's
Signature

SAC COUNTY SHERIFF'S OFFICE

ABSTRACT OF COURT RECORD

COURT NO.

CASE NO.

DOCKET NO.
LICENSE NO.

CASE NO.
STATE:

NO JURY TRIAL or
PROCEEDING

Notary/other

NOTARY

S81 BACK 150325 104649 0

TESTIMONY - JUDGE'S NOTES: (Other Orders)

Iowa

FILED 03/25/2015 11:22AM

CLERK DISTRICT COURT
SAC COUNTY IOWA

Other
BAIL CASH DEPOSIT
PLEA

VERDICT

GUILTY
NOT GUILTY

GUILTY
NOT GUILTY
Date

DISMISSED

Signature, person giving bail

Driver's License
Recommendation

OTHER DISPOSITION

None

School

Signature, person taking bail

Susp.

Revo

The court Therefore Enters in Following Order This Date

Mo.

FINED $
Incarceration in

, Iowa

SAC CITY - 6717

Notary/other
Signature

Citation #:

FORFEIT BOND

JURY TRIAL

at

CUDABACK, TORY
MARCH, 2015

Subscribed and sworn to me by

SURCHARGE $

Day

COST $
Days:

Yr.

DATE:

Continued to:

REASON

DATE:

Continued to:

REASON

DATE:

WARRANT ISSUED

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

Days

Dispatch /
Case #:

COMPLAINT
Form 420001E 1/07
PLAINTIFF

Reference #:

Law Enforcement Agency -

MOTOR VEHICLE ENFORCEMENT

City of:

SAC CITY

SAC COUNTY COURTHOUSE 100 NW STATE STREET SUITE 12

HIBBING

Name

IOWA UNIFORM CITATION AND COMPLAINT

County of: SAC - 81

State of Iowa
In the Court at
VS.

T01 T142 150323 105622 7

Citation #:

RICHARD

Defendant, Last

DUANE

First

Address 1514 WILLSON AVE

DL Class

03/23/2015

The undersigned states that on or about

US DOT# 00606058

ICC# 290229

$50.00
$17.50

Co. Enf. Surcharge

N/A

Court Costs

$60.00

Total Fine/Costs

$127.50

Court Appearance Required (805.10)

Reason:

Height

Serious P.I.

2007 MAR

Race W
50595-0000
5' 10"
Weight 195 LBS

Ethnicity N
Sex MALE

FREIGHT
LINER
F
Pass
End - NO

TT/ST

CDL YES
HazMat End Req? YES
Req?
Req?
Located in the county and state aforesaid and did then and there commit the following offense:

IA

State

Upon a public highway at US 71/KARR AVE AND D015/190TH ST

Criminal Surcharge

Zip Code

DL Rest. J

defendant did unlawfully: Operate Motor Vehicle/Boat

Lic. Plate #/REG SG2063

Scheduled Violation/Fine

State IA

WEBSTER CITY
DL End. LTX

at 10:50 AM

DOB 8/29/1955

Suffix

City

DL State IA

50583
DL/State ID
Viewed?
YES

364AE8238

DL#

Middle

IA

Year 2015

Road Work Zone

Fatal Accident

Non-scheduled Violation

Civil Damage Assessment

Speed

Other

Violation FAILING TO USE SEAT BELT WHILE OPERATING CMV

Sec #: 321.445

ICIS Sec #: 321.445

Zone

IA Code: 20 13
ICIS Ord.

Local Ord.

I.D. No. T142

Officer's
Signature

in

Fed/Adm Code: 392.16

NOTICE: Providing false identification information is a violation of Section 719.1A of

the Code of Iowa and is punishable as a simple misdemeanor.

Dated 03/23/2015

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.

Court Date: If you must appear in court or if you choose to appear to answer to a charge which does not
require an appearance, report to the above named court on:
04/06/2015 at
8:30 AM
My signature below is not a plea of guilty, but acknowledges all of the following:
1. I 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.
The following applies to simple misdemeanors only:

$161.25
4. I hereby give my unsecured appearance bond in the amount of
dollars and enter my 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.

*+T01T1421503231056227+*
Dated

Signature of
Defendant

03/23/2015

I swear that the foregoing complaint is true and correct.

this

25

day of

Agency

Officer's
Signature

MOTOR VEHICLE ENFORCEMENT

ABSTRACT OF COURT RECORD

COURT NO.

CASE NO.

DOCKET NO.
LICENSE NO.

CASE NO.
STATE:

NO JURY TRIAL or
PROCEEDING

OTHER

T01 T142 150323 105622 7

TESTIMONY - JUDGE'S NOTES: (Other Orders)

Iowa

FILED 03/25/2015 02:30PM

CLERK DISTRICT COURT
SAC COUNTY IOWA

BAIL CASH DEPOSIT

VERDICT

GUILTY
NOT GUILTY

GUILTY
NOT GUILTY
Date

DISMISSED

Signature, person giving bail

Driver's License
Recommendation

OTHER DISPOSITION

None

School

Signature, person taking bail

Susp.

Revo

The court Therefore Enters in Following Order This Date

Mo.

FINED $
Incarceration in

SURCHARGE $

Day

COST $
Days:

Yr.

, Iowa

Notary/other

Other

PLEA

FORT DODGE - 2690

Notary/other
Signature

Citation #:

FORFEIT BOND

JURY TRIAL

at

PEREZ, WILLIAM
MARCH, 2015

Subscribed and sworn to me by

DATE:

Continued to:

REASON

DATE:

Continued to:

REASON

DATE:

WARRANT ISSUED

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

Days

Dispatch /
Case #:

COMPLAINT
Form 420001E 1/07
PLAINTIFF

Reference #:

Law Enforcement Agency -

MOTOR VEHICLE ENFORCEMENT

City of:

SAC CITY

SAC COUNTY COURTHOUSE 100 NW STATE STREET SUITE 12

RUBNER

Name

IOWA UNIFORM CITATION AND COMPLAINT

County of: SAC - 81

State of Iowa
In the Court at
VS.

T01 T142 150323 121842 9

Citation #:

ROBERT

Defendant, Last

JAY

First

Address 813 E 1ST ST

DL Class

03/23/2015

The undersigned states that on or about

US DOT# 01739187

ICC# 406408

$50.00
$17.50

Co. Enf. Surcharge

N/A

Court Costs

$60.00

Total Fine/Costs

$127.50

Court Appearance Required (805.10)

Reason:

Height

Serious P.I.

2008 BLK

Race W
50674-0000
6' 00"
Weight 230 LBS

Ethnicity N
Sex MALE

DODGE - R35
TR/ST
DODG
Pass
End NO
HazMat End Req? NO

CDL YES
Req?
Req?
Located in the county and state aforesaid and did then and there commit the following offense:

IA

State

Upon a public highway at US 71/KARR AVE

Criminal Surcharge

Zip Code

DL Rest. BL

defendant did unlawfully: Operate Motor Vehicle/Boat

Lic. Plate #/REG AVJ755

Scheduled Violation/Fine

State IA

SUMNER
DL End. NONE

at 11:50 AM

DOB 7/7/1973

Suffix

City

DL State IA

50583
DL/State ID
Viewed?
YES

160BB7569

DL#

Middle

IA

Year 2015

Road Work Zone

Fatal Accident

Non-scheduled Violation

Civil Damage Assessment

Speed

Other

Violation LOG BOOK NOT CURRENT DRIVER DID NOT START LOG BOOK FOR TODAY
Sec #: 321.449

ICIS Sec #: 321.449-C

Zone

IA Code: 20 13
ICIS Ord.

Local Ord.

I.D. No. T142

Officer's
Signature

in

Fed/Adm Code: 395.8F1

NOTICE: Providing false identification information is a violation of Section 719.1A of

the Code of Iowa and is punishable as a simple misdemeanor.

Dated 03/23/2015

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.

Court Date: If you must appear in court or if you choose to appear to answer to a charge which does not
require an appearance, report to the above named court on:
04/06/2015 at
8:30 AM
My signature below is not a plea of guilty, but acknowledges all of the following:
1. I 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.
The following applies to simple misdemeanors only:

$161.25
4. I hereby give my unsecured appearance bond in the amount of
dollars and enter my 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.

*+T01T1421503231218429+*
Dated

Signature of
Defendant

03/23/2015

I swear that the foregoing complaint is true and correct.

this

25

day of

Agency

Officer's
Signature

MOTOR VEHICLE ENFORCEMENT

ABSTRACT OF COURT RECORD

COURT NO.

CASE NO.

DOCKET NO.
LICENSE NO.

CASE NO.
STATE:

NO JURY TRIAL or
PROCEEDING

OTHER

T01 T142 150323 121842 9

TESTIMONY - JUDGE'S NOTES: (Other Orders)

Iowa

FILED 03/25/2015 02:30PM

CLERK DISTRICT COURT
SAC COUNTY IOWA

BAIL CASH DEPOSIT

VERDICT

GUILTY
NOT GUILTY

GUILTY
NOT GUILTY
Date

DISMISSED

Signature, person giving bail

Driver's License
Recommendation

OTHER DISPOSITION

None

School

Signature, person taking bail

Susp.

Revo

The court Therefore Enters in Following Order This Date

Mo.

FINED $
Incarceration in

SURCHARGE $

Day

COST $
Days:

Yr.

, Iowa

Notary/other

Other

PLEA

FORT DODGE - 2690

Notary/other
Signature

Citation #:

FORFEIT BOND

JURY TRIAL

at

PEREZ, WILLIAM
MARCH, 2015

Subscribed and sworn to me by

DATE:

Continued to:

REASON

DATE:

Continued to:

REASON

DATE:

WARRANT ISSUED

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

Days

Dispatch /
Case #:

COMPLAINT
Form 420001E 1/07
PLAINTIFF

Reference #:

Law Enforcement Agency -

MOTOR VEHICLE ENFORCEMENT

City of:

SAC CITY

SAC COUNTY COURTHOUSE 100 NW STATE STREET SUITE 12

RUBNER

Name

IOWA UNIFORM CITATION AND COMPLAINT

County of: SAC - 81

State of Iowa
In the Court at
VS.

T01 T142 150323 121851 0

Citation #:

ROBERT

Defendant, Last

JAY

First

Address 813 E 1ST ST

DL Class

03/23/2015

The undersigned states that on or about

US DOT# 01739187

ICC# 406408

$50.00
$17.50

Co. Enf. Surcharge

N/A

Court Costs

$60.00

Total Fine/Costs

$127.50

Court Appearance Required (805.10)

Reason:

Height

Serious P.I.

2008 BLK

Race W
50674-0000
6' 00"
Weight 230 LBS

Ethnicity N
Sex MALE

DODGE - R35
TR/ST
DODG
Pass
End NO
HazMat End Req? NO

CDL YES
Req?
Req?
Located in the county and state aforesaid and did then and there commit the following offense:

IA

State

Upon a public highway at US 71/KARR AVE

Criminal Surcharge

Zip Code

DL Rest. BL

defendant did unlawfully: Operate Motor Vehicle/Boat

Lic. Plate #/REG AVJ755

Scheduled Violation/Fine

State IA

SUMNER
DL End. NONE

at 11:50 AM

DOB 7/7/1973

Suffix

City

DL State IA

50583
DL/State ID
Viewed?
YES

160BB7569

DL#

Middle

IA

Year 2015

Road Work Zone

Fatal Accident

Non-scheduled Violation

Civil Damage Assessment

Speed

Other

Violation AXLE #1 LEFT & RIGHT TIRES TREAD DEPTH LESS THAN 2/32 OF INCH
Sec #: 321.449

ICIS Sec #: 321.449-A

Zone

IA Code: 20 13
ICIS Ord.

Local Ord.

I.D. No. T142

Officer's
Signature

in

Fed/Adm Code: 393.75B

NOTICE: Providing false identification information is a violation of Section 719.1A of

the Code of Iowa and is punishable as a simple misdemeanor.

Dated 03/23/2015

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.

Court Date: If you must appear in court or if you choose to appear to answer to a charge which does not
require an appearance, report to the above named court on:
04/06/2015 at
8:30 AM
My signature below is not a plea of guilty, but acknowledges all of the following:
1. I 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.
The following applies to simple misdemeanors only:

$161.25
4. I hereby give my unsecured appearance bond in the amount of
dollars and enter my 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.

*+T01T1421503231218510+*
Dated

Signature of
Defendant

03/23/2015

I swear that the foregoing complaint is true and correct.

this

25

day of

Agency

Officer's
Signature

MOTOR VEHICLE ENFORCEMENT

ABSTRACT OF COURT RECORD

COURT NO.

CASE NO.

DOCKET NO.
LICENSE NO.

CASE NO.
STATE:

NO JURY TRIAL or
PROCEEDING

OTHER

T01 T142 150323 121851 0

TESTIMONY - JUDGE'S NOTES: (Other Orders)

Iowa

FILED 03/25/2015 02:30PM

CLERK DISTRICT COURT
SAC COUNTY IOWA

BAIL CASH DEPOSIT

VERDICT

GUILTY
NOT GUILTY

GUILTY
NOT GUILTY
Date

DISMISSED

Signature, person giving bail

Driver's License
Recommendation

OTHER DISPOSITION

None

School

Signature, person taking bail

Susp.

Revo

The court Therefore Enters in Following Order This Date

Mo.

FINED $
Incarceration in

SURCHARGE $

Day

COST $
Days:

Yr.

, Iowa

Notary/other

Other

PLEA

FORT DODGE - 2690

Notary/other
Signature

Citation #:

FORFEIT BOND

JURY TRIAL

at

PEREZ, WILLIAM
MARCH, 2015

Subscribed and sworn to me by

DATE:

Continued to:

REASON

DATE:

Continued to:

REASON

DATE:

WARRANT ISSUED

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

Days