COMPLAINT
`
`WHEN PRESENTED TO VIOLATOR, THE FOLLOWING AMOUNT WAS ENTERED.
`PAY A CIVIL PENALTY IN THE AMOUNTOF $
`CASE NO.
`DOCKET NO.
`
`PAGE NO.
`
`DATE
`
`COURT ACTION AND OTHER ORDERS BAIL FIXED AT §,
`
`OR CASH DEPOSIT OF $______
`
`SIGNATURE OF PERSON GIVING BAIL
`
`SIGNATURE OF PERSONTAKING BAIL
`
`FINE IN THE AMOUNTOF§
`REQUIRED BY COURT SCHEDULE.
`
`RECEIVED AS
`
`SIGNATURE OF CLERK
`
`REASON
`
`REASON
`
`CONTINUANCE TO
`
`CONTINUANCE TO
`BOND ESTREATED
`
`WARRANTISSUED
`VIOLATOR FAILED TO APPEAR-DRIVER LICENSE SUSPENDED
`
`VIOLATOR ARRAIGNED ON
`PLEA:
`FINDING:
`ADJUDICATION:
`SENTENCE: FINE
`JAILED
`DRIVER IMPROVEMENT SCHOOL
`OTHER—W
`DRIVER LICENSE SUSPENDED OR REVOKED FOR____DAYS
`RECOMMEND DRIVER LICENSE SUSPENSION FOR ___DAYS
`RECOMMENDRE-TEST_W___
`
`SIGNATURE OF JUDGE
`
`TESTIMONY- JUDGE'S NOTES (OR OTHER COURT ORDERS):
`
`APPEAL BOND OF $ _____
`
`VIOLATOR'S FINGERPRINT WHEN
`APPLICABLE ——p
`
`FLORIDA UNIFORM TRAFFIC CITATION
`COUNTY OF
`(1@oTHER
`[k]@) s.o.
`(0) FHe ep.
`JACKSONVILLE SHERIFFS OFFICE
`DUVAL(2)
`CITY OF(IF APPLICABLE)
`JACKSONVILLE
`IN THE COURT DESIGNATED BELOW THE UNDERSIGNEDCERTIFIES THAT HE/SHE
`HAS JUST AND REASONABLE GROUNDSTOBELIEVE AND DOES BELIEVE THAT ON
`DAY OF WEEK
`MONTH
`DAY
`NAME (PRINT) FIRST
`MIDDLE
`MAURICE
`TOMMIE
`STREET
`10635 HAVERFORD RD
`CITY
`JACKSONVILLE
`TELEPHONE NUMBER
`MO
`904-608-6951
`12
`DRIVER
`Y520558734490
`LICENSE
`STATE
`CLASS
`CDL LICENSE
`NUMBER
`Fe fe
`[Pye
`MAKE
`STYLE
`YR. VEHICLE
`Miss ut
`VEHICLE LICENSE NO.
`TRAILER TAG NO.
`STATE
`YEAR TAG EXPIRES |=
`pas[rt [zozs
`HVJB04
`UPON A PUBLIC STREET OR HIGHWAY, OR OTHER LOCATION, NAMELY
`1295 NORTH/ MERRILL RD EXIT
`
`ZIP CODE
`STATE
`32218-0000
`FL
`RACE
`|SEX
`HGT
`YEAR
`DAY
`B
`loo [1973
`Im [600
`YR. LICENSE EXP.
`[COMMERCIAL VEHICLE
`ye tate
`PLACARDEDHAZ. MATERIAL
`Lis
`Bee
`_16 PASSENGERS.
`MOTORCYCLE
`Gao
`Lys
`ICOMPANION CITATION(S)
`| eS
`xO
`
`[xo
`
`COLOR
`
`2011
`
`nnaAGZKPEE
`
`™l
`ous XK
`
`COMPLAINT
`(RETAINED BY COURT)
`YEAR
`
`Da".
`
`IF DIFFERENT THAN ONE ONDRIVER LICENSE "X" HERE
`>
`
`DATE OF
`BIRTH
`
`MILES
`FT.
`DID UNLAWFULLY COMMIT THE FOLLOWING OFFENSE.
`
`Dy CB CE DW oFnone
`CHECKONLY ONE OFFENSE EACH CITATION.
`
`[UNLAWFULSPEED
`[[]scHoor zone
`(LDnterstate
`SPEED MEASUREMENTDEVICE:
`
`MPH
`MPH SPEED APPLICABLE
`—[_J CONSTRUCTION WORKERS PRESENT)
`
`[_FarELess DRIVING
`IOLATION OF TRAFFIC
`ONTROLDEVICE
`‘AILURE TO STOP AT
`‘A TRAFFIC SIGNAL
`MPROPER LANE CHANGE
`IR COURSE
`(O PROOF OF INSURANCE
`IOLATION OF RIGHT-OF-WAY
`
`[ERHILb RESTRAINT
`AFETY BELT VIOLATION
`IMPROPER OR UNSAFE
`QUIPMENT
`
`[Exrirep Tac
`SIX (6) MONTHS OR LESS
`XPIRED TAG
`MORETHANSIX (6) MONTHS
`[merorer PASSING
`
`XPIRED DRIVERLICENSE
`IX (6) MONTHS OR LESS
`XPIRED DRIVERLICENSE
`MORETHANSIX (6) MONTHS,
`IO VALID DRIVER LICENSE
`RIVING WHILE LICENSE
`SUSPENDED OR REVOKED
`RIVING UNDER
`HE INFLUENCE
`
`Lrassenger Under 18 Yrs
`BAL
`
`OTHERVIOLATIONS OR COMMENTSPERTAINING TO OFFENSE:
`
`FOLLOWING TOO CLOSELY
`
`Ly}es [xo
`DL SEIZED
`
`
`Ly}es [x]}xo
`
`IN VIOLATION OF
`SUB-SECTION
`SECTION
`
`
`
`
`[accressive DRIVING
`STATE STATUTE
`316.0895(1)
`CRASH
`PROPERTY DAMAGE
`INJURY TO ANOTHER| SERIOUS BODILY INJURY TO ANOTHER| FATAL
`
`
`[x}res Lhe [Xx]ves s 20000 Lh Lhes [Xo Les [x]}so
`[hes [X]o
`
`
`
`
`
`CHECK
`oO CRIMINAL VIOLATION. COURT APPEARANCE REQUIRED. AS INDICATED BELOW.
`LJ INFRACTION. COURT APPEARANCE REQUIRED.AS INDICATED BELOW.
`DIGIT X
`INFRACTION WHICH DOES NOT REQUIRE APPEARANCEIN COURT.
`
`
`
`AGZKPEE
`
`CIVIL PENALTY IS $ 164.00
`COURT INFORMATION
`
`TIME
`
`TRAFFIC VIOLATIONS
`501 WEST ADAMS STREET- 1ST FLOOREASTSIDE LOBBY
`JACKSONVILLE, FLORIDA 32202. O°"
`WITHIN 30 CALENDAR DAYS CONTACT
`TRAFFIC VIOLATIONS
`501 WEST ADAMSSTREET- 1ST FLOOR EASTSIDE LOBBY
`JACKSONVILLE, FL 32202
`(904)255-2300
`
`(904) 255-2300
`
`DATE.
`ARRESTDELIVERED TO
`| AGREE AND PROMISE TO COMPLY AND ANSWERTO THE CHARGESAND INSTRUCTIONS
`SPECIFIED IN THIS CITATION. WILLFUL REFUSAL TO ACCEPT AND SIGN THE CITATION MAY RESULT
`IN ARREST. | UNDERSTAND MY SIGNATUREIS NOT AN ADMISSION OF GUILT OR WAIVER OFRIGHTS.
`IF YOU NEED REASONABLEFACILITY ACCOMMODATIONSTO COMPLYWITHTHIS CITATION,
`CONTACT THE CLERK OF THE COURT.
`
`X SIGNATURE OF VIOLATOR (SIGNATUREIS REQUIREDIF INFRACTION REQUIRES AN APPEARANCEIN COURT)
`PRU
`BADGE NO.
`
`83971
`ID NO.
`
`TROOP/ UNIT
`
`D.A. RUSSELL
`OFFICER
`RANK - NAME OF OFFICER
`
`[x] CERTIFY THIS CITATION WAS DELIVERED TO THE PERSON CITED ABOVE AND CERTIFY THE CHARGE ABOVE
`Additional Officer:
`
`RANK - NAME OF OFFICER
`
`BADGE NO.
`
`ID NO.
`
`TROOP/ UNIT
`
`HSMV75901 (REV. 06/19)
`
`