MORGAN HILL POLICE DEPARTMENT

rIcETo APPEAR

DATE OF VIOLATION TIME



CITATION No.
Traffic 4? ,1 If?
El Nontra?WEEK num?ER

 

 

 

. 

NAME MIDDLE. 



:1 RESPONSIBILITY Nah. Cude.? 40001)





 

 

 

 

 

 

 

STATE CLASS NIF COMMERCIAL 
:l DYEE EINO If 
.. .- 
BE): HAIR EYES HEIGHT WEIGHT RACE PHONE NO.
. .NO. 
VEH 0? VIN STATE 
. 
YFI.OF VEH. MAKE MODEL BODY STYLE COLOR El HAZARDOUS MATERIAL
1., 

 

 

 

EVIDENCE OF FINANCIAL RESPONSIBILITY r" I


 

REGISTERED OWNER OR LESSEE I. I

SAME As DRIVER

 

 

 

ADDRESS J, SAME As DRIVER
CITY . STATE ZIP CODE

CORRECTABLE VIOLATION IVER. Code, 40510] BOOKING REQUIRED MISDEMEANOH OR

INFRACTION 
NO CODE AND SECTION DEOGRIFTION

APFR . . . . . SA
SPEED OX SP5 FE CONTINUATION 
LIDARI: FORM ISSUED
LOCATION OF VIOLATIONISI CITY I COUNTY OF OCCURRENCE 
. . . . . . . 
COMMENTS: (WEATHER. ROAD. AND TRAFFIC Cl COLLISION

 


VIOLATIONS NOT COMMITTED IN MY PRESENCE. DECLARED ON INFORMATION AND BELIEF.
I declare under penalty Oi perjury under the laws of the State DI California the foregoing 'Is true and correct.

 

- I - .
ARRESTING OFI CITING OFFICER OFFICER ID 

I 
DATE NAME OF ARRESTINC OFFICER. IF DIFFERENT FROM CITINO OFFICER

WITHOUT ADMITTING GUILT, TO AT THERTIME AND PLACE INDICATED
,1 . .

OFFICER ID

 

 

 

 

 

 

BELOW. . .. 
XSI'gnature - Hf? 
WHEN: DAY: DATEWHAT TO DO: FOLLOW THE INSTRUCTIONS ON THE REVERSE.

WHERE: _El SOUTH COUNTY COURT El JUVENILE COURT
. 301 Diana Ave. 840 Guadalupe Pkwy.
Morgan Hill. CA 95037 San Jose. CA 95110
(408) 695-5000 (408) 278-5997

TRAFFIC COURT
1095 Homestead Rd.
Santa Clara, CA 95050
(403) 5503000

CI TO BE NOTIFIED

COURT LIEEONLYI

.V I.

5w Lin??i 

 

CEN (FOR COURT 


igu?Appear @111 Engraved Council DI Calilurnla.
Rev. 2015 {Van Code. 4050mm. ?05130?. 40522. 40300: Pan. Cada 353.9)

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