II 

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FLORIDA UNIFORM TRAFFIC CITATIUN SEEK 
comm? i/ SO. 

CITY (IF APPLICABLE) 60 AGENCY

IN THE COURT DESIGNATED BELOW THE UNDERSIGNED CERTIFIES THAT COMPLAINT
HAS JUST AND REASONABLE GROUNDS TO BELIEVE AND DOES BELIEVE THAT ON (RETAINED BY COU RT)

?7347" i ?7 20.35 Rs:
?,324/ a/ Amy 
7 is? ?rtyx?v? 4w 
?c?E'r "Wm/(2
[IoLICENSE

CDL LICE YR. LICENSE EXP IF COMMERCIAL MTR.
NUMBER 529' 3 i/ VEH. HERE . 
YR. VEHICLE I id ng IF PLACARDED HAZARDOUS
MATERIAL HERE
1? cap! I II 
TRAILER TAG NO. V?gl EXPIRES IF COMPANION CITATIONISI
. x- HERE
I A I I 
UPON LIC STR HIGHWAY. ngocz?N MAW 
- 1 '7 4

FT. MILES 9 9 OF 

DID UNLAWFULLY COMMIT THE FOLLOWING OFFENSE. CHECK ONLY ONE OFFENSE EACH CITATION.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

UNLAWFUL SPEED MPH SPEED APPLICABLE MPH
INTERSTATE 4-LANE va WITH 20 FT. MEDIAN OUTSIDE BUS. OR RES. DIST.)
CI CARELESS DRIVING SAFETY BELT VIOLATION EXPIRED DRIVER LICENSE
VIOLATION OF TRAFFIC CONTROL DEVICE El IMPROPER OR UNSAFE EQUIPMENT FOUR (4) MONTHS OR LESS
VIOLATION OF RIGHT-OF-WAY EXPIRED TAG MORE THAN FOUR (4) MONTHS
CI IMPROPER CHANGE OF LANE OR COURSE SIX (5) MONTHS OR LESS No VALID DRIVER LICENSE
El IMPROPER PASSING CI MORE THAN SIX (6) MONTHS DRIVING WHILE LICENSE
SUSPENDED 0R REVOKED
CI CHILD RESTRAINT N0 PROOF OF INSURANCE FAILURE TO STOP AT A TRAFFIC SIGNAL

CI DRIVING UNDER THE INFLUENCE OF ALCOHOLIC BEVERAGES. CHEMICAL OR CONTROLLED SUBSTANCES. PHYSICAL CONTROL
WHILE IMPAI .OFI PHYSICAL CONTROL UNLAWFULBREATHIBLOODIURINE ALCOHOL LEVEL. BAL

on? it; 411/{1'

OTHER VIOLATIONS YERTAINING To OFFENSE:

 

 

SEC I . SUB-SECTION
AGGRESSIVE DRIVING IN VIOLATION OF STATE STATUTE 3 -, 2 5

CRASH PROPERTY DAMAGE INJURY TO ANOTHER SERIOUS BODILY INJURY TO ANOTHER FATAL
YES B10 YES CRIMINAL VIOLATION. COURT APPEARANCE REQUIRED. AS INDICATED BELOW

INFRACTION. COURT APPEARANCE REQUIRED. AS INDICATED BELOW 904 3 EXN CHECK 
INFRACTION WHICH ES NOT RWJPIEARANCE IN 0; 
COURT INFORMATION a ,4 
DATE

TIME

 

COURT

 

LOCATION

 

ARREST DELIVERED TO DATE

AGREE AND PROMISE TO. COMPLY AND ANSWER TO THE INSTRUCTIONS SPECIFIED IN TION. WILLFUL REFUSAL TO ACCEPT AND SIGN
IS NOT AN ADMISSION 0F GUI OF RIGHTS. IF YOU NEED REASONABLE FACILITY
CLERK OF THE COURT.

   

   
   
  
 
  
   

  

THE CITATION MAY RESULT IN ARREST. I UNDERSTAND MYSIGNA
ACCOMMODATIONS T0 COMPEY WITH THIS CITATIIA TM: :7

      

 

Ay?'r'z

BADGE NO. ?bo N. TRODP UNIT

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HSMV 75901 (Rev. 02/05)

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COMPLAINT,
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