<html> <head> <meta name=Generator content="Microsoft Office HTML Filter 2.0"> <meta http-equiv=Content-Type content="text/html; charset=windows-1252"> <title>Rule 02:03:01 UNIFORM TRAFFIC TICKET</title> <META NAME="Keywords" Content="Administrative Rules 02:03:01"> <META NAME="Description" Content="Administrative Rules 02:03:01 UNIFORM TRAFFIC TICKET"> <style> <!-- --> </style> </head> <body lang=EN-US> <div> <p align=center><b>CHAPTER 2:03:01</b></p> <h1>UNIFORM TRAFFIC TICKET</h1> <p>Section</p> <p>&nbsp;<a href="DisplayRule.aspx?Rule=02:03:01:01">2:03:01:01</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Forms for petty offense complaints and summons.</p> <p>&nbsp;<a href="DisplayRule.aspx?Rule=02:03:01:02">2:03:01:02</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Forms for misdemeanor offense complaints and summons.</p> <p>&nbsp;<a href="DisplayRule.aspx?Rule=02:03:01:03">2:03:01:03</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Power of attorney form.</p> <p>&nbsp;<a href="DisplayRule.aspx?Rule=02:03:01:04">2:03:01:04</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Designated law enforcement agencies.</p> <p>&nbsp;<a href="DisplayRule.aspx?Rule=02:03:01:05">2:03:01:05</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Forms for juvenile cited violations.</p> </div> </body> </html> <br /><hr><br /><html> <head> <title>Rule 02:03:01:01 Forms for petty offense complaints and summons.</title> <META NAME="Keywords" Content="Administrative Rules 02:03:01:01"> <META NAME="Description" Content="Administrative Rules 02:03:01:01 Forms for petty offense complaints and summons."> <meta http-equiv=Content-Type content="text/html; charset=windows-1252"> <meta name=Generator content="Microsoft Word 14 (filtered)"> <style> <!-- /* Font Definitions */ @font-face {font-family:Calibri; panose-1:2 15 5 2 2 2 4 3 2 4;} @font-face {font-family:Times; panose-1:2 2 6 3 5 4 5 2 3 4;} /* Style Definitions */ p.MsoNormal, li.MsoNormal, div.MsoNormal {margin-top:0in; margin-right:0in; margin-bottom:10.0pt; margin-left:0in; line-height:115%; font-size:11.0pt; font-family:"Calibri","sans-serif";} @page WordSection1 {size:8.5in 11.0in; margin:1.0in 1.0in 1.0in 1.0in;} div.WordSection1 {page:WordSection1;} --> </style> </head> <body lang=EN-US> <div class=WordSection1> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;text-align: justify;line-height:normal'><a name="_GoBack"></a><span style='font-size:12.0pt; font-family:"Times New Roman","serif"'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <b>2:03:01</b><b>:01.&nbsp;&nbsp;Forms for petty offense complaints and summons.</b> Either Form A or B, or any other form that substantially complies with Form A or B, shall be used as a petty offense summons and complaint. If Form A is used, a power of attorney form in substantial compliance with &#167;&nbsp;2:03:01:03 shall be attached.</span></p> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;text-align: justify;line-height:normal'><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>&nbsp;</span></p> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;text-align: justify;line-height:normal'><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; If a law enforcement agency designated in &#167;&nbsp;2:03:01:04 chooses to use the declaration option set forth in SDCL <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=23-1A-5">23-1A-5</A>, either Form A or B, or any other form that substantially complies with Form A or B, may be modified by inserting the statutorily approved declaration above the officer's signature in addition to or in lieu of the oath acknowledgment.</span></p> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;text-align: justify;line-height:normal'><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>&nbsp;</span></p> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>&nbsp;</span></p> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:9.0pt;font-family:"Times","serif"'>(1) <u>Form A</u>:</span></p> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:9.0pt;font-family:"Times","serif"'>&nbsp;</span></p> <table class=MsoNormalTable border=1 cellspacing=0 cellpadding=0 style='border-collapse:collapse;border:none'> <tr> <td width=415 colspan=24 valign=top style='width:311.4pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt; text-align:center;line-height:normal'><b><span style='font-size:9.0pt; font-family:"Times","serif"'>UNIFORM TRAFFIC TICKET</span></b></p> </td> </tr> <tr> <td width=415 colspan=24 valign=top style='width:311.4pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt; text-align:center;line-height:normal'><b><span style='font-size:9.0pt; font-family:"Times","serif"'>SUMMONS-COMPLAINT</span></b></p> </td> </tr> <tr> <td width=415 colspan=24 valign=top style='width:311.4pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:8.0pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=415 colspan=24 valign=top style='width:311.4pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>PCN ______________</span></p> </td> </tr> <tr> <td width=415 colspan=24 valign=top style='width:311.4pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=195 colspan=11 valign=top style='width:146.45pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>State of South Dakota </span></p> </td> <td width=220 colspan=13 valign=top style='width:164.95pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>In Circuit Court</span></p> </td> </tr> <tr> <td width=195 colspan=11 valign=top style='width:146.45pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> <td width=220 colspan=13 valign=top style='width:164.95pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>Magistrate Division</span></p> </td> </tr> <tr> <td width=195 colspan=11 valign=top style='width:146.45pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>County</span><span style='font-size:7.5pt;font-family:"Times","serif"'> of_______________</span></p> </td> <td width=220 colspan=13 valign=top style='width:164.95pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>____________Judicial Court</span></p> </td> </tr> <tr> <td width=195 colspan=11 valign=top style='width:146.45pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> <td width=220 colspan=13 valign=top style='width:164.95pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=195 colspan=11 valign=top style='width:146.45pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>State of South Dakota (Plaintiff)</span></p> </td> <td width=220 colspan=13 valign=top style='width:164.95pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=195 colspan=11 valign=top style='width:146.45pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> <td width=220 colspan=13 valign=top style='width:164.95pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=195 colspan=11 valign=top style='width:146.45pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>vs</span></p> </td> <td width=220 colspan=13 valign=top style='width:164.95pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=195 colspan=11 valign=top style='width:146.45pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> <td width=220 colspan=13 valign=top style='width:164.95pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=195 colspan=11 valign=top style='width:146.45pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>___________________________________</span></p> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt; text-align:center;line-height:normal'><span style='font-size:7.5pt; font-family:"Times","serif"'>(Defendant)</span></p> </td> <td width=220 colspan=13 valign=top style='width:164.95pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>No. _____________HP</span></p> </td> </tr> <tr> <td width=415 colspan=24 valign=top style='width:311.4pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=415 colspan=24 valign=top style='width:311.4pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>THE UNDERSIGNED PEACE OFFICER COMPLAINS AND STATES THAT</span></p> </td> </tr> <tr> <td width=108 colspan=4 valign=top style='width:81.0pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>ON OR ABOUT</span></p> </td> <td width=211 colspan=18 valign=top style='width:158.15pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>AT OR NEAR (LOCATION/MILE POST)</span></p> </td> <td width=96 colspan=2 valign=top style='width:72.25pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>AT TIME</span></p> </td> </tr> <tr> <td width=319 colspan=22 valign=top style='width:239.15pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> <td width=96 colspan=2 valign=top style='width:72.25pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>A.M.</span></p> </td> </tr> <tr> <td width=319 colspan=22 valign=top style='width:239.15pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> <td width=96 colspan=2 valign=top style='width:72.25pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>P.M.</span></p> </td> </tr> <tr> <td width=108 colspan=4 valign=top style='width:81.0pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>_________________</span></p> </td> <td width=211 colspan=18 valign=top style='width:158.15pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>____________________________________</span></p> </td> <td width=96 colspan=2 valign=top style='width:72.25pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>________</span></p> </td> </tr> <tr> <td width=319 colspan=22 valign=top style='width:239.15pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> <td width=96 colspan=2 valign=top style='width:72.25pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=415 colspan=24 valign=top style='width:311.4pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt; text-align:center;line-height:normal'><span style='font-size:7.5pt; font-family:"Times","serif"'>WITHIN THE COUNTY AND STATE AFORESAID</span></p> </td> </tr> <tr> <td width=415 colspan=24 valign=top style='width:311.4pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=167 colspan=6 valign=top style='width:125.05pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>NAME</span></p> </td> <td width=152 colspan=16 valign=top style='width:114.1pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt; text-align:center;line-height:normal'><span style='font-size:7.5pt; font-family:"Times","serif"'>HEIGHT</span></p> </td> <td width=96 colspan=2 valign=top style='width:72.25pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>SEX</span></p> </td> </tr> <tr> <td width=167 colspan=6 valign=top style='width:125.05pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>_____________________________</span></p> </td> <td width=152 colspan=16 valign=top style='width:114.1pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt; text-align:center;line-height:normal'><span style='font-size:7.5pt; font-family:"Times","serif"'>________</span></p> </td> <td width=96 colspan=2 valign=top style='width:72.25pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>_____</span></p> </td> </tr> <tr> <td width=167 colspan=6 valign=top style='width:125.05pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> <td width=152 colspan=16 valign=top style='width:114.1pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt; text-align:center;line-height:normal'><span style='font-size:7.5pt; font-family:"Times","serif"'>&nbsp;</span></p> </td> <td width=96 colspan=2 valign=top style='width:72.25pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=167 colspan=6 valign=top style='width:125.05pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>ADDRESS</span></p> </td> <td width=152 colspan=16 valign=top style='width:114.1pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt; text-align:center;line-height:normal'><span style='font-size:7.5pt; font-family:"Times","serif"'>WEIGHT</span></p> </td> <td width=96 colspan=2 valign=top style='width:72.25pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=167 colspan=6 valign=top style='width:125.05pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>_____________________________</span></p> </td> <td width=152 colspan=16 valign=top style='width:114.1pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt; text-align:center;line-height:normal'><span style='font-size:7.5pt; font-family:"Times","serif"'>________</span></p> </td> <td width=96 colspan=2 valign=top style='width:72.25pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=167 colspan=6 valign=top style='width:125.05pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> <td width=152 colspan=16 valign=top style='width:114.1pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt; text-align:center;line-height:normal'><span style='font-size:7.5pt; font-family:"Times","serif"'>&nbsp;</span></p> </td> <td width=96 colspan=2 valign=top style='width:72.25pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=167 colspan=6 valign=top style='width:125.05pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>CITY</span></p> </td> <td width=152 colspan=16 valign=top style='width:114.1pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt; text-align:center;line-height:normal'><span style='font-size:7.5pt; font-family:"Times","serif"'>STATE</span></p> </td> <td width=96 colspan=2 valign=top style='width:72.25pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>BIRTH DATE</span></p> </td> </tr> <tr> <td width=167 colspan=6 valign=top style='width:125.05pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>_____________________________</span></p> </td> <td width=152 colspan=16 valign=top style='width:114.1pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt; text-align:center;line-height:normal'><span style='font-size:7.5pt; font-family:"Times","serif"'>________</span></p> </td> <td width=96 colspan=2 valign=top style='width:72.25pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>____________</span></p> </td> </tr> <tr> <td width=167 colspan=6 valign=top style='width:125.05pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> <td width=152 colspan=16 valign=top style='width:114.1pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt; text-align:center;line-height:normal'><span style='font-size:7.5pt; font-family:"Times","serif"'>&nbsp;</span></p> </td> <td width=96 colspan=2 valign=top style='width:72.25pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=167 colspan=6 valign=top style='width:125.05pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>DRIVER'S LICENSE NO.</span></p> </td> <td width=152 colspan=16 valign=top style='width:114.1pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt; text-align:center;line-height:normal'><span style='font-size:7.5pt; font-family:"Times","serif"'>STATE</span></p> </td> <td width=96 colspan=2 valign=top style='width:72.25pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=167 colspan=6 valign=top style='width:125.05pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>_____________________________</span></p> </td> <td width=152 colspan=16 valign=top style='width:114.1pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt; text-align:center;line-height:normal'><span style='font-size:7.5pt; font-family:"Times","serif"'>________</span></p> </td> <td width=96 colspan=2 valign=top style='width:72.25pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=167 colspan=6 valign=top style='width:125.05pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> <td width=152 colspan=16 valign=top style='width:114.1pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> <td width=96 colspan=2 valign=top style='width:72.25pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=84 colspan=3 valign=top style='width:62.9pt;border:none;padding: 0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt; text-align:center;line-height:normal'><span style='font-size:7.5pt; font-family:"Times","serif"'>DID UNLAWFULLY</span></p> </td> <td width=83 colspan=3 valign=top style='width:62.15pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt; text-align:center;line-height:normal'><span style='font-size:7.5pt; font-family:"Times","serif"'>OPERATE</span></p> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt; text-align:center;line-height:normal'><span style='font-size:7.5pt; font-family:"Times","serif"'>_________</span></p> </td> <td width=52 colspan=8 valign=top style='width:39.3pt;border:none;padding: 0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt; text-align:center;line-height:normal'><span style='font-size:7.5pt; font-family:"Times","serif"'>PARK</span></p> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt; text-align:center;line-height:normal'><span style='font-size:7.5pt; font-family:"Times","serif"'>______</span></p> </td> <td width=100 colspan=8 valign=top style='width:74.8pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt; text-align:center;line-height:normal'><span style='font-size:7.5pt; font-family:"Times","serif"'>VEHICLE MAKE</span></p> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt; text-align:center;line-height:normal'><span style='font-size:7.5pt; font-family:"Times","serif"'>_______________</span></p> </td> <td width=96 colspan=2 valign=top style='width:72.25pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>BODY STYLE</span></p> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>_____________</span></p> </td> </tr> <tr> <td width=167 colspan=6 valign=top style='width:125.05pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> <td width=152 colspan=16 valign=top style='width:114.1pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> <td width=96 colspan=2 valign=top style='width:72.25pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=167 colspan=6 valign=top style='width:125.05pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>STATE LICENSE NO.</span></p> </td> <td width=77 colspan=10 valign=top style='width:58.0pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt; text-align:center;line-height:normal'><span style='font-size:7.5pt; font-family:"Times","serif"'>YEAR</span></p> </td> <td width=75 colspan=6 valign=top style='width:56.1pt;border:none;padding: 0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt; text-align:center;line-height:normal'><span style='font-size:7.5pt; font-family:"Times","serif"'>STATE</span></p> </td> <td width=96 colspan=2 valign=top style='width:72.25pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>FR______Y</span></p> </td> </tr> <tr> <td width=167 colspan=6 valign=top style='width:125.05pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>_____________________________</span></p> </td> <td width=76 colspan=9 valign=top style='width:57.05pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt; text-align:center;line-height:normal'><span style='font-size:7.5pt; font-family:"Times","serif"'>______</span></p> </td> <td width=76 colspan=7 valign=top style='width:57.05pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt; text-align:center;line-height:normal'><span style='font-size:7.5pt; font-family:"Times","serif"'>_______</span></p> </td> <td width=96 colspan=2 valign=top style='width:72.25pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>______N</span></p> </td> </tr> <tr> <td width=167 colspan=6 valign=top style='width:125.05pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> <td width=152 colspan=16 valign=top style='width:114.1pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> <td width=96 colspan=2 valign=top style='width:72.25pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=415 colspan=24 valign=top style='width:311.4pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>AND THEN AND THERE COMMIT THE FOLLOWING OFFENSE TO WIT:</span></p> </td> </tr> <tr> <td width=194 colspan=10 valign=top style='width:145.65pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt; text-align:center;line-height:normal'><span style='font-size:7.5pt; font-family:"Times","serif"'>PETTY OFF _____</span></p> </td> <td width=75 colspan=7 valign=top style='width:56.1pt;border:none;padding: 0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>MIS ______</span></p> </td> <td width=146 colspan=7 valign=top style='width:109.65pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=269 colspan=17 valign=top style='width:201.75pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> <td width=146 colspan=7 valign=top style='width:109.65pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=269 colspan=17 valign=top style='width:201.75pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>DESCRIBE VIOLATION:</span></p> </td> <td width=146 colspan=7 valign=top style='width:109.65pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=269 colspan=17 valign=top style='width:201.75pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> <td width=146 colspan=7 valign=top style='width:109.65pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=269 colspan=17 valign=top style='width:201.75pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>_________________________________________________</span></p> </td> <td width=146 colspan=7 valign=top style='width:109.65pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>CDL ____Y____N</span></p> </td> </tr> <tr> <td width=269 colspan=17 valign=top style='width:201.75pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> <td width=146 colspan=7 valign=top style='width:109.65pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>C Veh.____Y____N____E</span></p> </td> </tr> <tr> <td width=269 colspan=17 valign=top style='width:201.75pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>_________________________________________________</span></p> </td> <td width=146 colspan=7 valign=top style='width:109.65pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>Haz. Materials ____Y____N</span></p> </td> </tr> <tr> <td width=269 colspan=17 valign=top style='width:201.75pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> <td width=146 colspan=7 valign=top style='width:109.65pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=415 colspan=24 valign=top style='width:311.4pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>in violation of SDCL_________________________________</span></p> </td> </tr> <tr> <td width=187 colspan=9 valign=top style='width:1.95in;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> <td width=228 colspan=15 valign=top style='width:171.0pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=82 colspan=2 valign=top style='width:61.5pt;border:none;padding: 0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> <td width=105 colspan=7 valign=top style='width:78.9pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>_____Municipal</span></p> </td> <td width=228 colspan=15 valign=top style='width:171.0pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=82 colspan=2 valign=top style='width:61.5pt;border:none;padding: 0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>SPEEDING</span></p> </td> <td width=105 colspan=7 valign=top style='width:78.9pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>_____Interstate</span></p> </td> <td width=228 colspan=15 valign=top style='width:171.0pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=82 colspan=2 valign=top style='width:61.5pt;border:none;padding: 0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> <td width=105 colspan=7 valign=top style='width:78.9pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>_____Other</span></p> </td> <td width=94 colspan=10 valign=top style='width:70.7pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>______M.P.H. IN</span></p> </td> <td width=134 colspan=5 valign=top style='width:100.3pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>______M.P.H. ZONE</span></p> </td> </tr> <tr> <td width=415 colspan=24 valign=top style='width:311.4pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=157 colspan=5 valign=top style='width:117.6pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>OFFICER ISSUING SUMMONS</span></p> </td> <td width=50 colspan=8 valign=top style='width:37.4pt;border:none;padding: 0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>NO.</span></p> </td> <td width=87 colspan=7 valign=top style='width:65.45pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>CITY</span></p> </td> <td width=62 colspan=3 valign=top style='width:46.75pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>COUNTY</span></p> </td> <td width=59 valign=top style='width:44.2pt;border:none;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>STATE</span></p> </td> </tr> <tr> <td width=157 colspan=5 valign=top style='width:117.6pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>___________________________</span></p> </td> <td width=50 colspan=8 valign=top style='width:37.4pt;border:none;padding: 0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>_____</span></p> </td> <td width=87 colspan=7 valign=top style='width:65.45pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>______________</span></p> </td> <td width=62 colspan=3 valign=top style='width:46.75pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>_________</span></p> </td> <td width=59 valign=top style='width:44.2pt;border:none;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:-267.2pt;margin-bottom:.0001pt;text-align:right; line-height:normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>_______</span></p> </td> </tr> <tr> <td width=415 colspan=24 valign=top style='width:311.4pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=356 colspan=23 valign=top style='width:267.2pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>ABOVE COMPLAINT IS TRUE AS I VERILY BELIEVE</span></p> </td> <td width=59 valign=top style='width:44.2pt;border:none;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>DATE</span></p> </td> </tr> <tr style='height:14.15pt'> <td width=356 colspan=23 valign=top style='width:267.2pt;border:none; padding:0in 5.4pt 0in 5.4pt;height:14.15pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>OFFICER SIGN IN PRESENCE OF COURT OR NOTARY</span></p> </td> <td width=59 valign=top style='width:44.2pt;border:none;padding:0in 5.4pt 0in 5.4pt; height:14.15pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=356 colspan=23 valign=top style='width:267.2pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>__________________________________________________________________</span></p> </td> <td width=59 valign=top style='width:44.2pt;border:none;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>_______</span></p> </td> </tr> <tr> <td width=356 colspan=23 valign=top style='width:267.2pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> <td width=59 valign=top style='width:44.2pt;border:none;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>&nbsp;</span></p> </td> </tr> <tr style='height:.2in'> <td width=356 colspan=23 valign=top style='width:267.2pt;border:none; padding:0in 5.4pt 0in 5.4pt;height:.2in'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>SUBSCRIBED AND SWORN TO ME THIS DATE (NAME AND TITLE)</span></p> </td> <td width=59 valign=top style='width:44.2pt;border:none;padding:0in 5.4pt 0in 5.4pt; height:.2in'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>DATE</span></p> </td> </tr> <tr> <td width=356 colspan=23 valign=top style='width:267.2pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>__________________________________________________________________</span></p> </td> <td width=59 valign=top style='width:44.2pt;border:none;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>_______</span></p> </td> </tr> <tr> <td width=356 colspan=23 valign=top style='width:267.2pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> <td width=59 valign=top style='width:44.2pt;border:none;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=415 colspan=24 valign=top style='width:311.4pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt; text-align:center;line-height:normal'><b><span style='font-size:9.0pt; font-family:"Times","serif"'>SUMMONS and PROMISE TO APPEAR</span></b></p> </td> </tr> <tr> <td width=415 colspan=24 valign=top style='width:311.4pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=415 colspan=24 valign=top style='width:311.4pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>Defendant is ordered and does promise to appear in the above Court located in the city of</span></p> </td> </tr> <tr> <td width=415 colspan=24 valign=top style='width:311.4pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=178 colspan=7 valign=top style='width:133.6pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>_______________________________</span></p> </td> <td width=41 colspan=7 valign=top style='width:30.75pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>on</span></p> </td> <td width=196 colspan=10 valign=top style='width:147.05pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>________________________________&nbsp; at</span></p> </td> </tr> <tr> <td width=415 colspan=24 valign=top style='width:311.4pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=70 valign=top style='width:52.15pt;border:none;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>a.m.</span></p> </td> <td width=346 colspan=23 valign=top style='width:259.25pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=70 valign=top style='width:52.15pt;border:none;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>p.m.</span></p> </td> <td width=346 colspan=23 valign=top style='width:259.25pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=70 valign=top style='width:52.15pt;border:none;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;text-align: justify;line-height:normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>_______</span></p> </td> <td width=346 colspan=23 valign=top style='width:259.25pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=70 valign=top style='width:52.15pt;border:none;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>&nbsp;</span></p> </td> <td width=346 colspan=23 valign=top style='width:259.25pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=415 colspan=24 valign=top style='width:311.4pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>X ____________________________________________________________________________ </span></p> </td> </tr> <tr> <td width=415 colspan=24 valign=top style='width:311.4pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt; text-align:center;line-height:normal'><span style='font-size:7.5pt; font-family:"Times","serif"'>Defendant's signature</span></p> </td> </tr> <tr> <td width=415 colspan=24 valign=top style='width:311.4pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=415 colspan=24 valign=top style='width:311.4pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt; text-align:center;line-height:normal'><span style='font-size:7.5pt; font-family:"Times","serif"'>(Signing this form is a promise to appear - not an admission of guilt. Violation of promise to</span></p> </td> </tr> <tr> <td width=415 colspan=24 valign=top style='width:311.4pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt; text-align:center;line-height:normal'><span style='font-size:7.5pt; font-family:"Times","serif"'>appear is a Class 2 misdemeanor, and a warrant may be issued.)</span></p> </td> </tr> <tr> <td width=108 colspan=4 valign=top style='width:81.0pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> <td width=307 colspan=20 valign=top style='width:3.2in;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=108 colspan=4 valign=top style='width:81.0pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>_____Yes _____No</span></p> </td> <td width=307 colspan=20 valign=top style='width:3.2in;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>Court appearance required.</span></p> </td> </tr> <tr> <td width=108 colspan=4 valign=top style='width:81.0pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>_____Yes _____No</span></p> </td> <td width=307 colspan=20 valign=top style='width:3.2in;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>Power of attorney in lieu of appearance.&nbsp; Amount $______________</span></p> </td> </tr> <tr> <td width=108 colspan=4 valign=top style='width:81.0pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> <td width=307 colspan=20 valign=top style='width:3.2in;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=108 colspan=4 valign=top style='width:81.0pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> <td width=307 colspan=20 valign=top style='width:3.2in;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=108 colspan=4 valign=top style='width:81.0pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>(2) <u>Form B</u>:</span></p> </td> <td width=307 colspan=20 valign=top style='width:3.2in;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=108 colspan=4 valign=top style='width:81.0pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> <td width=307 colspan=20 valign=top style='width:3.2in;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=415 colspan=24 valign=top style='width:311.4pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt; text-align:center;line-height:normal'><b><span style='font-size:9.0pt; font-family:"Times","serif"'>UNIFORM TRAFFIC TICKET</span></b></p> </td> </tr> <tr> <td width=415 colspan=24 valign=top style='width:311.4pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt; text-align:center;line-height:normal'><b><span style='font-size:9.0pt; font-family:"Times","serif"'>SUMMONS-COMPLAINT</span></b></p> </td> </tr> <tr> <td width=415 colspan=24 valign=top style='width:311.4pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:8.0pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=415 colspan=24 valign=top style='width:311.4pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=195 colspan=11 valign=top style='width:146.45pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>State of South Dakota </span></p> </td> <td width=220 colspan=13 valign=top style='width:164.95pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>In Circuit Court</span></p> </td> </tr> <tr> <td width=195 colspan=11 valign=top style='width:146.45pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> <td width=220 colspan=13 valign=top style='width:164.95pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>Magistrate Division</span></p> </td> </tr> <tr> <td width=195 colspan=11 valign=top style='width:146.45pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>County</span><span style='font-size:7.5pt;font-family:"Times","serif"'> of_______________</span></p> </td> <td width=220 colspan=13 valign=top style='width:164.95pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>____________Judicial Court</span></p> </td> </tr> <tr> <td width=195 colspan=11 valign=top style='width:146.45pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> <td width=220 colspan=13 valign=top style='width:164.95pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=195 colspan=11 valign=top style='width:146.45pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>State of South Dakota (Plaintiff)</span></p> </td> <td width=220 colspan=13 valign=top style='width:164.95pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=195 colspan=11 valign=top style='width:146.45pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> <td width=220 colspan=13 valign=top style='width:164.95pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=195 colspan=11 valign=top style='width:146.45pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>vs</span></p> </td> <td width=220 colspan=13 valign=top style='width:164.95pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=195 colspan=11 valign=top style='width:146.45pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> <td width=220 colspan=13 valign=top style='width:164.95pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=195 colspan=11 valign=top style='width:146.45pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>___________________________________</span></p> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt; text-align:center;line-height:normal'><span style='font-size:7.5pt; font-family:"Times","serif"'>(Defendant)</span></p> </td> <td width=220 colspan=13 valign=top style='width:164.95pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=415 colspan=24 valign=top style='width:311.4pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=415 colspan=24 valign=top style='width:311.4pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>THE UNDERSIGNED PEACE OFFICER COMPLAINS AND STATES THAT</span></p> </td> </tr> <tr> <td width=108 colspan=4 valign=top style='width:81.0pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>ON OR ABOUT</span></p> </td> <td width=211 colspan=18 valign=top style='width:158.15pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>AT OR NEAR (LOCATION/MILE POST)</span></p> </td> <td width=96 colspan=2 valign=top style='width:72.25pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>AT TIME</span></p> </td> </tr> <tr> <td width=319 colspan=22 valign=top style='width:239.15pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> <td width=96 colspan=2 valign=top style='width:72.25pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>A.M.</span></p> </td> </tr> <tr> <td width=319 colspan=22 valign=top style='width:239.15pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> <td width=96 colspan=2 valign=top style='width:72.25pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>P.M.</span></p> </td> </tr> <tr> <td width=108 colspan=4 valign=top style='width:81.0pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>_________________</span></p> </td> <td width=211 colspan=18 valign=top style='width:158.15pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>____________________________________</span></p> </td> <td width=96 colspan=2 valign=top style='width:72.25pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>________</span></p> </td> </tr> <tr> <td width=319 colspan=22 valign=top style='width:239.15pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> <td width=96 colspan=2 valign=top style='width:72.25pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=415 colspan=24 valign=top style='width:311.4pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt; text-align:center;line-height:normal'><span style='font-size:7.5pt; font-family:"Times","serif"'>WITHIN THE COUNTY AND STATE AFORESAID</span></p> </td> </tr> <tr> <td width=415 colspan=24 valign=top style='width:311.4pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=167 colspan=6 valign=top style='width:125.05pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>NAME</span></p> </td> <td width=152 colspan=16 valign=top style='width:114.1pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt; text-align:center;line-height:normal'><span style='font-size:7.5pt; font-family:"Times","serif"'>HEIGHT</span></p> </td> <td width=96 colspan=2 valign=top style='width:72.25pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>SEX</span></p> </td> </tr> <tr> <td width=167 colspan=6 valign=top style='width:125.05pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>_____________________________</span></p> </td> <td width=152 colspan=16 valign=top style='width:114.1pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt; text-align:center;line-height:normal'><span style='font-size:7.5pt; font-family:"Times","serif"'>________</span></p> </td> <td width=96 colspan=2 valign=top style='width:72.25pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>_____</span></p> </td> </tr> <tr> <td width=167 colspan=6 valign=top style='width:125.05pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> <td width=152 colspan=16 valign=top style='width:114.1pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt; text-align:center;line-height:normal'><span style='font-size:7.5pt; font-family:"Times","serif"'>&nbsp;</span></p> </td> <td width=96 colspan=2 valign=top style='width:72.25pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=167 colspan=6 valign=top style='width:125.05pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>ADDRESS</span></p> </td> <td width=152 colspan=16 valign=top style='width:114.1pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt; text-align:center;line-height:normal'><span style='font-size:7.5pt; font-family:"Times","serif"'>WEIGHT</span></p> </td> <td width=96 colspan=2 valign=top style='width:72.25pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=167 colspan=6 valign=top style='width:125.05pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>_____________________________</span></p> </td> <td width=152 colspan=16 valign=top style='width:114.1pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt; text-align:center;line-height:normal'><span style='font-size:7.5pt; font-family:"Times","serif"'>________</span></p> </td> <td width=96 colspan=2 valign=top style='width:72.25pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=167 colspan=6 valign=top style='width:125.05pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> <td width=152 colspan=16 valign=top style='width:114.1pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt; text-align:center;line-height:normal'><span style='font-size:7.5pt; font-family:"Times","serif"'>&nbsp;</span></p> </td> <td width=96 colspan=2 valign=top style='width:72.25pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=167 colspan=6 valign=top style='width:125.05pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>CITY</span></p> </td> <td width=152 colspan=16 valign=top style='width:114.1pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt; text-align:center;line-height:normal'><span style='font-size:7.5pt; font-family:"Times","serif"'>STATE</span></p> </td> <td width=96 colspan=2 valign=top style='width:72.25pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>BIRTH DATE</span></p> </td> </tr> <tr> <td width=167 colspan=6 valign=top style='width:125.05pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>_____________________________</span></p> </td> <td width=152 colspan=16 valign=top style='width:114.1pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt; text-align:center;line-height:normal'><span style='font-size:7.5pt; font-family:"Times","serif"'>________</span></p> </td> <td width=96 colspan=2 valign=top style='width:72.25pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>____________</span></p> </td> </tr> <tr> <td width=167 colspan=6 valign=top style='width:125.05pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> <td width=152 colspan=16 valign=top style='width:114.1pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt; text-align:center;line-height:normal'><span style='font-size:7.5pt; font-family:"Times","serif"'>&nbsp;</span></p> </td> <td width=96 colspan=2 valign=top style='width:72.25pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=167 colspan=6 valign=top style='width:125.05pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>DRIVER'S LICENSE NO.</span></p> </td> <td width=152 colspan=16 valign=top style='width:114.1pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt; text-align:center;line-height:normal'><span style='font-size:7.5pt; font-family:"Times","serif"'>STATE</span></p> </td> <td width=96 colspan=2 valign=top style='width:72.25pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=167 colspan=6 valign=top style='width:125.05pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>_____________________________</span></p> </td> <td width=152 colspan=16 valign=top style='width:114.1pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt; text-align:center;line-height:normal'><span style='font-size:7.5pt; font-family:"Times","serif"'>________</span></p> </td> <td width=96 colspan=2 valign=top style='width:72.25pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=167 colspan=6 valign=top style='width:125.05pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> <td width=152 colspan=16 valign=top style='width:114.1pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> <td width=96 colspan=2 valign=top style='width:72.25pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=84 colspan=3 valign=top style='width:62.9pt;border:none;padding: 0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt; text-align:center;line-height:normal'><span style='font-size:7.5pt; font-family:"Times","serif"'>DID UNLAWFULLY</span></p> </td> <td width=83 colspan=3 valign=top style='width:62.15pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt; text-align:center;line-height:normal'><span style='font-size:7.5pt; font-family:"Times","serif"'>OPERATE</span></p> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt; text-align:center;line-height:normal'><span style='font-size:7.5pt; font-family:"Times","serif"'>_________</span></p> </td> <td width=52 colspan=8 valign=top style='width:39.3pt;border:none;padding: 0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt; text-align:center;line-height:normal'><span style='font-size:7.5pt; font-family:"Times","serif"'>PARK</span></p> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt; text-align:center;line-height:normal'><span style='font-size:7.5pt; font-family:"Times","serif"'>______</span></p> </td> <td width=100 colspan=8 valign=top style='width:74.8pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt; text-align:center;line-height:normal'><span style='font-size:7.5pt; font-family:"Times","serif"'>VEHICLE MAKE</span></p> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt; text-align:center;line-height:normal'><span style='font-size:7.5pt; font-family:"Times","serif"'>_______________</span></p> </td> <td width=96 colspan=2 valign=top style='width:72.25pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>BODY STYLE</span></p> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>_____________</span></p> </td> </tr> <tr> <td width=167 colspan=6 valign=top style='width:125.05pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> <td width=152 colspan=16 valign=top style='width:114.1pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> <td width=96 colspan=2 valign=top style='width:72.25pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=167 colspan=6 valign=top style='width:125.05pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>STATE LICENSE NO.</span></p> </td> <td width=77 colspan=10 valign=top style='width:58.0pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt; text-align:center;line-height:normal'><span style='font-size:7.5pt; font-family:"Times","serif"'>YEAR</span></p> </td> <td width=75 colspan=6 valign=top style='width:56.1pt;border:none;padding: 0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt; text-align:center;line-height:normal'><span style='font-size:7.5pt; font-family:"Times","serif"'>STATE</span></p> </td> <td width=96 colspan=2 valign=top style='width:72.25pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>FR______Y</span></p> </td> </tr> <tr> <td width=167 colspan=6 valign=top style='width:125.05pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>_____________________________</span></p> </td> <td width=76 colspan=9 valign=top style='width:57.05pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt; text-align:center;line-height:normal'><span style='font-size:7.5pt; font-family:"Times","serif"'>______</span></p> </td> <td width=76 colspan=7 valign=top style='width:57.05pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt; text-align:center;line-height:normal'><span style='font-size:7.5pt; font-family:"Times","serif"'>_______</span></p> </td> <td width=96 colspan=2 valign=top style='width:72.25pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>______N</span></p> </td> </tr> <tr> <td width=167 colspan=6 valign=top style='width:125.05pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> <td width=152 colspan=16 valign=top style='width:114.1pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> <td width=96 colspan=2 valign=top style='width:72.25pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=415 colspan=24 valign=top style='width:311.4pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>AND THEN AND THERE COMMIT THE FOLLOWING OFFENSE TO WIT:</span></p> </td> </tr> <tr> <td width=194 colspan=10 valign=top style='width:145.65pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt; text-align:center;line-height:normal'><span style='font-size:7.5pt; font-family:"Times","serif"'>PETTY OFF _____</span></p> </td> <td width=75 colspan=7 valign=top style='width:56.1pt;border:none;padding: 0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>MIS ______</span></p> </td> <td width=146 colspan=7 valign=top style='width:109.65pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=269 colspan=17 valign=top style='width:201.75pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> <td width=146 colspan=7 valign=top style='width:109.65pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=269 colspan=17 valign=top style='width:201.75pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>DESCRIBE VIOLATION:</span></p> </td> <td width=146 colspan=7 valign=top style='width:109.65pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=269 colspan=17 valign=top style='width:201.75pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> <td width=146 colspan=7 valign=top style='width:109.65pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=269 colspan=17 valign=top style='width:201.75pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>_________________________________________________</span></p> </td> <td width=146 colspan=7 valign=top style='width:109.65pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>CDL ____Y____N</span></p> </td> </tr> <tr> <td width=269 colspan=17 valign=top style='width:201.75pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> <td width=146 colspan=7 valign=top style='width:109.65pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>C Veh.____Y____N____E</span></p> </td> </tr> <tr> <td width=269 colspan=17 valign=top style='width:201.75pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>_________________________________________________</span></p> </td> <td width=146 colspan=7 valign=top style='width:109.65pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>Haz. Materials ____Y____N</span></p> </td> </tr> <tr> <td width=269 colspan=17 valign=top style='width:201.75pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> <td width=146 colspan=7 valign=top style='width:109.65pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=415 colspan=24 valign=top style='width:311.4pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>in violation of SDCL_________________________________</span></p> </td> </tr> <tr> <td width=182 colspan=8 valign=top style='width:136.3pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> <td width=233 colspan=16 valign=top style='width:175.1pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=82 colspan=2 valign=top style='width:61.5pt;border:none;padding: 0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> <td width=100 colspan=6 valign=top style='width:74.8pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>_____Municipal</span></p> </td> <td width=233 colspan=16 valign=top style='width:175.1pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=82 colspan=2 valign=top style='width:61.5pt;border:none;padding: 0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>SPEEDING</span></p> </td> <td width=100 colspan=6 valign=top style='width:74.8pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>_____Interstate</span></p> </td> <td width=233 colspan=16 valign=top style='width:175.1pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=82 colspan=2 valign=top style='width:61.5pt;border:none;padding: 0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> <td width=100 colspan=6 valign=top style='width:74.8pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>_____Other</span></p> </td> <td width=88 colspan=10 valign=top style='width:66.15pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>______M.P.H. IN</span></p> </td> <td width=145 colspan=6 valign=top style='width:108.95pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>______M.P.H. ZONE</span></p> </td> </tr> <tr> <td width=415 colspan=24 valign=top style='width:311.4pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=157 colspan=5 valign=top style='width:117.6pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>OFFICER ISSUING SUMMONS</span></p> </td> <td width=50 colspan=8 valign=top style='width:37.4pt;border:none;padding: 0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>NO.</span></p> </td> <td width=88 colspan=8 valign=top style='width:66.15pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>CITY</span></p> </td> <td width=61 colspan=2 valign=top style='width:46.05pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>COUNTY</span></p> </td> <td width=59 valign=top style='width:44.2pt;border:none;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>STATE</span></p> </td> </tr> <tr> <td width=157 colspan=5 valign=top style='width:117.6pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>___________________________</span></p> </td> <td width=50 colspan=8 valign=top style='width:37.4pt;border:none;padding: 0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>_____</span></p> </td> <td width=88 colspan=8 valign=top style='width:66.15pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>______________</span></p> </td> <td width=61 colspan=2 valign=top style='width:46.05pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>_________</span></p> </td> <td width=59 valign=top style='width:44.2pt;border:none;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:-267.2pt;margin-bottom:.0001pt;text-align:right; line-height:normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>_______</span></p> </td> </tr> <tr> <td width=415 colspan=24 valign=top style='width:311.4pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=356 colspan=23 valign=top style='width:267.2pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>ABOVE COMPLAINT IS TRUE AS I VERILY BELIEVE</span></p> </td> <td width=59 valign=top style='width:44.2pt;border:none;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>DATE</span></p> </td> </tr> <tr style='height:7.0pt'> <td width=356 colspan=23 valign=top style='width:267.2pt;border:none; padding:0in 5.4pt 0in 5.4pt;height:7.0pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>OFFICER SIGN IN PRESENCE OF COURT OR NOTARY</span></p> </td> <td width=59 valign=top style='width:44.2pt;border:none;padding:0in 5.4pt 0in 5.4pt; height:7.0pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=356 colspan=23 valign=top style='width:267.2pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>__________________________________________________________________</span></p> </td> <td width=59 valign=top style='width:44.2pt;border:none;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>_______</span></p> </td> </tr> <tr> <td width=356 colspan=23 valign=top style='width:267.2pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> <td width=59 valign=top style='width:44.2pt;border:none;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>&nbsp;</span></p> </td> </tr> <tr style='height:.2in'> <td width=356 colspan=23 valign=top style='width:267.2pt;border:none; padding:0in 5.4pt 0in 5.4pt;height:.2in'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>SUBSCRIBED AND SWORN TO ME THIS DATE (NAME AND TITLE)</span></p> </td> <td width=59 valign=top style='width:44.2pt;border:none;padding:0in 5.4pt 0in 5.4pt; height:.2in'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>DATE</span></p> </td> </tr> <tr> <td width=356 colspan=23 valign=top style='width:267.2pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>__________________________________________________________________</span></p> </td> <td width=59 valign=top style='width:44.2pt;border:none;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>_______</span></p> </td> </tr> <tr> <td width=356 colspan=23 valign=top style='width:267.2pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> <td width=59 valign=top style='width:44.2pt;border:none;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=415 colspan=24 valign=top style='width:311.4pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt; text-align:center;line-height:normal'><b><span style='font-size:9.0pt; font-family:"Times","serif"'>SUMMONS and PROMISE TO APPEAR</span></b></p> </td> </tr> <tr> <td width=415 colspan=24 valign=top style='width:311.4pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=415 colspan=24 valign=top style='width:311.4pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>Defendant is ordered and does promise to appear in the above Court located in the city of</span></p> </td> </tr> <tr> <td width=415 colspan=24 valign=top style='width:311.4pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=178 colspan=7 valign=top style='width:133.6pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>_______________________________</span></p> </td> <td width=27 colspan=5 valign=top style='width:20.3pt;border:none;padding: 0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>on</span></p> </td> <td width=210 colspan=12 valign=top style='width:157.5pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>___________________________________&nbsp; at</span></p> </td> </tr> <tr> <td width=415 colspan=24 valign=top style='width:311.4pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=70 valign=top style='width:52.15pt;border:none;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>a.m.</span></p> </td> <td width=346 colspan=23 valign=top style='width:259.25pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=70 valign=top style='width:52.15pt;border:none;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>p.m.</span></p> </td> <td width=346 colspan=23 valign=top style='width:259.25pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=70 valign=top style='width:52.15pt;border:none;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>_______</span></p> </td> <td width=346 colspan=23 valign=top style='width:259.25pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=70 valign=top style='width:52.15pt;border:none;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> <td width=346 colspan=23 valign=top style='width:259.25pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=415 colspan=24 valign=top style='width:311.4pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>X ____________________________________________________________________________ </span></p> </td> </tr> <tr> <td width=415 colspan=24 valign=top style='width:311.4pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt; text-align:center;line-height:normal'><span style='font-size:7.5pt; font-family:"Times","serif"'>Defendant's signature</span></p> </td> </tr> <tr> <td width=415 colspan=24 valign=top style='width:311.4pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt; text-align:center;line-height:normal'><span style='font-size:7.5pt; font-family:"Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=415 colspan=24 valign=top style='width:311.4pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt; text-align:center;line-height:normal'><span style='font-size:7.5pt; font-family:"Times","serif"'>(Signing this form is a promise to appear - not an admission of guilt. Violation of promise to</span></p> </td> </tr> <tr> <td width=415 colspan=24 valign=top style='width:311.4pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt; text-align:center;line-height:normal'><span style='font-size:7.5pt; font-family:"Times","serif"'>appear is a Class 2 misdemeanor, and a warrant may be issued.)</span></p> </td> </tr> <tr> <td width=108 colspan=4 valign=top style='width:81.0pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> <td width=307 colspan=20 valign=top style='width:3.2in;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=108 colspan=4 valign=top style='width:81.0pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>_____Yes _____No</span></p> </td> <td width=307 colspan=20 valign=top style='width:3.2in;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>Court appearance required.</span></p> </td> </tr> <tr> <td width=108 colspan=4 valign=top style='width:81.0pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>_____Yes _____No</span></p> </td> <td width=307 colspan=20 valign=top style='width:3.2in;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>Power of attorney in lieu of appearance.&nbsp; Amount $________________</span></p> </td> </tr> <tr> <td width=415 colspan=24 valign=top style='width:311.4pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=415 colspan=24 valign=top style='width:311.4pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;text-align: justify;line-height:normal'><u><span style='font-size:7.5pt;font-family:"Times","serif"'>PETTY OFFENSES</span></u><span style='font-size:7.5pt;font-family:"Times","serif"'>:&nbsp; If charged with&nbsp; a petty offense involving&nbsp; the operation and use of a motor</span></p> </td> </tr> <tr> <td width=415 colspan=24 valign=top style='width:311.4pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;text-align: justify;line-height:normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>vehicle and you&nbsp; possess or have proof of&nbsp; a valid&nbsp; South Dakota driver's license,&nbsp; you may choose</span></p> </td> </tr> <tr> <td width=415 colspan=24 valign=top style='width:311.4pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;text-align: justify;line-height:normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>alternatives&nbsp; 1, 2 or 3 below.&nbsp; If unable to meet the&nbsp; license requirement or if&nbsp; charged&nbsp; with a non-</span></p> </td> </tr> <tr> <td width=415 colspan=24 valign=top style='width:311.4pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;text-align: justify;line-height:normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>traffic offense, you may choose alternate 2 or 3 below. Upon refusal of the following&nbsp; alternatives</span></p> </td> </tr> <tr> <td width=415 colspan=24 valign=top style='width:311.4pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;text-align: justify;line-height:normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>you will be taken immediately to a magistrate for hearing.</span></p> </td> </tr> <tr> <td width=415 colspan=24 valign=top style='width:311.4pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;text-align: justify;line-height:normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=415 colspan=24 valign=top style='width:311.4pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;text-align: justify;line-height:normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>1. <u>Promise to Appear. </u>&nbsp;You may&nbsp; sign the complaint&nbsp; as a written&nbsp; promise to&nbsp; appear.&nbsp;&nbsp; Intentional</span></p> </td> </tr> <tr> <td width=415 colspan=24 valign=top style='width:311.4pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;text-align: justify;line-height:normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>failure to appear is a Class 2 misdemeanor</span></p> </td> </tr> <tr> <td width=415 colspan=24 valign=top style='width:311.4pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;text-align: justify;line-height:normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=415 colspan=24 valign=top style='width:311.4pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;text-align: justify;line-height:normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>2. <u>Admission and Deposit. </u>&nbsp;You may&nbsp; sign a stipulation admitting the allegations in the complaint</span></p> </td> </tr> <tr> <td width=415 colspan=24 valign=top style='width:311.4pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;text-align: justify;line-height:normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>which, together with the required deposit, will be filed with the clerk of courts.</span></p> </td> </tr> <tr> <td width=415 colspan=24 valign=top style='width:311.4pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;text-align: justify;line-height:normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=415 colspan=24 valign=top style='width:311.4pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;text-align: justify;line-height:normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>3. <u>Deposit.</u>&nbsp; You may&nbsp; immediately mail said deposit&nbsp; to the clerk of courts or personally make the</span></p> </td> </tr> <tr> <td width=415 colspan=24 valign=top style='width:311.4pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;text-align: justify;line-height:normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>deposit,&nbsp; either alternative to be in&nbsp; the presence of the officer.&nbsp; Refer to schedule of petty offenses</span></p> </td> </tr> <tr> <td width=415 colspan=24 valign=top style='width:311.4pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;text-align: justify;line-height:normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>for amount required for the deposit.</span></p> </td> </tr> <tr> <td width=415 colspan=24 valign=top style='width:311.4pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;text-align: justify;line-height:normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=415 colspan=24 valign=top style='width:311.4pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;text-align: justify;line-height:normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>If you&nbsp; choose&nbsp; alternative 2 or 3&nbsp; and do not&nbsp; appear in court&nbsp; on the date specified,&nbsp; the clerk&nbsp; will</span></p> </td> </tr> <tr> <td width=415 colspan=24 valign=top style='width:311.4pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;text-align: justify;line-height:normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>enter&nbsp; judgment&nbsp; against you&nbsp; and you will&nbsp; forfeit&nbsp; your&nbsp; deposit.&nbsp; You&nbsp; may&nbsp; appear in court&nbsp; after</span></p> </td> </tr> <tr> <td width=415 colspan=24 valign=top style='width:311.4pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;text-align: justify;line-height:normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>signing&nbsp; an admission and&nbsp; the court may,&nbsp; upon&nbsp; motion,&nbsp; relieve you&nbsp; from the stipulation and the</span></p> </td> </tr> <tr> <td width=415 colspan=24 valign=top style='width:311.4pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;text-align: justify;line-height:normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>effects thereof.</span></p> </td> </tr> <tr height=0> <td width=70 style='border:none'></td> <td width=12 style='border:none'></td> <td width=2 style='border:none'></td> <td width=24 style='border:none'></td> <td width=49 style='border:none'></td> <td width=10 style='border:none'></td> <td width=11 style='border:none'></td> <td width=4 style='border:none'></td> <td width=5 style='border:none'></td> <td width=7 style='border:none'></td> <td width=1 style='border:none'></td> <td width=10 style='border:none'></td> <td width=1 style='border:none'></td> <td width=12 style='border:none'></td> <td width=24 style='border:none'></td> <td width=1 style='border:none'></td> <td width=25 style='border:none'></td> <td width=1 style='border:none'></td> <td width=12 style='border:none'></td> <td width=12 style='border:none'></td> <td width=1 style='border:none'></td> <td width=24 style='border:none'></td> <td width=37 style='border:none'></td> <td width=59 style='border:none'></td> </tr> </table> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;text-align: justify;line-height:normal'><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>&nbsp;</span></p> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;text-align: justify;line-height:normal'><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <b>Source:</b> 4 SDR 64, effective March 26, 1978; 27 SDR 53, effective December 4, 2000; 41 SDR 218, effective July 1, 2015.</span></p> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;text-align: justify;line-height:normal'><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <b>General Authority:</b> SDCL <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=23-1A-2">23-1A-2.</A></span></p> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;text-align: justify;line-height:normal'><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <b>Law Implemented:</b> SDCL <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=23-1A-2">23-1A-2</A>, <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=23-1A-5">23-1A-5.</A></span></p> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;text-align: justify;line-height:normal'><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>&nbsp;</span></p> </div> </body> </html> <br /><hr><br /><html> <head> <title>Rule 02:03:01:02 Forms for misdemeanor offense complaints and summons.</title> <META NAME="Keywords" Content="Administrative Rules 02:03:01:02"> <META NAME="Description" Content="Administrative Rules 02:03:01:02 Forms for misdemeanor offense complaints and summons."> <meta http-equiv=Content-Type content="text/html; charset=windows-1252"> <meta name=Generator content="Microsoft Word 14 (filtered)"> <style> <!-- /* Font Definitions */ @font-face {font-family:Calibri; panose-1:2 15 5 2 2 2 4 3 2 4;} @font-face {font-family:Times; panose-1:2 2 6 3 5 4 5 2 3 4;} /* Style Definitions */ p.MsoNormal, li.MsoNormal, div.MsoNormal {margin-top:0in; margin-right:0in; margin-bottom:10.0pt; margin-left:0in; line-height:115%; font-size:11.0pt; font-family:"Calibri","sans-serif";} @page WordSection1 {size:8.5in 11.0in; margin:1.0in 1.0in 1.0in 1.0in;} div.WordSection1 {page:WordSection1;} --> </style> </head> <body lang=EN-US> <div class=WordSection1> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;text-align: justify;line-height:normal'><a name="_GoBack"></a><span style='font-size:12.0pt; font-family:"Times New Roman","serif"'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <b>2:03:01</b><b>:02.&nbsp;&nbsp;Forms for misdemeanor offense complaints and summons.</b> The following form, or one which substantially complies with it, shall be used as a misdemeanor offense summons and complaint for traffic offenses. A power of attorney form in substantial compliance with &#167;&nbsp;2:03:01:03 shall be attached to the form. The promise to appear option may not be utilized for offenses set forth in SDCL <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=32-33-2.1">32-33-2.1</A> and <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=32-33-4">32-33-4</A>, or in contradiction to SDCL 32-33-2.</span></p> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;text-align: justify;line-height:normal'><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>&nbsp;</span></p> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;text-align: justify;line-height:normal'><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; If a law enforcement agency designated in &#167;&nbsp;2:03:01:04 determinations to use the declaration option set forth in SDCL <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=23-1A-5">23-1A-5</A> and SDCL 23A-2-1, the form or one which substantially complies with it, may be modified by inserting the statutorily approved declaration above the officer's signature in addition to or in lieu of the oath acknowledgment.</span></p> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;text-align: justify;line-height:normal'><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>&nbsp;</span></p> <table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0 style='border-collapse:collapse'> <tr> <td width=407 colspan=20 valign=top style='width:305.5pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt; text-align:center;line-height:normal'><b><span style='font-size:9.0pt; font-family:"Times","serif"'>UNIFORM TRAFFIC TICKET</span></b></p> </td> </tr> <tr> <td width=407 colspan=20 valign=top style='width:305.5pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt; text-align:center;line-height:normal'><b><span style='font-size:9.0pt; font-family:"Times","serif"'>SUMMONS-COMPLAINT</span></b></p> </td> </tr> <tr> <td width=407 colspan=20 valign=top style='width:305.5pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:8.0pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=407 colspan=20 valign=top style='width:305.5pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>PCN ______________</span></p> </td> </tr> <tr> <td width=407 colspan=20 valign=top style='width:305.5pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=195 colspan=10 valign=top style='width:146.45pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>State of South Dakota </span></p> </td> <td width=212 colspan=10 valign=top style='width:159.05pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>In Circuit Court</span></p> </td> </tr> <tr> <td width=195 colspan=10 valign=top style='width:146.45pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> <td width=212 colspan=10 valign=top style='width:159.05pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>Magistrate Division</span></p> </td> </tr> <tr> <td width=195 colspan=10 valign=top style='width:146.45pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>County</span><span style='font-size:7.5pt;font-family:"Times","serif"'> of_______________</span></p> </td> <td width=212 colspan=10 valign=top style='width:159.05pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>____________Judicial Court</span></p> </td> </tr> <tr> <td width=195 colspan=10 valign=top style='width:146.45pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> <td width=212 colspan=10 valign=top style='width:159.05pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=195 colspan=10 valign=top style='width:146.45pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>State of South Dakota (Plaintiff)</span></p> </td> <td width=212 colspan=10 valign=top style='width:159.05pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=195 colspan=10 valign=top style='width:146.45pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> <td width=212 colspan=10 valign=top style='width:159.05pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=195 colspan=10 valign=top style='width:146.45pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>vs</span></p> </td> <td width=212 colspan=10 valign=top style='width:159.05pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=195 colspan=10 valign=top style='width:146.45pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> <td width=212 colspan=10 valign=top style='width:159.05pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=195 colspan=10 valign=top style='width:146.45pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>___________________________________</span></p> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt; text-align:center;line-height:normal'><span style='font-size:7.5pt; font-family:"Times","serif"'>(Defendant)</span></p> </td> <td width=212 colspan=10 valign=top style='width:159.05pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>No. _____________HP</span></p> </td> </tr> <tr> <td width=407 colspan=20 valign=top style='width:305.5pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=407 colspan=20 valign=top style='width:305.5pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>THE UNDERSIGNED PEACE OFFICER COMPLAINS AND STATES THAT</span></p> </td> </tr> <tr> <td width=108 colspan=4 valign=top style='width:81.0pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>ON OR ABOUT</span></p> </td> <td width=211 colspan=14 valign=top style='width:158.15pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>AT OR NEAR (LOCATION/MILE POST)</span></p> </td> <td width=88 colspan=2 valign=top style='width:66.35pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>AT TIME</span></p> </td> </tr> <tr> <td width=319 colspan=18 valign=top style='width:239.15pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> <td width=88 colspan=2 valign=top style='width:66.35pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>A.M.</span></p> </td> </tr> <tr> <td width=319 colspan=18 valign=top style='width:239.15pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> <td width=88 colspan=2 valign=top style='width:66.35pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>P.M.</span></p> </td> </tr> <tr> <td width=108 colspan=4 valign=top style='width:81.0pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>_________________</span></p> </td> <td width=211 colspan=14 valign=top style='width:158.15pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>____________________________________</span></p> </td> <td width=88 colspan=2 valign=top style='width:66.35pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>________</span></p> </td> </tr> <tr> <td width=319 colspan=18 valign=top style='width:239.15pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> <td width=88 colspan=2 valign=top style='width:66.35pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=407 colspan=20 valign=top style='width:305.5pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt; text-align:center;line-height:normal'><span style='font-size:7.5pt; font-family:"Times","serif"'>WITHIN THE COUNTY AND STATE AFORESAID</span></p> </td> </tr> <tr> <td width=407 colspan=20 valign=top style='width:305.5pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=167 colspan=6 valign=top style='width:125.05pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>NAME</span></p> </td> <td width=152 colspan=12 valign=top style='width:114.1pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt; text-align:center;line-height:normal'><span style='font-size:7.5pt; font-family:"Times","serif"'>HEIGHT</span></p> </td> <td width=88 colspan=2 valign=top style='width:66.35pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>SEX</span></p> </td> </tr> <tr> <td width=167 colspan=6 valign=top style='width:125.05pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>_____________________________</span></p> </td> <td width=152 colspan=12 valign=top style='width:114.1pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt; text-align:center;line-height:normal'><span style='font-size:7.5pt; font-family:"Times","serif"'>________</span></p> </td> <td width=88 colspan=2 valign=top style='width:66.35pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>_____</span></p> </td> </tr> <tr> <td width=167 colspan=6 valign=top style='width:125.05pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> <td width=152 colspan=12 valign=top style='width:114.1pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt; text-align:center;line-height:normal'><span style='font-size:7.5pt; font-family:"Times","serif"'>&nbsp;</span></p> </td> <td width=88 colspan=2 valign=top style='width:66.35pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=167 colspan=6 valign=top style='width:125.05pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>ADDRESS</span></p> </td> <td width=152 colspan=12 valign=top style='width:114.1pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt; text-align:center;line-height:normal'><span style='font-size:7.5pt; font-family:"Times","serif"'>WEIGHT</span></p> </td> <td width=88 colspan=2 valign=top style='width:66.35pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=167 colspan=6 valign=top style='width:125.05pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>_____________________________</span></p> </td> <td width=152 colspan=12 valign=top style='width:114.1pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt; text-align:center;line-height:normal'><span style='font-size:7.5pt; font-family:"Times","serif"'>________</span></p> </td> <td width=88 colspan=2 valign=top style='width:66.35pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=167 colspan=6 valign=top style='width:125.05pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> <td width=152 colspan=12 valign=top style='width:114.1pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt; text-align:center;line-height:normal'><span style='font-size:7.5pt; font-family:"Times","serif"'>&nbsp;</span></p> </td> <td width=88 colspan=2 valign=top style='width:66.35pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=167 colspan=6 valign=top style='width:125.05pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>CITY</span></p> </td> <td width=152 colspan=12 valign=top style='width:114.1pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt; text-align:center;line-height:normal'><span style='font-size:7.5pt; font-family:"Times","serif"'>STATE</span></p> </td> <td width=88 colspan=2 valign=top style='width:66.35pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>BIRTH DATE</span></p> </td> </tr> <tr> <td width=167 colspan=6 valign=top style='width:125.05pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>_____________________________</span></p> </td> <td width=152 colspan=12 valign=top style='width:114.1pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt; text-align:center;line-height:normal'><span style='font-size:7.5pt; font-family:"Times","serif"'>________</span></p> </td> <td width=88 colspan=2 valign=top style='width:66.35pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>____________</span></p> </td> </tr> <tr> <td width=167 colspan=6 valign=top style='width:125.05pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> <td width=152 colspan=12 valign=top style='width:114.1pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt; text-align:center;line-height:normal'><span style='font-size:7.5pt; font-family:"Times","serif"'>&nbsp;</span></p> </td> <td width=88 colspan=2 valign=top style='width:66.35pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=167 colspan=6 valign=top style='width:125.05pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>DRIVER'S LICENSE NO.</span></p> </td> <td width=152 colspan=12 valign=top style='width:114.1pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt; text-align:center;line-height:normal'><span style='font-size:7.5pt; font-family:"Times","serif"'>STATE</span></p> </td> <td width=88 colspan=2 valign=top style='width:66.35pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=167 colspan=6 valign=top style='width:125.05pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>_____________________________</span></p> </td> <td width=152 colspan=12 valign=top style='width:114.1pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt; text-align:center;line-height:normal'><span style='font-size:7.5pt; font-family:"Times","serif"'>________</span></p> </td> <td width=88 colspan=2 valign=top style='width:66.35pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=167 colspan=6 valign=top style='width:125.05pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> <td width=152 colspan=12 valign=top style='width:114.1pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> <td width=88 colspan=2 valign=top style='width:66.35pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=84 colspan=3 valign=top style='width:62.9pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt; text-align:center;line-height:normal'><span style='font-size:7.5pt; font-family:"Times","serif"'>DID UNLAWFULLY</span></p> </td> <td width=83 colspan=3 valign=top style='width:62.15pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt; text-align:center;line-height:normal'><span style='font-size:7.5pt; font-family:"Times","serif"'>OPERATE</span></p> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt; text-align:center;line-height:normal'><span style='font-size:7.5pt; font-family:"Times","serif"'>_________</span></p> </td> <td width=52 colspan=6 valign=top style='width:39.3pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt; text-align:center;line-height:normal'><span style='font-size:7.5pt; font-family:"Times","serif"'>PARK</span></p> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt; text-align:center;line-height:normal'><span style='font-size:7.5pt; font-family:"Times","serif"'>______</span></p> </td> <td width=100 colspan=6 valign=top style='width:74.8pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt; text-align:center;line-height:normal'><span style='font-size:7.5pt; font-family:"Times","serif"'>VEHICLE MAKE</span></p> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt; text-align:center;line-height:normal'><span style='font-size:7.5pt; font-family:"Times","serif"'>_______________</span></p> </td> <td width=88 colspan=2 valign=top style='width:66.35pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>BODY STYLE</span></p> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>_____________</span></p> </td> </tr> <tr> <td width=167 colspan=6 valign=top style='width:125.05pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> <td width=152 colspan=12 valign=top style='width:114.1pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> <td width=88 colspan=2 valign=top style='width:66.35pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=167 colspan=6 valign=top style='width:125.05pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>STATE LICENSE NO.</span></p> </td> <td width=77 colspan=8 valign=top style='width:58.0pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt; text-align:center;line-height:normal'><span style='font-size:7.5pt; font-family:"Times","serif"'>YEAR</span></p> </td> <td width=75 colspan=4 valign=top style='width:56.1pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt; text-align:center;line-height:normal'><span style='font-size:7.5pt; font-family:"Times","serif"'>STATE</span></p> </td> <td width=88 colspan=2 valign=top style='width:66.35pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>FR______Y</span></p> </td> </tr> <tr> <td width=167 colspan=6 valign=top style='width:125.05pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>_____________________________</span></p> </td> <td width=76 colspan=7 valign=top style='width:57.05pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt; text-align:center;line-height:normal'><span style='font-size:7.5pt; font-family:"Times","serif"'>______</span></p> </td> <td width=76 colspan=5 valign=top style='width:57.05pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt; text-align:center;line-height:normal'><span style='font-size:7.5pt; font-family:"Times","serif"'>_______</span></p> </td> <td width=88 colspan=2 valign=top style='width:66.35pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>______N</span></p> </td> </tr> <tr> <td width=167 colspan=6 valign=top style='width:125.05pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> <td width=152 colspan=12 valign=top style='width:114.1pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> <td width=88 colspan=2 valign=top style='width:66.35pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=407 colspan=20 valign=top style='width:305.5pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>AND THEN AND THERE COMMIT THE FOLLOWING OFFENSE TO WIT:</span></p> </td> </tr> <tr> <td width=194 colspan=9 valign=top style='width:145.65pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt; text-align:center;line-height:normal'><span style='font-size:7.5pt; font-family:"Times","serif"'>PETTY OFF _____</span></p> </td> <td width=75 colspan=6 valign=top style='width:56.1pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>MIS ______</span></p> </td> <td width=138 colspan=5 valign=top style='width:103.75pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=269 colspan=15 valign=top style='width:201.75pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> <td width=138 colspan=5 valign=top style='width:103.75pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=269 colspan=15 valign=top style='width:201.75pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>DESCRIBE VIOLATION:</span></p> </td> <td width=138 colspan=5 valign=top style='width:103.75pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=269 colspan=15 valign=top style='width:201.75pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> <td width=138 colspan=5 valign=top style='width:103.75pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=269 colspan=15 valign=top style='width:201.75pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>_________________________________________________</span></p> </td> <td width=138 colspan=5 valign=top style='width:103.75pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>CDL ____Y____N</span></p> </td> </tr> <tr> <td width=269 colspan=15 valign=top style='width:201.75pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> <td width=138 colspan=5 valign=top style='width:103.75pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>C Veh.____Y____N____E</span></p> </td> </tr> <tr> <td width=269 colspan=15 valign=top style='width:201.75pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>_________________________________________________</span></p> </td> <td width=138 colspan=5 valign=top style='width:103.75pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>Haz. Materials ____Y____N</span></p> </td> </tr> <tr> <td width=269 colspan=15 valign=top style='width:201.75pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> <td width=138 colspan=5 valign=top style='width:103.75pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=407 colspan=20 valign=top style='width:305.5pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>in violation of SDCL_________________________________</span></p> </td> </tr> <tr> <td width=193 colspan=8 valign=top style='width:144.9pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> <td width=214 colspan=12 valign=top style='width:160.6pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=82 colspan=2 valign=top style='width:61.5pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> <td width=111 colspan=6 valign=top style='width:83.4pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>_____Municipal</span></p> </td> <td width=214 colspan=12 valign=top style='width:160.6pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=82 colspan=2 valign=top style='width:61.5pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>SPEEDING</span></p> </td> <td width=111 colspan=6 valign=top style='width:83.4pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>_____Interstate</span></p> </td> <td width=214 colspan=12 valign=top style='width:160.6pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=82 colspan=2 valign=top style='width:61.5pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> <td width=111 colspan=6 valign=top style='width:83.4pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>_____Other</span></p> </td> <td width=88 colspan=8 valign=top style='width:66.2pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>______M.P.H. IN</span></p> </td> <td width=126 colspan=4 valign=top style='width:94.4pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>______M.P.H. ZONE</span></p> </td> </tr> <tr> <td width=407 colspan=20 valign=top style='width:305.5pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=157 colspan=5 valign=top style='width:117.6pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>OFFICER ISSUING SUMMONS</span></p> </td> <td width=50 colspan=6 valign=top style='width:37.4pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>NO.</span></p> </td> <td width=87 colspan=6 valign=top style='width:65.45pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>CITY</span></p> </td> <td width=62 colspan=2 valign=top style='width:46.75pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>COUNTY</span></p> </td> <td width=51 valign=top style='width:38.3pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>STATE</span></p> </td> </tr> <tr> <td width=157 colspan=5 valign=top style='width:117.6pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>___________________________</span></p> </td> <td width=50 colspan=6 valign=top style='width:37.4pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>_____</span></p> </td> <td width=87 colspan=6 valign=top style='width:65.45pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>______________</span></p> </td> <td width=62 colspan=2 valign=top style='width:46.75pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>_________</span></p> </td> <td width=51 valign=top style='width:38.3pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:-267.2pt;margin-bottom:.0001pt;text-align:right; line-height:normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>_______</span></p> </td> </tr> <tr> <td width=407 colspan=20 valign=top style='width:305.5pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=356 colspan=19 valign=top style='width:267.2pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>ABOVE COMPLAINT IS TRUE AS I VERILY BELIEVE</span></p> </td> <td width=51 valign=top style='width:38.3pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>DATE</span></p> </td> </tr> <tr style='height:14.15pt'> <td width=356 colspan=19 valign=top style='width:267.2pt;padding:0in 5.4pt 0in 5.4pt; height:14.15pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>OFFICER SIGN IN PRESENCE OF COURT OR NOTARY</span></p> </td> <td width=51 valign=top style='width:38.3pt;padding:0in 5.4pt 0in 5.4pt; height:14.15pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=356 colspan=19 valign=top style='width:267.2pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>__________________________________________________________________</span></p> </td> <td width=51 valign=top style='width:38.3pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>_______</span></p> </td> </tr> <tr> <td width=356 colspan=19 valign=top style='width:267.2pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> <td width=51 valign=top style='width:38.3pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>&nbsp;</span></p> </td> </tr> <tr style='height:.2in'> <td width=356 colspan=19 valign=top style='width:267.2pt;padding:0in 5.4pt 0in 5.4pt; height:.2in'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>SUBSCRIBED AND SWORN TO ME THIS DATE (NAME AND TITLE)</span></p> </td> <td width=51 valign=top style='width:38.3pt;padding:0in 5.4pt 0in 5.4pt; height:.2in'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>DATE</span></p> </td> </tr> <tr> <td width=356 colspan=19 valign=top style='width:267.2pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>__________________________________________________________________</span></p> </td> <td width=51 valign=top style='width:38.3pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>_______</span></p> </td> </tr> <tr> <td width=356 colspan=19 valign=top style='width:267.2pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> <td width=51 valign=top style='width:38.3pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=407 colspan=20 valign=top style='width:305.5pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt; text-align:center;line-height:normal'><b><span style='font-size:9.0pt; font-family:"Times","serif"'>SUMMONS and PROMISE TO APPEAR</span></b></p> </td> </tr> <tr> <td width=407 colspan=20 valign=top style='width:305.5pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=407 colspan=20 valign=top style='width:305.5pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>Defendant is ordered and does promise to appear in the above Court located in the city of</span></p> </td> </tr> <tr> <td width=407 colspan=20 valign=top style='width:305.5pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=182 colspan=7 valign=top style='width:136.3pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>________________________________</span></p> </td> <td width=25 colspan=4 valign=top style='width:18.7pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>on</span></p> </td> <td width=201 colspan=9 valign=top style='width:150.5pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>_________________________________&nbsp; at</span></p> </td> </tr> <tr> <td width=407 colspan=20 valign=top style='width:305.5pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=70 valign=top style='width:52.15pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>a.m.</span></p> </td> <td width=338 colspan=19 valign=top style='width:253.35pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=70 valign=top style='width:52.15pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>p.m.</span></p> </td> <td width=338 colspan=19 valign=top style='width:253.35pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=70 valign=top style='width:52.15pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;text-align: justify;line-height:normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>_______</span></p> </td> <td width=338 colspan=19 valign=top style='width:253.35pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=70 valign=top style='width:52.15pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>&nbsp;</span></p> </td> <td width=338 colspan=19 valign=top style='width:253.35pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='margin-bottom:0in;margin-bottom:.0001pt; text-align:right;line-height:normal'><span style='font-size:7.5pt;font-family: "Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=407 colspan=20 valign=top style='width:305.5pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>X __________________________________________________________________________ </span></p> </td> </tr> <tr> <td width=407 colspan=20 valign=top style='width:305.5pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt; text-align:center;line-height:normal'><span style='font-size:7.5pt; font-family:"Times","serif"'>Defendant's signature</span></p> </td> </tr> <tr> <td width=407 colspan=20 valign=top style='width:305.5pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=407 colspan=20 valign=top style='width:305.5pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt; text-align:center;line-height:normal'><span style='font-size:7.5pt; font-family:"Times","serif"'>(Signing this form is a promise to appear - not an admission of guilt. Violation of promise to</span></p> </td> </tr> <tr> <td width=407 colspan=20 valign=top style='width:305.5pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='margin-bottom:0in;margin-bottom:.0001pt; text-align:center;line-height:normal'><span style='font-size:7.5pt; font-family:"Times","serif"'>appear is a Class 2 misdemeanor, and a warrant may be issued.)</span></p> </td> </tr> <tr> <td width=108 colspan=4 valign=top style='width:81.0pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> <td width=299 colspan=16 valign=top style='width:224.5pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=108 colspan=4 valign=top style='width:81.0pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>_____Yes _____No</span></p> </td> <td width=299 colspan=16 valign=top style='width:224.5pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>Court appearance required.</span></p> </td> </tr> <tr> <td width=108 colspan=4 valign=top style='width:81.0pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>_____Yes _____No</span></p> </td> <td width=299 colspan=16 valign=top style='width:224.5pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>Power of attorney in lieu of appearance.&nbsp; Amount $______________</span></p> </td> </tr> <tr> <td width=108 colspan=4 valign=top style='width:81.0pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> <td width=299 colspan=16 valign=top style='width:224.5pt;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;line-height: normal'><span style='font-size:7.5pt;font-family:"Times","serif"'>&nbsp;</span></p> </td> </tr> <tr height=0> <td width=70 style='border:none'></td> <td width=12 style='border:none'></td> <td width=2 style='border:none'></td> <td width=24 style='border:none'></td> <td width=49 style='border:none'></td> <td width=10 style='border:none'></td> <td width=15 style='border:none'></td> <td width=11 style='border:none'></td> <td width=1 style='border:none'></td> <td width=1 style='border:none'></td> <td width=11 style='border:none'></td> <td width=12 style='border:none'></td> <td width=24 style='border:none'></td> <td width=1 style='border:none'></td> <td width=25 style='border:none'></td> <td width=12 style='border:none'></td> <td width=12 style='border:none'></td> <td width=25 style='border:none'></td> <td width=37 style='border:none'></td> <td width=51 style='border:none'></td> </tr> </table> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;text-align: justify;line-height:normal'><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>&nbsp;</span></p> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;text-align: justify;line-height:normal'><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <b>Source:</b> 27 SDR 53, effective December 4, 2000; 41 SDR 218, effective July 1, 2015.</span></p> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;text-align: justify;line-height:normal'><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <b>General Authority:</b> SDCL <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=23-1A-2">23-1A-2.</A></span></p> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;text-align: justify;line-height:normal'><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <b>Law Implemented:</b> SDCL <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=23-1A-2">23-1A-2</A>, <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=32-33-2">32-33-2</A>, <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=32-33-2.1">32-33-2.1</A>, <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=32-33-4">32-33-4</A>, <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=23-1A-5">23-1A-5</A>, <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=23A-2-1">23A-2-1.</A></span></p> <p class=MsoNormal style='margin-bottom:0in;margin-bottom:.0001pt;text-align: justify;line-height:normal'><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>&nbsp;</span></p> </div> </body> </html> <br /><hr><br /><html xmlns:o="urn:schemas-microsoft-com:office:office" xmlns:w="urn:schemas-microsoft-com:office:word" xmlns="http://www.w3.org/TR/REC-html40"> <head> <title>Rule 02:03:01:03 Power of attorney form.</title> <META NAME="Keywords" Content="Administrative Rules 02:03:01:03"> <META NAME="Description" Content="Administrative Rules 02:03:01:03 Power of attorney form."> <meta http-equiv=Content-Type content="text/html; charset=windows-1252"> <meta name=ProgId content=Word.Document> <meta name=Generator content="Microsoft Word 10"> <meta name=Originator content="Microsoft Word 10"> <link rel=File-List href="0203010000300D_files/filelist.xml"> <!--[if gte mso 9]><xml> <o:DocumentProperties> <o:Author>lrpr13879</o:Author> <o:LastAuthor>lrpr14296</o:LastAuthor> <o:Revision>2</o:Revision> <o:TotalTime>11</o:TotalTime> <o:LastPrinted>2007-11-30T19:34:00Z</o:LastPrinted> <o:Created>2007-11-30T20:08:00Z</o:Created> <o:LastSaved>2007-11-30T20:08:00Z</o:LastSaved> <o:Pages>2</o:Pages> <o:Words>477</o:Words> <o:Characters>2721</o:Characters> <o:Company>State of South Dakota</o:Company> <o:Lines>22</o:Lines> <o:Paragraphs>6</o:Paragraphs> <o:CharactersWithSpaces>3192</o:CharactersWithSpaces> <o:Version>10.6830</o:Version> </o:DocumentProperties> </xml><![endif]--><!--[if gte mso 9]><xml> <w:WordDocument> <w:GrammarState>Clean</w:GrammarState> <w:DisplayHorizontalDrawingGridEvery>0</w:DisplayHorizontalDrawingGridEvery> <w:DisplayVerticalDrawingGridEvery>0</w:DisplayVerticalDrawingGridEvery> <w:UseMarginsForDrawingGridOrigin/> <w:Compatibility> <w:FootnoteLayoutLikeWW8/> <w:ShapeLayoutLikeWW8/> <w:AlignTablesRowByRow/> <w:ForgetLastTabAlignment/> <w:LayoutRawTableWidth/> <w:LayoutTableRowsApart/> <w:UseWord97LineBreakingRules/> </w:Compatibility> <w:BrowserLevel>MicrosoftInternetExplorer4</w:BrowserLevel> </w:WordDocument> </xml><![endif]--> <style> <!-- /* Font Definitions */ @font-face {font-family:Times; 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mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; border:solid windowtext 1.0pt; mso-border-alt:solid windowtext .5pt; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-border-insideh:.5pt solid windowtext; mso-border-insidev:.5pt solid windowtext; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman";} </style> <![endif]--> </head> <body lang=EN-US style='tab-interval:.5in'> <div class=Section1> <p class=MsoNormal style='text-align:justify;tab-stops:.4in .6in .9in 1.1in 1.4in 1.6in 1.9in 2.1in 2.4in 2.6in 2.9in 3.1in 3.4in 3.6in 3.9in 4.1in'><span style='font-size:12.0pt;mso-bidi-font-size:10.0pt;font-family:"Times New Roman"'><span style='mso-tab-count:1'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span><b style='mso-bidi-font-weight:normal'>2:03:01:03.<span class=GramE>&nbsp;&nbsp;Power</span> of attorney form.</b> The following form, or any other form that substantially complies with it, shall be used for offenses included on the schedule of offenses adopted pursuant to SDCL <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=16-2-21">16-2-21</A> and where a power of attorney option is provided:<o:p></o:p></span></p> <p class=MsoNormal style='text-align:justify;tab-stops:.4in .6in .9in 1.1in 1.4in 1.6in 1.9in 2.1in 2.4in 2.6in 2.9in 3.1in 3.4in 3.6in 3.9in 4.1in'><span style='font-size:12.0pt;mso-bidi-font-size:10.0pt;font-family:"Times New Roman"'><o:p>&nbsp;</o:p></span></p> <table class=MsoTableGrid border=1 cellspacing=0 cellpadding=0 style='border-collapse:collapse;border:none;mso-border-alt:solid windowtext .5pt; mso-yfti-tbllook:480;mso-padding-alt:0in 5.4pt 0in 5.4pt;mso-border-insideh: .5pt solid windowtext;mso-border-insidev:.5pt solid windowtext'> <tr style='mso-yfti-irow:0'> <td width=415 colspan=18 valign=top style='width:311.4pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='text-align:center'><b style='mso-bidi-font-weight:normal'><span style='font-size:9.0pt'>POWER OF ATTORNEY<o:p></o:p></span></b></p> </td> </tr> <tr style='mso-yfti-irow:0'> <td width=415 colspan=18 valign=top style='width:311.4pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span style='font-size:8.0pt'><o:p>&nbsp;</o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:0'> <td width=415 colspan=18 valign=top style='width:311.4pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span style='font-size:7.5pt'>PCN ______________<o:p></o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:0'> <td width=415 colspan=18 valign=top style='width:311.4pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span style='font-size:7.5pt'><o:p>&nbsp;</o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:0'> <td width=195 colspan=7 valign=top style='width:146.45pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span style='font-size:7.5pt'>State of South Dakota<o:p></o:p></span></p> </td> <td width=220 colspan=11 valign=top style='width:164.95pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='text-align:right'><span style='font-size:7.5pt'>In Circuit Court<o:p></o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:0'> <td width=195 colspan=7 valign=top style='width:146.45pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span style='font-size:7.5pt'><o:p>&nbsp;</o:p></span></p> </td> <td width=220 colspan=11 valign=top style='width:164.95pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='text-align:right'><span style='font-size:7.5pt'>Magistrate Division<o:p></o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:0'> <td width=195 colspan=7 valign=top style='width:146.45pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span style='font-size:7.5pt'>County of_______________<o:p></o:p></span></p> </td> <td width=220 colspan=11 valign=top style='width:164.95pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='text-align:right'><span style='font-size:7.5pt'>____________Judicial Court<o:p></o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:0'> <td width=195 colspan=7 valign=top style='width:146.45pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span style='font-size:7.5pt'><o:p>&nbsp;</o:p></span></p> </td> <td width=220 colspan=11 valign=top style='width:164.95pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span style='font-size:7.5pt'><o:p>&nbsp;</o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:0'> <td width=195 colspan=7 valign=top style='width:146.45pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span style='font-size:7.5pt'>State of South Dakota (Plaintiff)<o:p></o:p></span></p> </td> <td width=220 colspan=11 valign=top style='width:164.95pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span style='font-size:7.5pt'><o:p>&nbsp;</o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:0'> <td width=195 colspan=7 valign=top style='width:146.45pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span style='font-size:7.5pt'><o:p>&nbsp;</o:p></span></p> </td> <td width=220 colspan=11 valign=top style='width:164.95pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span style='font-size:7.5pt'><o:p>&nbsp;</o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:0'> <td width=195 colspan=7 valign=top style='width:146.45pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span style='font-size:7.5pt'>Vs<o:p></o:p></span></p> </td> <td width=220 colspan=11 valign=top style='width:164.95pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span style='font-size:7.5pt'><o:p>&nbsp;</o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:0'> <td width=195 colspan=7 valign=top style='width:146.45pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span style='font-size:7.5pt'><o:p>&nbsp;</o:p></span></p> </td> <td width=220 colspan=11 valign=top style='width:164.95pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span style='font-size:7.5pt'><o:p>&nbsp;</o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:0'> <td width=195 colspan=7 valign=top style='width:146.45pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span style='font-size:7.5pt'>___________________________________<o:p></o:p></span></p> <p class=MsoNormal align=center style='text-align:center'><span style='font-size:7.5pt'>(Defendant)<o:p></o:p></span></p> </td> <td width=220 colspan=11 valign=top style='width:164.95pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='text-align:right'><span style='font-size:7.5pt'>No. _____________HP<o:p></o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:0'> <td width=415 colspan=18 valign=top style='width:311.4pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span style='font-size:7.5pt'><o:p>&nbsp;</o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:0'> <td width=415 colspan=18 valign=top style='width:311.4pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span style='font-size:7.5pt'>THE UNDERSIGNED PEACE OFFICER COMPLAINS AND STATES THAT<o:p></o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:0'> <td width=108 colspan=3 valign=top style='width:81.0pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span style='font-size:7.5pt'>ON OR ABOUT<o:p></o:p></span></p> </td> <td width=211 colspan=13 valign=top style='width:158.15pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span style='font-size:7.5pt'>AT OR NEAR (LOCATION/MILE POST)<o:p></o:p></span></p> </td> <td width=96 colspan=2 valign=top style='width:72.25pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='text-align:right'><span style='font-size:7.5pt'>AT TIME<o:p></o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:0'> <td width=319 colspan=16 valign=top style='width:239.15pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span style='font-size:7.5pt'><o:p>&nbsp;</o:p></span></p> </td> <td width=96 colspan=2 valign=top style='width:72.25pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='text-align:right'><span style='font-size:7.5pt'>A.M.<o:p></o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:0'> <td width=319 colspan=16 valign=top style='width:239.15pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span style='font-size:7.5pt'><o:p>&nbsp;</o:p></span></p> </td> <td width=96 colspan=2 valign=top style='width:72.25pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='text-align:right'><span style='font-size:7.5pt'>P.M.<o:p></o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:0'> <td width=108 colspan=3 valign=top style='width:81.0pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span style='font-size:7.5pt'>_________________<o:p></o:p></span></p> </td> <td width=211 colspan=13 valign=top style='width:158.15pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span style='font-size:7.5pt'>____________________________________<o:p></o:p></span></p> </td> <td width=96 colspan=2 valign=top style='width:72.25pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='text-align:right'><span style='font-size:7.5pt'>________<o:p></o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:0'> <td width=319 colspan=16 valign=top style='width:239.15pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span style='font-size:7.5pt'><o:p>&nbsp;</o:p></span></p> </td> <td width=96 colspan=2 valign=top style='width:72.25pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='text-align:right'><span style='font-size:7.5pt'><o:p>&nbsp;</o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:0'> <td width=415 colspan=18 valign=top style='width:311.4pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='text-align:center'><span style='font-size:7.5pt'>WITHIN THE COUNTY AND STATE AFORESAID<o:p></o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:0'> <td width=415 colspan=18 valign=top style='width:311.4pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='text-align:right'><span style='font-size:7.5pt'><o:p>&nbsp;</o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:0'> <td width=167 colspan=5 valign=top style='width:125.05pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span style='font-size:7.5pt'>NAME<o:p></o:p></span></p> </td> <td width=152 colspan=11 valign=top style='width:114.1pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='text-align:center'><span style='font-size:7.5pt'>HEIGHT<o:p></o:p></span></p> </td> <td width=96 colspan=2 valign=top style='width:72.25pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='text-align:right'><span style='font-size:7.5pt'>SEX<o:p></o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:0'> <td width=167 colspan=5 valign=top style='width:125.05pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span style='font-size:7.5pt'>_____________________________<o:p></o:p></span></p> </td> <td width=152 colspan=11 valign=top style='width:114.1pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='text-align:center'><span style='font-size:7.5pt'>________<o:p></o:p></span></p> </td> <td width=96 colspan=2 valign=top style='width:72.25pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='text-align:right'><span style='font-size:7.5pt'>_____<o:p></o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:0'> <td width=167 colspan=5 valign=top style='width:125.05pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span style='font-size:7.5pt'><o:p>&nbsp;</o:p></span></p> </td> <td width=152 colspan=11 valign=top style='width:114.1pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='text-align:center'><span style='font-size:7.5pt'><o:p>&nbsp;</o:p></span></p> </td> <td width=96 colspan=2 valign=top style='width:72.25pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='text-align:right'><span style='font-size:7.5pt'><o:p>&nbsp;</o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:0'> <td width=167 colspan=5 valign=top style='width:125.05pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span style='font-size:7.5pt'>ADDRESS<o:p></o:p></span></p> </td> <td width=152 colspan=11 valign=top style='width:114.1pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='text-align:center'><span style='font-size:7.5pt'>WEIGHT<o:p></o:p></span></p> </td> <td width=96 colspan=2 valign=top style='width:72.25pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='text-align:right'><span style='font-size:7.5pt'><o:p>&nbsp;</o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:0'> <td width=167 colspan=5 valign=top style='width:125.05pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span style='font-size:7.5pt'>_____________________________<o:p></o:p></span></p> </td> <td width=152 colspan=11 valign=top style='width:114.1pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='text-align:center'><span style='font-size:7.5pt'>________<o:p></o:p></span></p> </td> <td width=96 colspan=2 valign=top style='width:72.25pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='text-align:right'><span style='font-size:7.5pt'><o:p>&nbsp;</o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:0'> <td width=167 colspan=5 valign=top style='width:125.05pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span style='font-size:7.5pt'><o:p>&nbsp;</o:p></span></p> </td> <td width=152 colspan=11 valign=top style='width:114.1pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='text-align:center'><span style='font-size:7.5pt'><o:p>&nbsp;</o:p></span></p> </td> <td width=96 colspan=2 valign=top style='width:72.25pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='text-align:right'><span style='font-size:7.5pt'><o:p>&nbsp;</o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:0'> <td width=167 colspan=5 valign=top style='width:125.05pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span style='font-size:7.5pt'>CITY<o:p></o:p></span></p> </td> <td width=152 colspan=11 valign=top style='width:114.1pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='text-align:center'><span style='font-size:7.5pt'>STATE<o:p></o:p></span></p> </td> <td width=96 colspan=2 valign=top style='width:72.25pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='text-align:right'><span style='font-size:7.5pt'>BIRTH DATE<o:p></o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:0'> <td width=167 colspan=5 valign=top style='width:125.05pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span style='font-size:7.5pt'>_____________________________<o:p></o:p></span></p> </td> <td width=152 colspan=11 valign=top style='width:114.1pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='text-align:center'><span style='font-size:7.5pt'>________<o:p></o:p></span></p> </td> <td width=96 colspan=2 valign=top style='width:72.25pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='text-align:right'><span style='font-size:7.5pt'>____________<o:p></o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:0'> <td width=167 colspan=5 valign=top style='width:125.05pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span style='font-size:7.5pt'><o:p>&nbsp;</o:p></span></p> </td> <td width=152 colspan=11 valign=top style='width:114.1pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='text-align:center'><span style='font-size:7.5pt'><o:p>&nbsp;</o:p></span></p> </td> <td width=96 colspan=2 valign=top style='width:72.25pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='text-align:right'><span style='font-size:7.5pt'><o:p>&nbsp;</o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:0'> <td width=167 colspan=5 valign=top style='width:125.05pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span style='font-size:7.5pt'>DRIVER'S LICENSE NO.<o:p></o:p></span></p> </td> <td width=152 colspan=11 valign=top style='width:114.1pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='text-align:center'><span style='font-size:7.5pt'>STATE<o:p></o:p></span></p> </td> <td width=96 colspan=2 valign=top style='width:72.25pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='text-align:right'><span style='font-size:7.5pt'><o:p>&nbsp;</o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:0'> <td width=167 colspan=5 valign=top style='width:125.05pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span style='font-size:7.5pt'>_____________________________<o:p></o:p></span></p> </td> <td width=152 colspan=11 valign=top style='width:114.1pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='text-align:center'><span style='font-size:7.5pt'>________<o:p></o:p></span></p> </td> <td width=96 colspan=2 valign=top style='width:72.25pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='text-align:right'><span style='font-size:7.5pt'><o:p>&nbsp;</o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:0'> <td width=167 colspan=5 valign=top style='width:125.05pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span style='font-size:7.5pt'><o:p>&nbsp;</o:p></span></p> </td> <td width=152 colspan=11 valign=top style='width:114.1pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span style='font-size:7.5pt'><o:p>&nbsp;</o:p></span></p> </td> <td width=96 colspan=2 valign=top style='width:72.25pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='text-align:right'><span style='font-size:7.5pt'><o:p>&nbsp;</o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:0'> <td width=84 colspan=2 valign=top style='width:62.9pt;border:none;padding: 0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='text-align:center'><span style='font-size:7.5pt'>DID UNLAWFULLY<o:p></o:p></span></p> </td> <td width=83 colspan=3 valign=top style='width:62.15pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='text-align:center'><span style='font-size:7.5pt'>OPERATE<o:p></o:p></span></p> <p class=MsoNormal align=center style='text-align:center'><span style='font-size:7.5pt'>_________<o:p></o:p></span></p> </td> <td width=52 colspan=5 valign=top style='width:39.3pt;border:none;padding: 0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='text-align:center'><span style='font-size:7.5pt'>PARK<o:p></o:p></span></p> <p class=MsoNormal align=center style='text-align:center'><span style='font-size:7.5pt'>______<o:p></o:p></span></p> </td> <td width=100 colspan=6 valign=top style='width:74.8pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='text-align:center'><span style='font-size:7.5pt'>VEHICLE MAKE<o:p></o:p></span></p> <p class=MsoNormal align=center style='text-align:center'><span style='font-size:7.5pt'>_______________<o:p></o:p></span></p> </td> <td width=96 colspan=2 valign=top style='width:72.25pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='text-align:right'><span style='font-size:7.5pt'>BODY STYLE<o:p></o:p></span></p> <p class=MsoNormal align=right style='text-align:right'><span style='font-size:7.5pt'>_____________<o:p></o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:0'> <td width=167 colspan=5 valign=top style='width:125.05pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span style='font-size:7.5pt'><o:p>&nbsp;</o:p></span></p> </td> <td width=152 colspan=11 valign=top style='width:114.1pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span style='font-size:7.5pt'><o:p>&nbsp;</o:p></span></p> </td> <td width=96 colspan=2 valign=top style='width:72.25pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='text-align:right'><span style='font-size:7.5pt'><o:p>&nbsp;</o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:0'> <td width=167 colspan=5 valign=top style='width:125.05pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span style='font-size:7.5pt'>STATE LICENSE NO.<o:p></o:p></span></p> </td> <td width=77 colspan=7 valign=top style='width:58.0pt;border:none;padding: 0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='text-align:center'><span style='font-size:7.5pt'>YEAR<o:p></o:p></span></p> </td> <td width=75 colspan=4 valign=top style='width:56.1pt;border:none;padding: 0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='text-align:center'><span style='font-size:7.5pt'>STATE<o:p></o:p></span></p> </td> <td width=96 colspan=2 valign=top style='width:72.25pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='text-align:right'><span style='font-size:7.5pt'>FR______Y<o:p></o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:0'> <td width=167 colspan=5 valign=top style='width:125.05pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span style='font-size:7.5pt'>_____________________________<o:p></o:p></span></p> </td> <td width=76 colspan=6 valign=top style='width:57.05pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='text-align:center'><span style='font-size:7.5pt'>______<o:p></o:p></span></p> </td> <td width=76 colspan=5 valign=top style='width:57.05pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='text-align:center'><span style='font-size:7.5pt'>_______<o:p></o:p></span></p> </td> <td width=96 colspan=2 valign=top style='width:72.25pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='text-align:right'><span style='font-size:7.5pt'>______N<o:p></o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:0'> <td width=167 colspan=5 valign=top style='width:125.05pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span style='font-size:7.5pt'><o:p>&nbsp;</o:p></span></p> </td> <td width=152 colspan=11 valign=top style='width:114.1pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span style='font-size:7.5pt'><o:p>&nbsp;</o:p></span></p> </td> <td width=96 colspan=2 valign=top style='width:72.25pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='text-align:right'><span style='font-size:7.5pt'><o:p>&nbsp;</o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:0'> <td width=415 colspan=18 valign=top style='width:311.4pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span style='font-size:7.5pt'>AND THEN AND THERE COMMIT THE FOLLOWING OFFENSE TO WIT:<o:p></o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:0'> <td width=194 colspan=6 valign=top style='width:145.65pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='text-align:center'><span style='font-size:7.5pt'>PETTY OFF _____<o:p></o:p></span></p> </td> <td width=75 colspan=7 valign=top style='width:56.1pt;border:none;padding: 0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span style='font-size:7.5pt'>MIS ______<o:p></o:p></span></p> </td> <td width=146 colspan=5 valign=top style='width:109.65pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='text-align:right'><span style='font-size:7.5pt'><o:p>&nbsp;</o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:0'> <td width=269 colspan=13 valign=top style='width:201.75pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span style='font-size:7.5pt'><o:p>&nbsp;</o:p></span></p> </td> <td width=146 colspan=5 valign=top style='width:109.65pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='text-align:right'><span style='font-size:7.5pt'><o:p>&nbsp;</o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:0'> <td width=269 colspan=13 valign=top style='width:201.75pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span style='font-size:7.5pt'>DESCRIBE VIOLATION:<o:p></o:p></span></p> </td> <td width=146 colspan=5 valign=top style='width:109.65pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='text-align:right'><span style='font-size:7.5pt'><o:p>&nbsp;</o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:0'> <td width=269 colspan=13 valign=top style='width:201.75pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span style='font-size:7.5pt'><o:p>&nbsp;</o:p></span></p> </td> <td width=146 colspan=5 valign=top style='width:109.65pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='text-align:right'><span style='font-size:7.5pt'><o:p>&nbsp;</o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:0'> <td width=269 colspan=13 valign=top style='width:201.75pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span style='font-size:7.5pt'>_________________________________________________<o:p></o:p></span></p> </td> <td width=146 colspan=5 valign=top style='width:109.65pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='text-align:right'><span style='font-size:7.5pt'>CDL ____Y____N<o:p></o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:0'> <td width=269 colspan=13 valign=top style='width:201.75pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span style='font-size:7.5pt'><o:p>&nbsp;</o:p></span></p> </td> <td width=146 colspan=5 valign=top style='width:109.65pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='text-align:right'><span style='font-size:7.5pt'>C Veh.____Y____N____E<o:p></o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:0'> <td width=269 colspan=13 valign=top style='width:201.75pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span style='font-size:7.5pt'>_________________________________________________<o:p></o:p></span></p> </td> <td width=146 colspan=5 valign=top style='width:109.65pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='text-align:right'><span style='font-size:7.5pt'>Haz. Materials ____Y____N<o:p></o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:0'> <td width=269 colspan=13 valign=top style='width:201.75pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span style='font-size:7.5pt'><o:p>&nbsp;</o:p></span></p> </td> <td width=146 colspan=5 valign=top style='width:109.65pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='text-align:right'><span style='font-size:7.5pt'><o:p>&nbsp;</o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:0'> <td width=415 colspan=18 valign=top style='width:311.4pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span style='font-size:7.5pt'>in violation of SDCL_________________________________<o:p></o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:0'> <td width=194 colspan=6 valign=top style='width:145.65pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span style='font-size:7.5pt'><o:p>&nbsp;</o:p></span></p> </td> <td width=221 colspan=12 valign=top style='width:165.75pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='text-align:right'><span style='font-size:7.5pt'><o:p>&nbsp;</o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:0'> <td width=82 valign=top style='width:61.5pt;border:none;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span style='font-size:7.5pt'><o:p>&nbsp;</o:p></span></p> </td> <td width=112 colspan=5 valign=top style='width:84.15pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span style='font-size:7.5pt'>_____Municipal<o:p></o:p></span></p> </td> <td width=221 colspan=12 valign=top style='width:165.75pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='text-align:right'><span style='font-size:7.5pt'><o:p>&nbsp;</o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:0'> <td width=82 valign=top style='width:61.5pt;border:none;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span style='font-size:7.5pt'>SPEEDING<o:p></o:p></span></p> </td> <td width=112 colspan=5 valign=top style='width:84.15pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span style='font-size:7.5pt'>_____Interstate<o:p></o:p></span></p> </td> <td width=221 colspan=12 valign=top style='width:165.75pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='text-align:right'><span style='font-size:7.5pt'><o:p>&nbsp;</o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:0'> <td width=82 valign=top style='width:61.5pt;border:none;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span style='font-size:7.5pt'><o:p>&nbsp;</o:p></span></p> </td> <td width=112 colspan=5 valign=top style='width:84.15pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span style='font-size:7.5pt'>_____Other<o:p></o:p></span></p> </td> <td width=87 colspan=8 valign=top style='width:65.45pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span style='font-size:7.5pt'>______M.P.H. IN<o:p></o:p></span></p> </td> <td width=134 colspan=4 valign=top style='width:100.3pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span style='font-size:7.5pt'>______M.P.H. ZONE<o:p></o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:0'> <td width=415 colspan=18 valign=top style='width:311.4pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='text-align:right'><span style='font-size:7.5pt'><o:p>&nbsp;</o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:0'> <td width=157 colspan=4 valign=top style='width:117.6pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span style='font-size:7.5pt'>OFFICER ISSUING SUMMONS<o:p></o:p></span></p> </td> <td width=50 colspan=5 valign=top style='width:37.4pt;border:none;padding: 0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span style='font-size:7.5pt'>NO.<o:p></o:p></span></p> </td> <td width=87 colspan=6 valign=top style='width:65.45pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span style='font-size:7.5pt'>CITY<o:p></o:p></span></p> </td> <td width=62 colspan=2 valign=top style='width:46.75pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span style='font-size:7.5pt'>COUNTY<o:p></o:p></span></p> </td> <td width=59 valign=top style='width:44.2pt;border:none;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='text-align:right'><span style='font-size:7.5pt'>STATE<o:p></o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:0'> <td width=157 colspan=4 valign=top style='width:117.6pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span style='font-size:7.5pt'>___________________________<o:p></o:p></span></p> </td> <td width=50 colspan=5 valign=top style='width:37.4pt;border:none;padding: 0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span style='font-size:7.5pt'>_____<o:p></o:p></span></p> </td> <td width=87 colspan=6 valign=top style='width:65.45pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span style='font-size:7.5pt'>______________<o:p></o:p></span></p> </td> <td width=62 colspan=2 valign=top style='width:46.75pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span style='font-size:7.5pt'>_________<o:p></o:p></span></p> </td> <td width=59 valign=top style='width:44.2pt;border:none;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='text-align:right'><span style='font-size:7.5pt'>_______<o:p></o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:0'> <td width=415 colspan=18 valign=top style='width:311.4pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='text-align:right'><span style='font-size:7.5pt'><o:p>&nbsp;</o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:0'> <td width=415 colspan=18 valign=top style='width:311.4pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='text-align:center'><b style='mso-bidi-font-weight:normal'><span style='font-size:9.0pt'>POWER OF ATTORNEY<o:p></o:p></span></b></p> </td> </tr> <tr style='mso-yfti-irow:0'> <td width=415 colspan=18 valign=top style='width:311.4pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span style='font-size:7.5pt'><o:p>&nbsp;</o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:0'> <td width=415 colspan=18 valign=top style='width:311.4pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span style='font-size:7.5pt'>____________________________________<span style='mso-spacerun:yes'>&nbsp;&nbsp; </span>I<span style='mso-spacerun:yes'>&nbsp; </span>hereby<span style='mso-spacerun:yes'>&nbsp; </span>deposit<span style='mso-spacerun:yes'>&nbsp; </span>with<span style='mso-spacerun:yes'>&nbsp; </span>the<span style='mso-spacerun:yes'>&nbsp; </span>Clerk<span style='mso-spacerun:yes'>&nbsp; </span>of<span style='mso-spacerun:yes'>&nbsp; </span>Courts<span style='mso-spacerun:yes'>&nbsp; </span>of<o:p></o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:0'> <td width=415 colspan=18 valign=top style='width:311.4pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span style='font-size:7.5pt'>__________________________<span style='mso-spacerun:yes'>&nbsp; </span>County, South Dakota, as a cash appearance bond, the sum of<o:p></o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:0'> <td width=415 colspan=18 valign=top style='width:311.4pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span style='font-size:7.5pt'>$ ________________________ and understand that my initial appearance will be located in the<o:p></o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:0'> <td width=415 colspan=18 valign=top style='width:311.4pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span class=GramE><span style='font-size:7.5pt'>city</span></span><span style='font-size:7.5pt'> of ____________________________________.<o:p></o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:0'> <td width=415 colspan=18 valign=top style='width:311.4pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='text-align:right'><span style='font-size:7.5pt'>a m.<o:p></o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:0'> <td width=415 colspan=18 valign=top style='width:311.4pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span style='font-size:7.5pt'>on _____________________________________ at ________________________________ p.m.<o:p></o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:0'> <td width=415 colspan=18 valign=top style='width:311.4pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span style='font-size:7.5pt'>If I desire to contest this matter, I will appear at the date, time, and place for my initial appearance<o:p></o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:0'> <td width=415 colspan=18 valign=top style='width:311.4pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span style='font-size:7.5pt'>or<span style='mso-spacerun:yes'>&nbsp; </span>contact the<span style='mso-spacerun:yes'>&nbsp; </span>clerk<span style='mso-spacerun:yes'>&nbsp; </span>of<span style='mso-spacerun:yes'>&nbsp; </span>courts before<span style='mso-spacerun:yes'>&nbsp; </span>that date<span style='mso-spacerun:yes'>&nbsp; </span>and ask the<span style='mso-spacerun:yes'>&nbsp; </span>clerk to<span style='mso-spacerun:yes'>&nbsp; </span>reschedule<span style='mso-spacerun:yes'>&nbsp; </span>the date for my<o:p></o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:0'> <td width=415 colspan=18 valign=top style='width:311.4pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span class=GramE><span style='font-size:7.5pt'>initial</span></span><span style='font-size:7.5pt'> appearance.<span style='mso-spacerun:yes'>&nbsp; </span>If I do not appear or contact the clerk of courts within the time period, (or if<o:p></o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:0'> <td width=415 colspan=18 valign=top style='width:311.4pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span style='font-size:7.5pt'>after the court date is set, I<span style='mso-spacerun:yes'>&nbsp; </span>fail to appear,)<span style='mso-spacerun:yes'>&nbsp; </span>I hereby plead guilty to the charge, and direct the clerk<o:p></o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:0'> <td width=415 colspan=18 valign=top style='width:311.4pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span style='font-size:7.5pt'>to apply the money<span style='mso-spacerun:yes'>&nbsp; </span>deposited as bond<span style='mso-spacerun:yes'>&nbsp; </span>herewith<span style='mso-spacerun:yes'>&nbsp; </span>to the<span style='mso-spacerun:yes'>&nbsp; </span>payment<span style='mso-spacerun:yes'>&nbsp; </span>of<span style='mso-spacerun:yes'>&nbsp; </span>the fine<span style='mso-spacerun:yes'>&nbsp; </span>and costs assessed<o:p></o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:0'> <td width=415 colspan=18 valign=top style='width:311.4pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span class=GramE><span style='font-size:7.5pt'>against</span></span><span style='font-size:7.5pt'> me.<o:p></o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:0'> <td width=415 colspan=18 valign=top style='width:311.4pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span style='font-size:7.5pt'><o:p>&nbsp;</o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:0'> <td width=415 colspan=18 valign=top style='width:311.4pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span style='font-size:7.5pt'>__________________ Cash taken by Officer - Officer signed<o:p></o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:0'> <td width=415 colspan=18 valign=top style='width:311.4pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span style='font-size:7.5pt'>I have read this document and have been given a copy.<o:p></o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:0'> <td width=415 colspan=18 valign=top style='width:311.4pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span style='font-size:7.5pt'><o:p>&nbsp;</o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:0'> <td width=415 colspan=18 valign=top style='width:311.4pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span style='font-size:7.5pt'>Signed<o:p></o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:0'> <td width=415 colspan=18 valign=top style='width:311.4pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span style='font-size:7.5pt'>____________________________________________________________________________<o:p></o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:0'> <td width=204 colspan=8 valign=top style='width:152.75pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='text-align:center'><span style='font-size:7.5pt'>Defendant<o:p></o:p></span></p> </td> <td width=212 colspan=10 valign=top style='width:158.65pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='text-align:center'><span style='font-size:7.5pt'>Date<o:p></o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:0'> <td width=415 colspan=18 valign=top style='width:311.4pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span style='font-size:7.5pt'><o:p>&nbsp;</o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:0;mso-yfti-lastrow:yes'> <td width=415 colspan=18 valign=top style='width:311.4pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span style='font-size:7.0pt'>THE SIGNED COPY MUST BE ENCLOSED WITH MONEY IN THE ENVELOPE <span style='mso-spacerun:yes'>&nbsp;</span>PROVIDED<o:p></o:p></span></p> </td> </tr> <![if !supportMisalignedColumns]> <tr height=0> <td width=82 style='border:none'></td> <td width=2 style='border:none'></td> <td width=24 style='border:none'></td> <td width=49 style='border:none'></td> <td width=10 style='border:none'></td> <td width=27 style='border:none'></td> <td width=1 style='border:none'></td> <td width=8 style='border:none'></td> <td width=3 style='border:none'></td> <td width=12 style='border:none'></td> <td width=24 style='border:none'></td> <td width=1 style='border:none'></td> <td width=25 style='border:none'></td> <td width=12 style='border:none'></td> <td width=12 style='border:none'></td> <td width=25 style='border:none'></td> <td width=37 style='border:none'></td> <td width=59 style='border:none'></td> </tr> <![endif]> </table> <p class=MsoNormal style='margin-right:206.65pt;text-align:justify;tab-stops: .4in .6in .9in 1.1in 1.4in 1.6in 1.9in 2.1in 2.4in 2.6in 2.9in 3.1in 3.4in 3.6in 3.9in 4.1in'><span style='font-size:12.0pt;mso-bidi-font-size:10.0pt;font-family:"Times New Roman"'><o:p>&nbsp;</o:p></span></p> <p class=MsoNormal style='text-align:justify;tab-stops:.4in .6in .9in 1.1in 1.4in 1.6in 1.9in 2.1in 2.4in 2.6in 2.9in 3.1in 3.4in 3.6in 3.9in 4.1in'><span style='font-size:12.0pt;mso-bidi-font-size:10.0pt;font-family:"Times New Roman"'><span style='mso-tab-count:1'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span><b style='mso-bidi-font-weight:normal'>Source:</b> 27 SDR 53, effective December 4, 2000.<o:p></o:p></span></p> <p class=MsoNormal style='text-align:justify;tab-stops:.4in .6in .9in 1.1in 1.4in 1.6in 1.9in 2.1in 2.4in 2.6in 2.9in 3.1in 3.4in 3.6in 3.9in 4.1in'><span style='font-size:12.0pt;mso-bidi-font-size:10.0pt;font-family:"Times New Roman"'><span style='mso-tab-count:1'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span><b style='mso-bidi-font-weight:normal'>General Authority:</b> SDCL <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=23-1A-2">23-1A-2.</A><o:p></o:p></span></p> <p class=MsoNormal style='text-align:justify;tab-stops:.4in .6in .9in 1.1in 1.4in 1.6in 1.9in 2.1in 2.4in 2.6in 2.9in 3.1in 3.4in 3.6in 3.9in 4.1in'><span style='font-size:12.0pt;mso-bidi-font-size:10.0pt;font-family:"Times New Roman"'><span style='mso-tab-count:1'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span><b style='mso-bidi-font-weight:normal'>Law Implemented:</b> SDCL <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=23-1A-2">23-1A-2</A>, <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=32-33-2">32-33-2.</A><o:p></o:p></span></p> <p class=MsoNormal style='text-align:justify;tab-stops:.4in .6in .9in 1.1in 1.4in 1.6in 1.9in 2.1in 2.4in 2.6in 2.9in 3.1in 3.4in 3.6in 3.9in 4.1in'><span style='font-size:12.0pt;mso-bidi-font-size:10.0pt;font-family:"Times New Roman"'><o:p>&nbsp;</o:p></span></p> </div> </body> </html> <br /><hr><br /><html> <head> <title>Rule 02:03:01:04 Designated law enforcement agencies.</title> <META NAME="Keywords" Content="Administrative Rules 02:03:01:04"> <META NAME="Description" Content="Administrative Rules 02:03:01:04 Designated law enforcement agencies."> <meta name=Generator content="Microsoft Office HTML Filter 2.0"> <meta http-equiv=Content-Type content="text/html; charset=windows-1252"> <meta name=Originator content="Microsoft Word 10"> <style> <!-- --> </style> </head> <body lang=EN-US> <div> <p>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <b>2:03:01:04.&nbsp;&nbsp;Designated law enforcement agencies.</b> The Division of Highway Patrol and local government law enforcement agencies shall use the uniform traffic ticket forms that are contained in this chapter or forms in substantial compliance with those forms.</p> <p>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <b>Source:</b> 27 SDR 53, effective December 4, 2000.</p> <p>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <b>General Authority:</b>SDCL <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=23-1A-2">23-1A-2.</A></p> <p>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <b>Law Implemented:</b>SDCL <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=23-1A-2">23-1A-2</A>, <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=32-33-2">32-33-2.</A></p> </div> </body> </html> <br /><hr><br /><html> <head> <title>Rule 02:03:01:05 Forms for juvenile cited violations.</title> <META NAME="Keywords" Content="Administrative Rules 02:03:01:05"> <META NAME="Description" Content="Administrative Rules 02:03:01:05 Forms for juvenile cited violations."> <meta http-equiv=Content-Type content="text/html; charset=windows-1252"> <meta name=Generator content="Microsoft Word 14 (filtered)"> <style> <!-- /* Font Definitions */ @font-face {font-family:Calibri; panose-1:2 15 5 2 2 2 4 3 2 4;} @font-face {font-family:Times; panose-1:2 2 6 3 5 4 5 2 3 4;} /* Style Definitions */ p.MsoNormal, li.MsoNormal, div.MsoNormal {margin:0in; margin-bottom:.0001pt; font-size:10.0pt; font-family:"Times","serif";} @page WordSection1 {size:8.5in 11.0in; margin:49.7pt 1.0in 49.7pt 63.35pt;} div.WordSection1 {page:WordSection1;} --> </style> </head> <body lang=EN-US> <div class=WordSection1> <p class=MsoNormal style='text-align:justify'><a name="_GoBack"></a><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <b>2:03:01:05.&nbsp;&nbsp;Forms for juvenile cited violations.</b> Either Form A or B, or any other form that substantially complies with Form A or B, shall be used as a summons and complaint for juvenile cited violations.</span></p> <p class=MsoNormal style='text-align:justify'><span style='font-size:12.0pt; font-family:"Times New Roman","serif"'>&nbsp;</span></p> <table class=MsoNormalTable border=1 cellspacing=0 cellpadding=0 style='border-collapse:collapse;border:none'> <tr> <td width=325 colspan=2 valign=top style='width:243.7pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='text-align:justify'><span style='font-size:12.0pt; font-family:"Times New Roman","serif"'>(1) <u>Form A</u>:</span></p> </td> <td width=325 colspan=2 valign=top style='width:243.75pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='text-align:justify'><span style='font-size:12.0pt; font-family:"Times New Roman","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=650 colspan=4 valign=top style='width:487.45pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='text-align:center'><b><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>JUVENILE CITATION</span></b></p> <p class=MsoNormal align=center style='text-align:center'><b><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>COMPLAINT-SUMMONS</span></b></p> </td> </tr> <tr> <td width=325 colspan=2 valign=top style='width:243.7pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>State of South Dakota</span></p> </td> <td width=325 colspan=2 valign=top style='width:243.75pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='text-align:right'><span style='font-size:12.5pt;font-family:"Times New Roman","serif"'>In Circuit Court</span></p> </td> </tr> <tr> <td width=325 colspan=2 valign=top style='width:243.7pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>&nbsp;</span></p> </td> <td width=325 colspan=2 valign=top style='width:243.75pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='text-align:right'><span style='font-size:12.5pt;font-family:"Times New Roman","serif"'>Juvenile Division</span></p> </td> </tr> <tr> <td width=325 colspan=2 valign=top style='width:243.7pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span style='font-size:12.5pt;font-family:"Times New Roman","serif"'>County of _________________</span></p> </td> <td width=325 colspan=2 valign=top style='width:243.75pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='text-align:right'><span style='font-size:12.5pt;font-family:"Times New Roman","serif"'>_____ Judicial Circuit</span></p> </td> </tr> <tr> <td width=325 colspan=2 valign=top style='width:243.7pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='text-autospace:none'><span style='font-size:12.5pt; font-family:"Times New Roman","serif"'>State of South Dakota (Plaintiff)</span></p> <p class=MsoNormal style='text-autospace:none'><span style='font-size:12.5pt; font-family:"Times New Roman","serif"'>vs.</span></p> <p class=MsoNormal><span style='font-size:12.5pt;font-family:"Times New Roman","serif"'>___________________________</span></p> <p class=MsoNormal><span style='font-size:12.5pt;font-family:"Times New Roman","serif"'>(Juvenile / Defendant)</span></p> </td> <td width=325 colspan=2 valign=top style='width:243.75pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='text-align:center'><span style='font-size:12.5pt;font-family:"Times New Roman","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=650 colspan=4 valign=top style='width:487.45pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span style='font-size:12.5pt;font-family:"Times New Roman","serif"'>THE UNDERSIGNED PEACE OFFICER COMPLAINS AND STATES THAT</span></p> </td> </tr> <tr> <td width=217 valign=top style='width:162.45pt;border:none;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span style='font-size:12.5pt;font-family:"Times New Roman","serif"'>ON OR ABOUT</span></p> </td> <td width=217 colspan=2 valign=top style='width:162.5pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span style='font-size:12.5pt;font-family:"Times New Roman","serif"'>AT OR NEAR</span></p> </td> <td width=217 valign=top style='width:162.5pt;border:none;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='text-align:right'><span style='font-size:12.5pt;font-family:"Times New Roman","serif"'>AT TIME</span></p> </td> </tr> <tr> <td width=217 valign=top style='width:162.45pt;border:none;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span style='font-size:12.5pt;font-family:"Times New Roman","serif"'>&nbsp;</span></p> </td> <td width=217 colspan=2 valign=top style='width:162.5pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span style='font-size:12.5pt;font-family:"Times New Roman","serif"'>&nbsp;</span></p> </td> <td width=217 valign=top style='width:162.5pt;border:none;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='text-align:right'><span style='font-size:12.5pt;font-family:"Times New Roman","serif"'>A.M.</span></p> </td> </tr> <tr> <td width=217 valign=top style='width:162.45pt;border:none;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span style='font-size:12.5pt;font-family:"Times New Roman","serif"'>_____________________</span></p> </td> <td width=217 colspan=2 valign=top style='width:162.5pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span style='font-size:12.5pt;font-family:"Times New Roman","serif"'>______________________</span></p> </td> <td width=217 valign=top style='width:162.5pt;border:none;padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='text-align:right'><span style='font-size:12.5pt;font-family:"Times New Roman","serif"'>__________P.M.</span></p> </td> </tr> <tr> <td width=650 colspan=4 valign=top style='width:487.45pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span style='font-size:12.5pt;font-family:"Times New Roman","serif"'>WITHIN THE COUNTY AND STATE LISTED ABOVE</span></p> </td> </tr> <tr> <td width=325 colspan=2 valign=top style='width:243.7pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span style='font-size:12.5pt;font-family:"Times New Roman","serif"'>NAME</span></p> </td> <td width=325 colspan=2 valign=top style='width:243.75pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='text-align:right'><span style='font-size:12.5pt;font-family:"Times New Roman","serif"'>DATE OF BIRTH</span></p> </td> </tr> <tr> <td width=325 colspan=2 valign=top style='width:243.7pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span style='font-size:12.5pt;font-family:"Times New Roman","serif"'>_____________________________________</span></p> </td> <td width=325 colspan=2 valign=top style='width:243.75pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='text-align:right'><span style='font-size:12.5pt;font-family:"Times New Roman","serif"'>______________________</span></p> </td> </tr> <tr> <td width=325 colspan=2 valign=top style='width:243.7pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span style='font-size:12.5pt;font-family:"Times New Roman","serif"'>ADDRESS</span></p> </td> <td width=325 colspan=2 valign=top style='width:243.75pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='text-align:right'><span style='font-size:12.5pt;font-family:"Times New Roman","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=650 colspan=4 valign=top style='width:487.45pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span style='font-size:12.5pt;font-family:"Times New Roman","serif"'>______________________________________</span></p> </td> </tr> <tr> <td width=650 colspan=4 valign=top style='width:487.45pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span style='font-size:12.5pt;font-family:"Times New Roman","serif"'>______________________________________</span></p> </td> </tr> <tr> <td width=650 colspan=4 valign=top style='width:487.45pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span style='font-size:12.5pt;font-family:"Times New Roman","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=650 colspan=4 valign=top style='width:487.45pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span style='font-size:12.5pt;font-family:"Times New Roman","serif"'>DID THEN AND THERE COMMIT THE FOLLOWING OFFENSE(S)</span></p> </td> </tr> <tr> <td width=650 colspan=4 valign=top style='width:487.45pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='text-autospace:none'><span style='font-size:12.5pt; font-family:"Times New Roman","serif"'>_____&nbsp; Second Degree Petty Theft ($400 or less), in violation of SDCL 22-30A-</span><span style='font-size:12.0pt; font-family:"Times New Roman","serif"'>17.3</span></p> </td> </tr> <tr> <td width=650 colspan=4 valign=top style='width:487.45pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='text-autospace:none'><span style='font-size:12.5pt; font-family:"Times New Roman","serif"'>_____ Intentional Damage to Property ($400 or less), in violation of SDCL 22-</span><span style='font-size:12.0pt; font-family:"Times New Roman","serif"'>34-1</span></p> </td> </tr> <tr> <td width=650 colspan=4 valign=top style='width:487.45pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='text-autospace:none'><span style='font-size:12.5pt; font-family:"Times New Roman","serif"'>_____ Purchase, Possession, or Consumption (_____ PBT) of Alcoholic Beverage by Person</span></p> <p class=MsoNormal style='text-autospace:none'><span style='font-size:12.5pt; font-family:"Times New Roman","serif"'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; under 18, in violation of SDCL <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=35-9-2">35-9-2</A></span></p> </td> </tr> <tr> <td width=650 colspan=4 valign=top style='width:487.45pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='text-autospace:none'><span style='font-size:12.5pt; font-family:"Times New Roman","serif"'>_____ Habitual Absence from School by Child of Compulsory School Age, in violation of</span></p> <p class=MsoNormal style='text-autospace:none'><span style='font-size:12.5pt; font-family:"Times New Roman","serif"'>&nbsp;&nbsp; &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;SDCL <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=26-8B-2">26-8B-2(1)</A></span></p> </td> </tr> <tr> <td width=650 colspan=4 valign=top style='width:487.45pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='text-align:justify;text-autospace:none'><span style='font-size:12.5pt;font-family:"Times New Roman","serif"'>I DECLARE AND AFFIRM UNDER THE PENALTIES OF PERJURY THAT THIS COMPLAINT/SUMMONS HAS BEEN EXAMINED BY ME, AND TO THE BEST OF MY KNOWLEDGE AND BELIEF, IS IN ALL THINGS TRUE AND CORRECT.</span></p> </td> </tr> <tr> <td width=325 colspan=2 valign=top style='width:243.7pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='text-autospace:none'><span style='font-size:12.5pt; font-family:"Times New Roman","serif"'>____________________________________</span></p> </td> <td width=325 colspan=2 valign=top style='width:243.75pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='text-autospace:none'><span style='font-size:12.5pt; font-family:"Times New Roman","serif"'>_________________________________</span></p> </td> </tr> <tr> <td width=325 colspan=2 valign=top style='width:243.7pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='text-autospace:none'><span style='font-size:12.5pt; font-family:"Times New Roman","serif"'>Officer Signature</span></p> </td> <td width=325 colspan=2 valign=top style='width:243.75pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='text-autospace:none'><span style='font-size:12.5pt; font-family:"Times New Roman","serif"'>Officer ID</span></p> </td> </tr> <tr> <td width=325 colspan=2 valign=top style='width:243.7pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='text-autospace:none'><span style='font-size:12.5pt; font-family:"Times New Roman","serif"'>____________________________________</span></p> </td> <td width=325 colspan=2 valign=top style='width:243.75pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='text-autospace:none'><span style='font-size:12.5pt; font-family:"Times New Roman","serif"'>_________________________________</span></p> </td> </tr> <tr> <td width=325 colspan=2 valign=top style='width:243.7pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='text-autospace:none'><span style='font-size:12.5pt; font-family:"Times New Roman","serif"'>Agency</span></p> </td> <td width=325 colspan=2 valign=top style='width:243.75pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='text-autospace:none'><span style='font-size:12.5pt; font-family:"Times New Roman","serif"'>Date</span></p> </td> </tr> <tr> <td width=325 colspan=2 valign=top style='width:243.7pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='text-autospace:none'><span style='font-size:12.5pt; font-family:"Times New Roman","serif"'>&nbsp;</span></p> </td> <td width=325 colspan=2 valign=top style='width:243.75pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='text-autospace:none'><span style='font-size:12.5pt; font-family:"Times New Roman","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=650 colspan=4 valign=top style='width:487.45pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='text-align:center;text-autospace:none'><b><span style='font-size:12.5pt;font-family:"Times New Roman","serif"'>SUMMONS AND PROMISE TO APPEAR</span></b></p> </td> </tr> <tr> <td width=650 colspan=4 valign=top style='width:487.45pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='text-autospace:none'><span style='font-size:12.5pt; font-family:"Times New Roman","serif"'>Juvenile/Defendant is ordered and does promise to appear in the above named court located in the city of ______________________________ on __________________________, 20 ____, at __________________ a.m./p.m.</span></p> </td> </tr> <tr> <td width=650 colspan=4 valign=top style='width:487.45pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='text-autospace:none'><span style='font-size:12.5pt; font-family:"Times New Roman","serif"'>____________________________________________</span></p> </td> </tr> <tr> <td width=650 colspan=4 valign=top style='width:487.45pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='text-autospace:none'><span style='font-size:12.5pt; font-family:"Times New Roman","serif"'>Juvenile/Defendant signature</span></p> <p class=MsoNormal style='text-align:justify;text-autospace:none'><span style='font-size:12.5pt;font-family:"Times New Roman","serif"'>(Signing this form is a promise to appear  Not an admission of guilt. However, failure to appear may be considered an admission to the allegation(s) listed above and a judgement for payment may be entered.)</span></p> </td> </tr> <tr> <td width=650 colspan=4 valign=top style='width:487.45pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='text-autospace:none'><span style='font-size:12.5pt; font-family:"Times New Roman","serif"'>____ Parent(s)/Guardian Notification ________________________________________</span></p> </td> </tr> <tr> <td width=650 colspan=4 valign=top style='width:487.45pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='text-autospace:none'><span style='font-size:12.5pt; font-family:"Times New Roman","serif"'>Parent(s)/Guardian information</span></p> </td> </tr> <tr> <td width=650 colspan=4 valign=top style='width:487.45pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='text-autospace:none'><span style='font-size:12.5pt; font-family:"Times New Roman","serif"'>Name: ____________________________________&nbsp;&nbsp; _________________________________</span></p> </td> </tr> <tr> <td width=650 colspan=4 valign=top style='width:487.45pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='text-autospace:none'><span style='font-size:12.5pt; font-family:"Times New Roman","serif"'>Address: __________________________________&nbsp;&nbsp; _________________________________</span></p> </td> </tr> <tr> <td width=650 colspan=4 valign=top style='width:487.45pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='text-autospace:none'><span style='font-size:12.5pt; font-family:"Times New Roman","serif"'>City/State/Zip: ______________________________&nbsp; _________________________________</span></p> </td> </tr> <tr> <td width=650 colspan=4 valign=top style='width:487.45pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='text-autospace:none'><span style='font-size:12.5pt; font-family:"Times New Roman","serif"'>Phone: _____________________________________</span></p> </td> </tr> <tr height=0> <td width=232 style='border:none'></td> <td width=116 style='border:none'></td> <td width=108 style='border:none'></td> <td width=217 style='border:none'></td> </tr> </table> <p class=MsoNormal style='text-align:justify'><span style='font-size:12.0pt; font-family:"Times New Roman","serif"'>&nbsp;</span></p> <span style='font-size:12.0pt;font-family:"Times New Roman","serif"'><br clear=all style='page-break-before:always'> </span> <p class=MsoNormal style='text-align:justify'><span style='font-size:12.0pt; font-family:"Times New Roman","serif"'>&nbsp;</span></p> <table class=MsoNormalTable border=1 cellspacing=0 cellpadding=0 style='border-collapse:collapse;border:none'> <tr> <td width=325 colspan=7 valign=top style='width:243.7pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='text-align:justify'><span style='font-size:12.0pt; font-family:"Times New Roman","serif"'>(2) <u>Form B</u>:</span></p> </td> <td width=325 colspan=7 valign=top style='width:243.75pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='text-align:justify'><span style='font-size:12.0pt; font-family:"Times New Roman","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=650 colspan=14 valign=top style='width:487.45pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='text-align:center'><b><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>UNIFORM TRAFFIC TICKET</span></b></p> <p class=MsoNormal align=center style='text-align:center'><b><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>SUMMONS-COMPLAINT</span></b></p> </td> </tr> <tr> <td width=325 colspan=7 valign=top style='width:243.7pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='text-align:justify'><span style='font-size:12.0pt; font-family:"Times New Roman","serif"'>PCN ______________</span></p> </td> <td width=325 colspan=7 valign=top style='width:243.75pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='text-align:justify'><span style='font-size:12.0pt; font-family:"Times New Roman","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=325 colspan=7 valign=top style='width:243.7pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='text-align:justify'><span style='font-size:12.0pt; font-family:"Times New Roman","serif"'>State of South Dakota</span></p> </td> <td width=325 colspan=7 valign=top style='width:243.75pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='text-align:right'><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>____Juvenile Citation*</span></p> </td> </tr> <tr> <td width=325 colspan=7 valign=top style='width:243.7pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='text-align:justify'><span style='font-size:12.0pt; font-family:"Times New Roman","serif"'>&nbsp;</span></p> </td> <td width=325 colspan=7 valign=top style='width:243.75pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='text-align:right'><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>In Circuit Court</span></p> </td> </tr> <tr> <td width=325 colspan=7 valign=top style='width:243.7pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='text-align:justify'><span style='font-size:12.0pt; font-family:"Times New Roman","serif"'>County of _________________</span></p> </td> <td width=325 colspan=7 valign=top style='width:243.75pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='text-align:right'><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>_____Judicial Court</span></p> </td> </tr> <tr> <td width=325 colspan=7 valign=top style='width:243.7pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='text-align:justify'><span style='font-size:12.0pt; font-family:"Times New Roman","serif"'>State of South Dakota (Plaintiff)</span></p> </td> <td width=325 colspan=7 valign=top style='width:243.75pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='text-align:justify'><span style='font-size:12.0pt; font-family:"Times New Roman","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=325 colspan=7 valign=top style='width:243.7pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='text-align:justify'><span style='font-size:12.0pt; font-family:"Times New Roman","serif"'>Vs.</span></p> </td> <td width=325 colspan=7 valign=top style='width:243.75pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='text-align:justify'><span style='font-size:12.0pt; font-family:"Times New Roman","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=325 colspan=7 valign=top style='width:243.7pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal style='text-align:justify'><span style='font-size:12.0pt; font-family:"Times New Roman","serif"'>__________________________________</span></p> </td> <td width=325 colspan=7 valign=top style='width:243.75pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='text-align:right'><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>No. __________________HP</span></p> </td> </tr> <tr> <td width=325 colspan=7 valign=top style='width:243.7pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=center style='text-align:center'><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>(Defendant)</span></p> </td> <td width=325 colspan=7 valign=top style='width:243.75pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal align=right style='text-align:right'><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=650 colspan=14 valign=top style='width:487.45pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>&nbsp;</span></p> </td> </tr> <tr> <td width=650 colspan=14 valign=top style='width:487.45pt;border:none; padding:0in 5.4pt 0in 5.4pt'> <p class=MsoNormal><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>THE UNDERSIGNED PEACE OFFICER COMPLAINS AND STATES THAT</span></p> </td> </tr> <tr style='height:13.15pt'> <td width=217 colspan=4 valign=top style='width:162.45pt;border:none; padding:0in 5.4pt 0in 5.4pt;height:13.15pt'> <p class=MsoNormal><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>ON OR ABOUT</span></p> </td> <td width=301 colspan=8 valign=top style='width:225.45pt;border:none; padding:0in 5.4pt 0in 5.4pt;height:13.15pt'> <p class=MsoNormal><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>AT OR NEAR (LOCATION/MILE POST)</span></p> </td> <td width=133 colspan=2 valign=top style='width:99.55pt;border:none; padding:0in 5.4pt 0in 5.4pt;height:13.15pt'> <p class=MsoNormal align=right style='text-align:right'><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>AT TIME</span></p> </td> </tr> <tr style='height:13.05pt'> <td width=217 colspan=4 valign=top style='width:162.45pt;border:none; padding:0in 5.4pt 0in 5.4pt;height:13.05pt'> <p class=MsoNormal align=right style='text-align:right'><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>&nbsp;</span></p> </td> <td width=301 colspan=8 valign=top style='width:225.45pt;border:none; padding:0in 5.4pt 0in 5.4pt;height:13.05pt'> <p class=MsoNormal align=right style='text-align:right'><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>&nbsp;</span></p> </td> <td width=133 colspan=2 valign=top style='width:99.55pt;border:none; padding:0in 5.4pt 0in 5.4pt;height:13.05pt'> <p class=MsoNormal align=right style='text-align:right'><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>A.M.</span></p> </td> </tr> <tr style='height:13.05pt'> <td width=217 colspan=4 valign=top style='width:162.45pt;border:none; padding:0in 5.4pt 0in 5.4pt;height:13.05pt'> <p class=MsoNormal align=right style='text-align:right'><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>&nbsp;</span></p> </td> <td width=301 colspan=8 valign=top style='width:225.45pt;border:none; padding:0in 5.4pt 0in 5.4pt;height:13.05pt'> <p class=MsoNormal align=right style='text-align:right'><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>&nbsp;</span></p> </td> <td width=133 colspan=2 valign=top style='width:99.55pt;border:none; padding:0in 5.4pt 0in 5.4pt;height:13.05pt'> <p class=MsoNormal align=right style='text-align:right'><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>P.M.</span></p> </td> </tr> <tr style='height:13.05pt'> <td width=217 colspan=4 valign=top style='width:162.45pt;border:none; padding:0in 5.4pt 0in 5.4pt;height:13.05pt'> <p class=MsoNormal><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>________________________</span></p> </td> <td width=301 colspan=8 valign=top style='width:225.45pt;border:none; padding:0in 5.4pt 0in 5.4pt;height:13.05pt'> <p class=MsoNormal><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>________________________________</span></p> </td> <td width=133 colspan=2 valign=top style='width:99.55pt;border:none; padding:0in 5.4pt 0in 5.4pt;height:13.05pt'> <p class=MsoNormal align=right style='text-align:right'><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>___________</span></p> </td> </tr> <tr style='height:13.05pt'> <td width=650 colspan=14 valign=top style='width:487.45pt;border:none; padding:0in 5.4pt 0in 5.4pt;height:13.05pt'> <p class=MsoNormal align=center style='text-align:center'><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>&nbsp;</span></p> </td> </tr> <tr style='height:13.05pt'> <td width=650 colspan=14 valign=top style='width:487.45pt;border:none; padding:0in 5.4pt 0in 5.4pt;height:13.05pt'> <p class=MsoNormal align=center style='text-align:center'><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>WITHIN THE COUNTY AND STATE AFORESAID</span></p> </td> </tr> <tr style='height:13.05pt'> <td width=277 colspan=6 valign=top style='width:207.6pt;border:none; padding:0in 5.4pt 0in 5.4pt;height:13.05pt'> <p class=MsoNormal><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>NAME</span></p> </td> <td width=222 colspan=5 valign=top style='width:166.8pt;border:none; padding:0in 5.4pt 0in 5.4pt;height:13.05pt'> <p class=MsoNormal><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>HEIGHT</span></p> </td> <td width=151 colspan=3 valign=top style='width:113.05pt;border:none; padding:0in 5.4pt 0in 5.4pt;height:13.05pt'> <p class=MsoNormal align=right style='text-align:right'><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>SEX</span></p> </td> </tr> <tr style='height:13.05pt'> <td width=277 colspan=6 valign=top style='width:207.6pt;border:none; padding:0in 5.4pt 0in 5.4pt;height:13.05pt'> <p class=MsoNormal><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>_______________________________</span></p> </td> <td width=222 colspan=5 valign=top style='width:166.8pt;border:none; padding:0in 5.4pt 0in 5.4pt;height:13.05pt'> <p class=MsoNormal><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>________________</span></p> </td> <td width=151 colspan=3 valign=top style='width:113.05pt;border:none; padding:0in 5.4pt 0in 5.4pt;height:13.05pt'> <p class=MsoNormal align=right style='text-align:right'><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>____</span></p> </td> </tr> <tr style='height:13.05pt'> <td width=277 colspan=6 valign=top style='width:207.6pt;border:none; padding:0in 5.4pt 0in 5.4pt;height:13.05pt'> <p class=MsoNormal><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>ADDRESS</span></p> </td> <td width=222 colspan=5 valign=top style='width:166.8pt;border:none; padding:0in 5.4pt 0in 5.4pt;height:13.05pt'> <p class=MsoNormal><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>WEIGHT</span></p> </td> <td width=151 colspan=3 valign=top style='width:113.05pt;border:none; padding:0in 5.4pt 0in 5.4pt;height:13.05pt'> <p class=MsoNormal align=right style='text-align:right'><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>&nbsp;</span></p> </td> </tr> <tr style='height:13.05pt'> <td width=277 colspan=6 valign=top style='width:207.6pt;border:none; padding:0in 5.4pt 0in 5.4pt;height:13.05pt'> <p class=MsoNormal><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>_______________________________</span></p> </td> <td width=222 colspan=5 valign=top style='width:166.8pt;border:none; padding:0in 5.4pt 0in 5.4pt;height:13.05pt'> <p class=MsoNormal><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>________________</span></p> </td> <td width=151 colspan=3 valign=top style='width:113.05pt;border:none; padding:0in 5.4pt 0in 5.4pt;height:13.05pt'> <p class=MsoNormal align=right style='text-align:right'><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>&nbsp;</span></p> </td> </tr> <tr style='height:13.05pt'> <td width=277 colspan=6 valign=top style='width:207.6pt;border:none; padding:0in 5.4pt 0in 5.4pt;height:13.05pt'> <p class=MsoNormal><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>CITY</span></p> </td> <td width=222 colspan=5 valign=top style='width:166.8pt;border:none; padding:0in 5.4pt 0in 5.4pt;height:13.05pt'> <p class=MsoNormal><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>STATE</span></p> </td> <td width=151 colspan=3 valign=top style='width:113.05pt;border:none; padding:0in 5.4pt 0in 5.4pt;height:13.05pt'> <p class=MsoNormal align=right style='text-align:right'><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>BIRTH DATE</span></p> </td> </tr> <tr style='height:13.05pt'> <td width=277 colspan=6 valign=top style='width:207.6pt;border:none; padding:0in 5.4pt 0in 5.4pt;height:13.05pt'> <p class=MsoNormal><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>_________________________</span></p> </td> <td width=222 colspan=5 valign=top style='width:166.8pt;border:none; padding:0in 5.4pt 0in 5.4pt;height:13.05pt'> <p class=MsoNormal><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>________________</span></p> </td> <td width=151 colspan=3 valign=top style='width:113.05pt;border:none; padding:0in 5.4pt 0in 5.4pt;height:13.05pt'> <p class=MsoNormal align=right style='text-align:right'><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>____________</span></p> </td> </tr> <tr style='height:13.05pt'> <td width=277 colspan=6 valign=top style='width:207.6pt;border:none; padding:0in 5.4pt 0in 5.4pt;height:13.05pt'> <p class=MsoNormal><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>DRIVER'S LICENSE NO.</span></p> </td> <td width=222 colspan=5 valign=top style='width:166.8pt;border:none; padding:0in 5.4pt 0in 5.4pt;height:13.05pt'> <p class=MsoNormal><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>STATE</span></p> </td> <td width=151 colspan=3 valign=top style='width:113.05pt;border:none; padding:0in 5.4pt 0in 5.4pt;height:13.05pt'> <p class=MsoNormal align=right style='text-align:right'><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>&nbsp;</span></p> </td> </tr> <tr style='height:13.05pt'> <td width=277 colspan=6 valign=top style='width:207.6pt;border:none; padding:0in 5.4pt 0in 5.4pt;height:13.05pt'> <p class=MsoNormal><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>_________________________</span></p> </td> <td width=222 colspan=5 valign=top style='width:166.8pt;border:none; padding:0in 5.4pt 0in 5.4pt;height:13.05pt'> <p class=MsoNormal><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>________________</span></p> </td> <td width=151 colspan=3 valign=top style='width:113.05pt;border:none; padding:0in 5.4pt 0in 5.4pt;height:13.05pt'> <p class=MsoNormal align=right style='text-align:right'><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>&nbsp;</span></p> </td> </tr> <tr style='height:13.05pt'> <td width=130 valign=top style='width:97.45pt;border:none;padding:0in 5.4pt 0in 5.4pt; height:13.05pt'> <p class=MsoNormal align=center style='text-align:center'><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>&nbsp;</span></p> </td> <td width=130 colspan=4 valign=top style='width:97.5pt;border:none; padding:0in 5.4pt 0in 5.4pt;height:13.05pt'> <p class=MsoNormal align=center style='text-align:center'><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>&nbsp;</span></p> </td> <td width=130 colspan=4 valign=top style='width:97.5pt;border:none; padding:0in 5.4pt 0in 5.4pt;height:13.05pt'> <p class=MsoNormal align=center style='text-align:center'><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>&nbsp;</span></p> </td> <td width=145 colspan=4 valign=top style='width:108.95pt;border:none; padding:0in 5.4pt 0in 5.4pt;height:13.05pt'> <p class=MsoNormal align=center style='text-align:center'><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>&nbsp;</span></p> </td> <td width=115 valign=top style='width:86.05pt;border:none;padding:0in 5.4pt 0in 5.4pt; height:13.05pt'> <p class=MsoNormal align=right style='text-align:right'><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>&nbsp;</span></p> </td> </tr> <tr style='height:13.05pt'> <td width=130 valign=top style='width:97.45pt;border:none;padding:0in 5.4pt 0in 5.4pt; height:13.05pt'> <p class=MsoNormal align=center style='text-align:center'><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>DID</span></p> <p class=MsoNormal align=right style='text-align:right'><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>UNLAWFULLY</span></p> </td> <td width=130 colspan=4 valign=top style='width:97.5pt;border:none; padding:0in 5.4pt 0in 5.4pt;height:13.05pt'> <p class=MsoNormal align=center style='text-align:center'><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>OPERATE</span></p> <p class=MsoNormal align=center style='text-align:center'><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>__________</span></p> </td> <td width=130 colspan=4 valign=top style='width:97.5pt;border:none; padding:0in 5.4pt 0in 5.4pt;height:13.05pt'> <p class=MsoNormal align=center style='text-align:center'><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>PARK</span></p> <p class=MsoNormal align=center style='text-align:center'><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>______</span></p> </td> <td width=145 colspan=4 valign=top style='width:108.95pt;border:none; padding:0in 5.4pt 0in 5.4pt;height:13.05pt'> <p class=MsoNormal align=center style='text-align:center'><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>VEHICLE MAKE</span></p> <p class=MsoNormal align=center style='text-align:center'><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>______________</span></p> </td> <td width=115 valign=top style='width:86.05pt;border:none;padding:0in 5.4pt 0in 5.4pt; height:13.05pt'> <p class=MsoNormal align=right style='text-align:right'><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>BODY STYLE</span></p> <p class=MsoNormal align=right style='text-align:right'><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>____________</span></p> </td> </tr> <tr style='height:13.05pt'> <td width=187 colspan=3 valign=top style='width:1.95in;border:none; padding:0in 5.4pt 0in 5.4pt;height:13.05pt'> <p class=MsoNormal><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>&nbsp;</span></p> </td> <td width=138 colspan=4 valign=top style='width:103.3pt;border:none; padding:0in 5.4pt 0in 5.4pt;height:13.05pt'> <p class=MsoNormal><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>&nbsp;</span></p> </td> <td width=162 colspan=3 valign=top style='width:121.85pt;border:none; padding:0in 5.4pt 0in 5.4pt;height:13.05pt'> <p class=MsoNormal><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>&nbsp;</span></p> </td> <td width=163 colspan=4 valign=top style='width:121.9pt;border:none; padding:0in 5.4pt 0in 5.4pt;height:13.05pt'> <p class=MsoNormal><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>&nbsp;</span></p> </td> </tr> <tr style='height:13.05pt'> <td width=187 colspan=3 valign=top style='width:1.95in;border:none; padding:0in 5.4pt 0in 5.4pt;height:13.05pt'> <p class=MsoNormal><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>STATE LICENSE NO.</span></p> </td> <td width=138 colspan=4 valign=top style='width:103.3pt;border:none; padding:0in 5.4pt 0in 5.4pt;height:13.05pt'> <p class=MsoNormal><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>YEAR</span></p> </td> <td width=162 colspan=3 valign=top style='width:121.85pt;border:none; padding:0in 5.4pt 0in 5.4pt;height:13.05pt'> <p class=MsoNormal><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>STATE</span></p> </td> <td width=163 colspan=4 valign=top style='width:121.9pt;border:none; padding:0in 5.4pt 0in 5.4pt;height:13.05pt'> <p class=MsoNormal><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>FR_____Y</span></p> </td> </tr> <tr style='height:13.05pt'> <td width=187 colspan=3 valign=top style='width:1.95in;border:none; padding:0in 5.4pt 0in 5.4pt;height:13.05pt'> <p class=MsoNormal><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>___________________</span></p> </td> <td width=138 colspan=4 valign=top style='width:103.3pt;border:none; padding:0in 5.4pt 0in 5.4pt;height:13.05pt'> <p class=MsoNormal><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>_______</span></p> </td> <td width=162 colspan=3 valign=top style='width:121.85pt;border:none; padding:0in 5.4pt 0in 5.4pt;height:13.05pt'> <p class=MsoNormal><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>________</span></p> </td> <td width=163 colspan=4 valign=top style='width:121.9pt;border:none; padding:0in 5.4pt 0in 5.4pt;height:13.05pt'> <p class=MsoNormal><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>________N</span></p> </td> </tr> <tr style='height:13.05pt'> <td width=650 colspan=14 valign=top style='width:487.45pt;border:none; padding:0in 5.4pt 0in 5.4pt;height:13.05pt'> <p class=MsoNormal><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>&nbsp;</span></p> </td> </tr> <tr style='height:13.05pt'> <td width=650 colspan=14 valign=top style='width:487.45pt;border:none; padding:0in 5.4pt 0in 5.4pt;height:13.05pt'> <p class=MsoNormal><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>AND THEN AND THERE COMMIT THE FOLLOWING OFFENSE TO WIT:</span></p> </td> </tr> <tr style='height:13.05pt'> <td width=650 colspan=14 valign=top style='width:487.45pt;border:none; padding:0in 5.4pt 0in 5.4pt;height:13.05pt'> <p class=MsoNormal><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; PETTY OFF _____&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; MIS ______</span></p> </td> </tr> <tr style='height:13.05pt'> <td width=650 colspan=14 valign=top style='width:487.45pt;border:none; padding:0in 5.4pt 0in 5.4pt;height:13.05pt'> <p class=MsoNormal><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>&nbsp;</span></p> </td> </tr> <tr style='height:13.05pt'> <td width=650 colspan=14 valign=top style='width:487.45pt;border:none; padding:0in 5.4pt 0in 5.4pt;height:13.05pt'> <p class=MsoNormal><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>DESCRIBE VIOLATION</span></p> </td> </tr> <tr style='height:13.05pt'> <td width=385 colspan=8 valign=top style='width:288.9pt;border:none; padding:0in 5.4pt 0in 5.4pt;height:13.05pt'> <p class=MsoNormal><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>___________________________________________</span></p> </td> <td width=265 colspan=6 valign=top style='width:198.55pt;border:none; padding:0in 5.4pt 0in 5.4pt;height:13.05pt'> <p class=MsoNormal align=right style='text-align:right'><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>CDL ___Y ___N</span></p> </td> </tr> <tr style='height:13.05pt'> <td width=385 colspan=8 valign=top style='width:288.9pt;border:none; padding:0in 5.4pt 0in 5.4pt;height:13.05pt'> <p class=MsoNormal><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>&nbsp;</span></p> </td> <td width=265 colspan=6 valign=top style='width:198.55pt;border:none; padding:0in 5.4pt 0in 5.4pt;height:13.05pt'> <p class=MsoNormal align=right style='text-align:right'><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>C Veh. ___Y ___N ___E</span></p> </td> </tr> <tr style='height:13.05pt'> <td width=385 colspan=8 valign=top style='width:288.9pt;border:none; padding:0in 5.4pt 0in 5.4pt;height:13.05pt'> <p class=MsoNormal><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>___________________________________________</span></p> </td> <td width=265 colspan=6 valign=top style='width:198.55pt;border:none; padding:0in 5.4pt 0in 5.4pt;height:13.05pt'> <p class=MsoNormal align=right style='text-align:right'><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>Haz. Materials ___Y ___N</span></p> </td> </tr> <tr style='height:13.05pt'> <td width=385 colspan=8 valign=top style='width:288.9pt;border:none; padding:0in 5.4pt 0in 5.4pt;height:13.05pt'> <p class=MsoNormal><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>in violation of SDCL _________________________</span></p> </td> <td width=265 colspan=6 valign=top style='width:198.55pt;border:none; padding:0in 5.4pt 0in 5.4pt;height:13.05pt'> <p class=MsoNormal><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>&nbsp;</span></p> </td> </tr> <tr style='height:13.05pt'> <td width=162 colspan=2 valign=top style='width:121.85pt;border:none; padding:0in 5.4pt 0in 5.4pt;height:13.05pt'> <p class=MsoNormal><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>&nbsp;</span></p> </td> <td width=162 colspan=5 valign=top style='width:121.85pt;border:none; padding:0in 5.4pt 0in 5.4pt;height:13.05pt'> <p class=MsoNormal><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>&nbsp;</span></p> </td> <td width=162 colspan=3 valign=top style='width:121.85pt;border:none; padding:0in 5.4pt 0in 5.4pt;height:13.05pt'> <p class=MsoNormal><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>&nbsp;</span></p> </td> <td width=163 colspan=4 valign=top style='width:121.9pt;border:none; padding:0in 5.4pt 0in 5.4pt;height:13.05pt'> <p class=MsoNormal><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>&nbsp;</span></p> </td> </tr> <tr style='height:13.05pt'> <td width=162 colspan=2 valign=top style='width:121.85pt;border:none; padding:0in 5.4pt 0in 5.4pt;height:13.05pt'> <p class=MsoNormal><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>&nbsp;</span></p> </td> <td width=162 colspan=5 valign=top style='width:121.85pt;border:none; padding:0in 5.4pt 0in 5.4pt;height:13.05pt'> <p class=MsoNormal><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>___Municipal</span></p> </td> <td width=162 colspan=3 valign=top style='width:121.85pt;border:none; padding:0in 5.4pt 0in 5.4pt;height:13.05pt'> <p class=MsoNormal><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>&nbsp;</span></p> </td> <td width=163 colspan=4 valign=top style='width:121.9pt;border:none; padding:0in 5.4pt 0in 5.4pt;height:13.05pt'> <p class=MsoNormal><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>&nbsp;</span></p> </td> </tr> <tr style='height:13.05pt'> <td width=162 colspan=2 valign=top style='width:121.85pt;border:none; padding:0in 5.4pt 0in 5.4pt;height:13.05pt'> <p class=MsoNormal><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>SPEEDING</span></p> </td> <td width=162 colspan=5 valign=top style='width:121.85pt;border:none; padding:0in 5.4pt 0in 5.4pt;height:13.05pt'> <p class=MsoNormal><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>___Interstate</span></p> </td> <td width=162 colspan=3 valign=top style='width:121.85pt;border:none; padding:0in 5.4pt 0in 5.4pt;height:13.05pt'> <p class=MsoNormal><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>&nbsp;</span></p> </td> <td width=163 colspan=4 valign=top style='width:121.9pt;border:none; padding:0in 5.4pt 0in 5.4pt;height:13.05pt'> <p class=MsoNormal><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>&nbsp;</span></p> </td> </tr> <tr style='height:13.05pt'> <td width=162 colspan=2 valign=top style='width:121.85pt;border:none; padding:0in 5.4pt 0in 5.4pt;height:13.05pt'> <p class=MsoNormal><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>&nbsp;</span></p> </td> <td width=162 colspan=5 valign=top style='width:121.85pt;border:none; padding:0in 5.4pt 0in 5.4pt;height:13.05pt'> <p class=MsoNormal><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>___Other</span></p> </td> <td width=325 colspan=7 valign=top style='width:243.75pt;border:none; padding:0in 5.4pt 0in 5.4pt;height:13.05pt'> <p class=MsoNormal align=right style='text-align:right'><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>_____M.P.H. IN ____M.P.H. ZONE</span></p> </td> </tr> <tr style='height:13.05pt'> <td width=650 colspan=14 valign=top style='width:487.45pt;border:none; padding:0in 5.4pt 0in 5.4pt;height:13.05pt'> <p class=MsoNormal><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>&nbsp;</span></p> </td> </tr> <tr style='height:13.05pt'> <td width=650 colspan=14 valign=top style='width:487.45pt;border:none; padding:0in 5.4pt 0in 5.4pt;height:13.05pt'> <p class=MsoNormal><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>OFFICER ISSUING SUMMONS&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; NO&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; CITY&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; COUNTY&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; STATE</span></p> <p class=MsoNormal><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>___________________________&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; ___&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; __________&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; __________&nbsp;&nbsp;&nbsp; _______</span></p> </td> </tr> <tr style='height:13.05pt'> <td width=650 colspan=14 valign=top style='width:487.45pt;border:none; padding:0in 5.4pt 0in 5.4pt;height:13.05pt'> <p class=MsoNormal><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>&nbsp;</span></p> </td> </tr> <tr style='height:13.05pt'> <td width=650 colspan=14 valign=top style='width:487.45pt;border:none; padding:0in 5.4pt 0in 5.4pt;height:13.05pt'> <p class=MsoNormal><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>ABOVE COMPLAINT IS TRUE AS I VERILY BELIEVE&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; DATE</span></p> <p class=MsoNormal><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>OFFICER SIGN IN PRESENCE OF COURT OR NOTARY</span></p> <p class=MsoNormal><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>_____________________________________________________&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; _____________</span></p> </td> </tr> <tr style='height:13.05pt'> <td width=650 colspan=14 valign=top style='width:487.45pt;border:none; padding:0in 5.4pt 0in 5.4pt;height:13.05pt'> <p class=MsoNormal align=center style='text-align:center'><b><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>&nbsp;</span></b></p> </td> </tr> <tr style='height:13.05pt'> <td width=650 colspan=14 valign=top style='width:487.45pt;border:none; padding:0in 5.4pt 0in 5.4pt;height:13.05pt'> <p class=MsoNormal align=center style='text-align:center'><b><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>SUMMONS and PROMISE TO APPEAR</span></b></p> </td> </tr> <tr style='height:13.05pt'> <td width=650 colspan=14 valign=top style='width:487.45pt;border:none; padding:0in 5.4pt 0in 5.4pt;height:13.05pt'> <p class=MsoNormal><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>Defendant is ordered and does promise to appear in the above Court located in the city of __________________ on _________________ at __________&nbsp; a.m.</span></p> <p class=MsoNormal><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;&nbsp;&nbsp; p.m.</span></p> </td> </tr> <tr style='height:13.05pt'> <td width=650 colspan=14 valign=top style='width:487.45pt;border:none; padding:0in 5.4pt 0in 5.4pt;height:13.05pt'> <p class=MsoNormal><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>X__________________________________________________________________________</span></p> </td> </tr> <tr style='height:13.05pt'> <td width=650 colspan=14 valign=top style='width:487.45pt;border:none; padding:0in 5.4pt 0in 5.4pt;height:13.05pt'> <p class=MsoNormal align=center style='text-align:center'><span style='font-size:12.0pt;font-family:"Times New Roman","serif"'>Defendant's signature</span></p> </td> </tr> <tr style='height:13.05pt'> <td width=650 colspan=14 valign=top style='width:487.45pt;border:none; padding:0in 5.4pt 0in 5.4pt;height:13.05pt'> <p class=MsoNormal style='text-align:justify'><span style='font-size:12.0pt; font-family:"Times New Roman","serif"'>Signing this form is a promise to appear  Not an admission of guilt. However, failure to appear may be considered an admission to the allegation(s) listed above and a judgment for payment may be entered.</span></p> </td> </tr> <tr style='height:13.05pt'> <td width=650 colspan=14 valign=top style='width:487.45pt;border:none; padding:0in 5.4pt 0in 5.4pt;height:13.05pt'> <p class=MsoNormal style='text-align:justify'><span style='font-size:12.0pt; font-family:"Times New Roman","serif"'>___ Yes ___ No&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Court appearance required.</span></p> <p class=MsoNormal style='text-align:justify'><span style='font-size:12.0pt; font-family:"Times New Roman","serif"'>___ Yes ___ No&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Power of attorney in lieu of appearance. Amount $ ___________</span></p> </td> </tr> <tr style='height:13.05pt'> <td width=650 colspan=14 valign=top style='width:487.45pt;border:none; padding:0in 5.4pt 0in 5.4pt;height:13.05pt'> <p class=MsoNormal style='text-align:justify'><span style='font-size:12.0pt; font-family:"Times New Roman","serif"'>____Parent(s)/Guardian Notification ____________________________________________</span></p> </td> </tr> <tr style='height:13.05pt'> <td width=650 colspan=14 valign=top style='width:487.45pt;border:none; padding:0in 5.4pt 0in 5.4pt;height:13.05pt'> <p class=MsoNormal style='text-align:justify'><span style='font-size:12.0pt; font-family:"Times New Roman","serif"'>&nbsp;</span></p> </td> </tr> <tr style='height:13.05pt'> <td width=650 colspan=14 valign=top style='width:487.45pt;border:none; padding:0in 5.4pt 0in 5.4pt;height:13.05pt'> <p class=MsoNormal style='text-align:justify'><span style='font-size:12.0pt; font-family:"Times New Roman","serif"'>*FOR VIOLATIONS OF SDCL <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=22-30A-17.3">22-30A-17.3</A>, <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=22-34-1">22-34-1</A> (less than $400); 35-9-2; and 26-8B-2(1)</span></p> </td> </tr> <tr height=0> <td width=130 style='border:none'></td> <td width=33 style='border:none'></td> <td width=25 style='border:none'></td> <td width=29 style='border:none'></td> <td width=43 style='border:none'></td> <td width=17 style='border:none'></td> <td width=48 style='border:none'></td> <td width=60 style='border:none'></td> <td width=5 style='border:none'></td> <td width=97 style='border:none'></td> <td width=12 style='border:none'></td> <td width=18 style='border:none'></td> <td width=18 style='border:none'></td> <td width=115 style='border:none'></td> </tr> </table> <p class=MsoNormal style='text-align:justify'><span style='font-size:12.0pt; font-family:"Times New Roman","serif"'>&nbsp;</span></p> <p class=MsoNormal style='text-align:justify'><span style='font-size:12.0pt; font-family:"Times New Roman","serif"'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <b>Source:</b> 42 SDR 101, effective January 11, 2016.</span></p> <p class=MsoNormal style='text-align:justify'><span style='font-size:12.0pt; font-family:"Times New Roman","serif"'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <b>General Authority:</b> SDCL <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=23-1A-2.1">23-1A-2.1</A>, <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=23-1A-2">23-1A-2.</A></span></p> <p class=MsoNormal style='text-align:justify'><span style='font-size:12.0pt; font-family:"Times New Roman","serif"'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <b>Law Implemented:</b> SDCL <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=23-1A-2.1">23-1A-2.1</A></span></p> <p class=MsoNormal>&nbsp;</p> </div> </body> </html>