Sec. 6. (a) This section does not apply to electronic traffic tickets. (b) In traffic cases, the information and summons shall be in substantially the following form: In the _________ Court of __________ County Cause No. _________ Docket No. ___________ Page No. _____ State of Indiana SS: No.___________ County of ______________________________________________ INFORMATION AND SUMMONS The undersigned having probable cause to believe and being duly sworn upon his oath says that: On the ____________ Day of __________, 20 ____ at ____ M Name ____________________________________________ Last First Middle Street __________________________________________________ City ______________________ State _____ Zip Code ______ Race ___ Sex ___ Age ___ D.O.B. ______ HT ____ WT _____ Oper. Lic. #_____________ St. ____ Did Unlawfully Operate Veh. Color _______ Veh. Yr.___ Veh. Make ______ Veh. Lic. Yr. ____ Veh. Lic. St. ____ Veh. Lic. # ______ Upon, (Location) ______________________________________________________ ______________________________________________________ A PUBLIC STREET OR HIGHWAY IN ______________________ COUNTY, INDIANA, AND COMMIT, THE OFFENSE OF: ______________________________________________________ ______________________________________________________ CONTRARY TO THE FORM OF THE ( ) STATE STATUTE ( ) LOCAL ORDINANCE IN SUCH CASE MADE AND PROVIDED. OFFICER'S SIGNATURE _________________________________ I.D. No. ______________ Div. Dist. __________________________ POLICE AGENCY _______________________________________ Subscribed And Sworn to Before Me (Deputy Clerk) ______________________________________ This ____________ Day of _________________, 20 ____ COURT APPEARANCE I PROMISE TO APPEAR IN COURTROOM __________________________________________________ ADDRESS: ______________________________ ON ______________ THE ________ DAY OF_________, 20 ___ AT __ M. OR BE SUBJECT TO ARREST. SIGNATURE __________________________________________ "YOUR SIGNATURE IS NOT AN ADMISSION OF GUILT" The information and summons shall consist of four (4) parts: (1) the original copy, printed on white paper, which shall be the abstract of court record for the Indiana bureau of motor vehicles; (2) the court copy, printed on white paper; (3) the police record, which shall be a copy of the information, printed on pink paper; and (4) the summons copy, printed on white stock. The reverse sides of the information and abstract of court record shall be substantially as follows, with such additions or deletions as are necessary to adapt the form to the court involved: RECEIPT #_______________ DATE ___________________ COURT ACTION AND OTHER ORDERS BAIL $ ___________ REARREST BOND $ _____________ DATE ___________ 1. CONTINUANCE TO ___ 4. CONTINUANCE TO ____ 2. CONTINUANCE TO ___ 5. CONTINUANCE TO ____ 3. CONTINUANCE TO ___ 6. CONTINUANCE TO ____ Motions Date Ruling Date 1. ___ ___ ___ ___ 2. ___ ___ ___ ___ 3. ___ ___ ___ ___ 4. ___ ___ ___ ___ PLEA ( ) GUILTY ( ) NOT GUILTY FINDING ( ) GUILTY ( ) NOT GUILTY THE COURT THEREFORE, ENTERS THE FOLLOWING ORDER FINE $ _________ AMOUNT SUSP. $ ________ (STATE) $ _____________ COSTS (CITY) $ ______________ ___________ DAYS IN _____________ DAYS SUSP. _________ ( ) RECOMMENDED LICENSE SUSPENDED FOR _______ ( ) PROBATIONARY LICENSE AUTHORIZED FOR ONE YEAR PROBATION __________________________________________________ __________________________________________________ __________________________________________________ __________________________________________________ JUDGE: ______________________________________________ DATE: ______________________________________________ ATTORNEY FOR DEFENDANT _________________ ADDRESS________________________ TELEPHONE _________ WITNESSES _________________________________________________ _________________________________________________ The notice, the appearance, the plea of either guilty or not guilty, and the waiver shall be printed on the summons. The trimmed size of the paper and stock on which the form is printed shall be nominally four and one quarter (4 1/4) inches by eight and one quarter (8 1/4) inches. (c) In civil traffic cases, the complaint and summons shall be in substantially the following form: In the ____________________ Court of _______________ County Cause No. ______________ Docket No. ________________ Page No.__________________________ State of Indiana SS: No._____________ County of ______________________________________ COMPLAINT AND SUMMONS The undersigned having probable cause to believe and being duly sworn upon his oath says that: On the ____________ Day of___________, 20 ____ at __ M Name _________________________________________________ Last First Middle Street _____________________________________ City ________________________ State _____ Zip Code ________ Race ___ Sex ___ Age __ D.O.B. ________ HT ____ WT ___ Oper. Lic. # ____________ St. ______________ Did Unlawfully Operate Veh. Color _______ Veh. Yr. ___ Veh. Make _________ Veh. Lic. Yr. ____ Veh. Lic. St. ____ Veh. Lic. # _________ Upon, (Location) _________________________________________ _______________________________________________________ A PUBLIC STREET OR HIGHWAY IN ______________________ COUNTY, INDIANA, AND COMMIT, THE OFFENSE OF: __________________________________________________ __________________________________________________ __________________________________________________ CONTRARY TO THE FORM OF THE ( ) STATE STATUTE ( ) LOCAL ORDINANCE IN SUCH CASE MADE AND PROVIDED. OFFICER'S SIGNATURE ___________________________ I.D. No. _____________ Div. Dist. _______________________ POLICE AGENCY _________________________________ Subscribed And Sworn to Before Me (Deputy Clerk) __________________________________________ This ____________ Day of ______________, 20___ COURT APPEARANCE I PROMISE TO APPEAR IN ________________________ COURTROOM ___________________________________ ADDRESS: ______________________________________ ON ____________ THE ________ DAY OF ____, 20 ___ AT __ M. OR BE SUBJECT TO ARREST. SIGNATURE _____________________________________ "YOUR SIGNATURE IS NOT AN ADMISSION OF A VIOLATION" The complaint and summons shall consist of four (4) parts: (1) the original copy, printed on white paper, which shall be the abstract of court record for the Indiana bureau of motor vehicles; (2) the court copy, printed on white paper; (3) the police record, which shall be a copy of the complaint, printed on pink paper; and (4) the summons copy, printed on white stock. The reverse sides of the complaint and abstract of court record shall be substantially as follows, with such additions or deletions as are necessary to adapt the form to the court involved: RECEIPT #_________ DATE ________________ COURT ACTION AND OTHER ORDERS BAIL $ _______________ REARREST BOND $ _________ DATE _______ 1. CONTINUANCE TO ______ 4. CONTINUANCE TO ______ 2. CONTINUANCE TO ______ 5. CONTINUANCE TO ______ 3. CONTINUANCE TO ______ 6. CONTINUANCE TO ______ Motions Date Ruling Date 1. ___ ___ ___ ___ 2. ___ ___ ___ ___ 3. ___ ___ ___ ___ 4. ___ ___ ___ ___ PLEA ( ) ADMIT ( ) DENY ( ) NOLO CONTENDERE FINDING ( ) JUDGMENT FOR PLAINTIFF ( ) JUDGMENT FOR DEFENDANT THE COURT THEREFORE, ENTERS THE FOLLOWING ORDER FINE $ ________ AMOUNT SUSP. $ ________ (STATE) $ __________ COSTS (CITY) $ ___________ ( ) RECOMMENDED LICENSE SUSPENDED FOR ________ ( ) PROBATIONARY LICENSE AUTHORIZED FOR ONE YEAR PROBATION ______________________________________________ ______________________________________________ ______________________________________________ ______________________________________________ _______________________________________________ JUDGE: _________________________________________ DATE: __________________________________________ ATTORNEY FOR DEFENDANT ____________________ ADDRESS ___________________ TELEPHONE __________ WITNESSES _______________________________________________ _______________________________________________ The notice, appearance, plea of either admission, denial, or nolo contendere shall be printed on the summons. The trimmed size of the paper and stock on which the form is printed shall be nominally four and one quarter (4 1/4) inches by eight and one quarter (8 1/4) inches. (d) The complaint form shall be used in traffic cases, whether the charge is made by a law enforcement officer or by any other person. (e) Each judicial officer or police authority issuing traffic complaints and summons: (1) is responsible for the disposition of all the traffic complaints and summons issued under the authority of the officer or authority; and (2) shall prepare and submit the records and reports relating to the traffic complaints in the manner and at the time prescribed by both the state examiner of the state board of accounts and the bureau. [Pre-1991 Recodification Citation: 9-4-7-4.]
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