There is established a uniform complaint and summons that may be used in cases involving violations of statutes or ordinances. The use of a uniform complaint and summons must comply with the North Dakota Rules of Criminal Procedure and be in substantially the following form: State of North Dakota ) In ___________________ Court, ) ss. County of ____________ ) Before Hon. ________________; The undersigned, being sworn, says that, on ______________, ______, ___________________________________________________________________ First Name Middle Name Last Name Street City State did unlawfully operate a motor vehicle upon a public highway, namely __________, _______ N E S W of __________ and did then and there commit Location City the following offense:_____________________________________________________ MPH in________________________________________________________________ MPH Zone_____________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ All in violation of N. D. Century Code Sec. ______ and against the peace and dignity of the state of N. D. Officer _________ LET A WARRANT ISSUE HEREIN Sworn to and subscribed before me on ______________, ______. ____________________________ ___________________________________ Judge State's Attorney DESCRIPTION OF DEFENDANT AND VEHICLE Mo. _____Day _____Yr. _____Race _____Sex _____Wt. ______Ht. _____ Birth date Hair _____Dr. Lic: State _____No. _____Motor Vehicle: PSC Make _____Reg. No. _____State _____Year _____ICC No. ____ CLAIMED CONDITIONS OF THE VIOLATION SLIPPERY SURFACE ______ Rain ______ Snow ______ Ice DARKNESS ______ Night ______ Fog ______ Snow OTHER TRAFFIC PRESENT ______ Cross ______ Oncoming ______ Pedestrian ______ Same direction IN ACCIDENT ______ Ped. ______ Vehicle ______ Intersection ______ Right angle ______ Head on ______ Rear end ______ Ran off road ______ Other _______________________________________________________________ Area: ______ School ______ Rural ______ Business ______ Industrial ______ Residential Highway: _______ 2 Lane ______ 4 Lane ______ 4 Lane Divided Type: _________ Gravel ________ Dirt OFFENSE CONTRIBUTED MATERIALLY TO ACCIDENT _____ Yes ______ No THE STATE OF NORTH DAKOTA TO THE ABOVE-NAMED DEFENDANT (CITY ORDINANCE OR STATE CRIMINAL TRAFFIC VIOLATION) You are summoned to appear at the time and place designated below to answer to the charge made against you. ______________________________________________________________________ ______________________________________________________________________ Appearance Before: Municipal Judge District Ct.__________________________________ _______________________________________________________________A.M./P .M. Location Month Day Year Time Dated ______________, ______ Officer _________________________ PROMISE TO APPEAR I consent and promise to appear at the time and place specified in the above summons, the receipt of a copy of which is acknowledged, and I expressly waive earlier hearing. Dated ______________, ______ Defendant ______________________ (STATE NONCRIMINAL TRAFFIC VIOLATION) You are notified of your right to request, within fourteen days of the date of this citation, a hearing concerning the alleged traffic violation. If you do not request a hearing, the bond is deemed forfeited and the violation admitted. If you are requesting a hearing, date and sign the following portion of this citation AND INCLUDE THE BOND NOTED ON THIS CITATION for the alleged violation. Failure to do so may result in the suspension of your operator's license. You will be notified of the hearing date by the court for the county in which this citation was issued. REQUEST FOR HEARING I submit the designated bond and request a hearing on the alleged traffic violation and promise to appear at the time and date specified in the summons issued by the court for the county in which the citation was issued. Dated _______________, ___________ Defendant ________________________
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