COMPLAINT AND SUMMONS

COURT I.D.

PREFIX

TICKET NO.

COMPLAINT AND SUMMONS

MUNICIPAL COURT

ADDRESS

CITY,

NJ

YOU ARE HEREBY SUMMONED TO APPEAR BEFORE THE COURT TO ANSWER THE COMPLAINT CHARGING YOU WITH THE OFFENSE LISTED:

THE UNDERSIGNED CERTIFIES THAT THE OWNER/OPERATOR OF THIS

VEHICLE DID UNLAWFULLY PARK A

LICENSE PLATE

STATE EXP. DATE VEHICLE MAKE YEAR TYPE COLOR

OFFENSE DATE

TIME

FIRST OBSERVED

METER NO.

LOCATION

MUNICIPALITY

AND DID THEN AND THERE COMMIT THE FOLLOWING OFFENSE DESCRIPTION

THE UNDERSIGNED FURTHER STATES THAT THERE ARE JUST AND REASONABLE GROUNDS TO BELIEVE THAT YOU COMMITTED THE ABOVE OFFENSE AND WILL FILE THIS COMPLAINT IN THIS COURT

CHARGING YOU WITH THAT OFFENSE.

SIGNATURE OF COMPLAINANT

DATE ISSUED

OFFICER ID

POLICE UNIT

COURT DATE

SEE REVERSE FOR INSTRUCTIONS

COURT TIME

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NEW JERSEY UNIFORM ELECTRONIC TICKET PATS-1 (12/01)

PLEASE READ CAREFULLY

1. PLEA OF NOT GUILTY If you intend to plead not guilty to the offense charged in this Complaint and Summons and have a trial, you must notify the Court Administrator, whose address and telephone number are shown below, of your intention at least 7 days prior to your scheduled court date. If you fail to notify the Court Administrator, it may be necessary for you to make 2 court appearances.

Any Court, 123 Main Street

Any City, N.J. 99999 - Telephone: (999) 999-9999

2. COURT APPEARANCE REQUIRED If "Court Appearance Required" is printed on the front of this Complaint and Summons (see area in red on other side) you must appear in court at the time and place indicated, even if you wish to plead guilty. If "Court Appearance Required" is not printed on the front of this Complaint and Summons, you must still appear in court if you wish to have a trial.

3. PLEA OF GUILTY: PAYMENT THROUGH VIOLATIONS BUREAU If you wish to plead guilty and give up your rights to have a lawyer and a trial, you may do so provided a PAYABLE AMOUNT is listed on the front of this Complaint and Summons (see area in red on the other side). If the Violations Bureau is authorized to dispose of this charge, complete in full the APPEARANCE, GUILTY PLEA AND WAIVER (see below) and bring or mail this Complaint and Summons together with payment in the amount of the prescribed penalty, to the Violations Bureau at the address indicated below prior to your scheduled court date.

Send all payments to:

Any Court Violations Bureau 123 Main Street, Any City, NJ 99999

Telephone (999) 999-9999

Business Hours:

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If payment is made by mail do not send cash but send check or money order payable to this Municipal Court. If payment is received by the Violations Bureau after the appearance date you may be assessed additional penalties. A receipt will be sent to you only if your payment is accompanied by a self-addressed, stamped envelope. Please be sure to print the summons number on the front of your check or money order.

APPEARANCE, GUILTY PLEA AND WAIVER

By signing this document, I enter my appearance before the Court to answer the charge contained in this Complaint and Summons. I give up my rights to have a lawyer and a trial. I admit that I committed the offense charged, plead guilty, and make payment of the prescribed penalty.

_____________________________________ (Defendant's Signature)

Driver's License Number

_________________ (Date)

State

Exp. Date

NOTICE

IF YOU FAIL TO APPEAR IN RESPONSE TO THIS SUMMONS OR TO PAY THE PRESCRIBED PENALTY, ADDITIONAL PENALTIES MAY RESULT, A WARRANT MAY BE ISSUED FOR YOUR ARREST AND YOUR DRIVING PRIVILEGES IN NEW JERSEY MAY BE REVOKED. FAILURE TO APPEAR OR PAY THE PRESCRIBED PENALTY SHALL BE CONSIDERED AN ADMISSION OF LIABILITY AND A DEFAULT JUDGMENT MAY BE ENTERED AGAINST THE OWNER OF THE VEHICLE.

PLEASE NOTIFY COURT OF DISABILITY ACCOMMODATION NEEDS.

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