ATTACHMENT XV OFFICER S RECEIPT Agency NO. From: Thru Issued To Officer s Name Date Issued Issuing Authority I, the undersigned, certify that I have personally examined each of the twenty (20) pre-numbered complain forms with the numbers shown above and have found all said forms included in this book. I accept full responsibility and accountability for this uniform complaint book issued to me on the above date. Signature of Officer ID# IMPORTANT 1. EACH CITATION IN THIS BOOK MUST BE ACCOUNTED FOR. 2. IF CITATION IS SPOILED WHILE WRITING IT OR IS NOT COMPLETED FOR ANY REASON, MARK VOID ACROSS IT, SIGN IT, AND RETURN ALL COPIES TO PROPER AUTHORITY 3. IF CITATION IS LOST OR MISSING BEFORE OT AFTER WRITING IT, AN AFFIDAVIT CONCERNING THIS FACT SHOULD BE EXECUTED AND TRANSMITTED TO THE PROPER AUTHORITY. 4. IF THE ENTIRE BOOK OF CITATION OR PART OF IT IS RENDERED UNUSABLE IN ANY WAY, IT SHOULD BE TURNED IN FOR TRANSMITTAL TO THE PROPER AUTHORITY. PRE-CARBON PAPER
IN THE DESIGNATED BELOW THE UNDERSIGNED AFFIRMS THAT HE/SHE COMPLAINT (RETAINED BY THE ) UPON THE WATERS OF THE STATE OF FLORIDA, OR, NAMELY THIS CITATION IS FOR A CRIMINAL VIOLATION. APPEARANCE IS REQUIRED, AS INDICATED BELOW. THIS CITATION IS FOR A CRIMINAL VIOLATION. APPEARANCE IS NOT REQUIRED. THIS CITATION IS FOR AN INFRACTION WHICH DOES NOT REQUIRE APPEARANCE IN. (SEE REVERSE) THIS CITATION IS FOR AN INFRACTION. APPEARANCE IS REQUIRED AS INDICATED BELOW. COMPLAINT CASE NO. DOCKET NO PAGE NO. DATE ACTION AND ORDERS BAIL FIXED AT $ OR CASH DEPOSIT OF $ SIGNATURE OF PERSON GIVING BAIL SIGNATURE OF PERSON TAKING BAIL FINE IN THE AMOUNT OF $ RECEIVED AS REQUIRED BY SCHEDULE SIGNATURE OF CLERK CONTINUANCE TO REASON CONTINUANCE TO REASON BOND ENTREATED WARRANT ISSUED DEFENDANT FAILED TO APPEAR DEFENDANT ARRAIGNED ON (DATE) PLEA: FINDINGS: ADJUDICATION: SENTENCE: FINE COST JAILED DAYS PROBATION DAYS BOATER IMPROVEMENT SCHOOL REQUIRED NO SUBSTANCE ABUSE SCHOOL NO SIGNATURE OF JUDGE TESTIMONY JUDGE S NOTES (OR ORDERS): APPEAL BOND OF $
IN THE DESIGNATED BELOW THE UNDERSIGNED AFFIRMS THAT HE/SHE STATE ATTORNEY REPORT OF DISPOSITION ABSTRACT OF RECORD FOR UPON THE WATERS OF THE STATE OF FLORIDA, OR, NAMELY THIS CITATION IS FOR A CRIMINAL VIOLATION. APPEARANCE IS REQUIRED, AS INDICATED BELOW. THIS CITATION IS FOR A CRIMINAL VIOLATION. APPEARANCE IS NOT REQUIRED. THIS CITATION IS FOR AN INFRACTION WHICH DOES NOT REQUIRE APPEARANCE IN. (SEE REVERSE) THIS CITATION IS FOR AN INFRACTION. APPEARANCE IS REQUIRED AS INDICATED BELOW. I. II. UNIFORM BOATING CITATION REPORT OF DISPOSITION ABSTRACT OF RECORD FOR FWC - DIVISION OF LAW ENFORCEMENT MUST BE REPORTED WITHIN 10 DAYS AFTER FINAL ADJUDICATION PAID CIVIL PENALTY ACTION BY COUNTY CLERK NO HEARING OR TRIAL IN ACTION BY OR HEARING OFFICIAL WHERE APPEARANCE IN OR BEFORE HEARING OFFICIAL IS REQUIRED OR ELECTED. DEFENDANT'S PLEA: (CHECK ONE) GUILTY NOT GUILTY NOLO CONTENDERE TRIAL: JURY NON-JURY FINE AMOUNT: CHECK ONLY ONE III. IV. GUILTY VERDICT ESTREATED OR FORFEITED BOND ADJUDGED DELINQUENT (JUVENILE ONLY) NOT GUILTY DISMISSED NOLLE PROSEQUI ADJUDICATION WITHHELD BY JUDGE COUNTY CITY EXPLAIN COSTS SENTENCE BY OR HEARING OFFICIAL USE ONLY WHEN VERDICT IS GUILTY OR ADJUDICATION WITHHELD BY JUDGE SERVED TIME SENTENCE WITHHELD, DEFERRED OR SUSPENDED PROBATION BOATING SCHOOL FINE AND/OR COSTS EXPLAIN IF ORIGINAL CHARGE IS CHANGED, ENTER CHARGE OF WHICH DEFENDANT WAS CONVICTED. DO NOT MAKE ANY ADDITIONAL CHANGES ON FRONT OR BACK OF THIS CITATION. ORIGINAL BUI CHARGE CHANGED BY STATE ATTORNEY NO PRESIDING JUDGE OF TRIAL TYPE OF (IF THAN COUNTY, CHECK BOX AND ENTER TYPE) COUNTY V. BOATING OPERATION PRIVILEGE ACTION VI. TYPE SUSPENDED BY AS SPECIAL CONDITION OF PROBATION NO LENGTH VIOLATIONS CARRYING MANDATORY SUSPENSION SUSPENDED PENDING COMPLETION OF BOATING SCHOOL SUSPENDED PENDING PAYMENT OF $500 CIVIL PENALTY FOR REFUSAL TO FINAL ADJUDICATION OR ACTION ON SUBMITTED ON THE DATES BELOW MUST BE ENTERED ON ALL DISPOSITIONS DATE DATE SIGNATURE OF INDIVIDUAL SUBMITTING REPORT BY CLERK TO FWC- DLE RECORDS SECTION
IN THE DESIGNATED BELOW THE UNDERSIGNED AFFIRMS THAT HE/SHE DLE RECORDS 620 SOUTH MERIDIAN TALLAHASSEE, FLORIDA 32399 UPON THE WATERS OF THE STATE OF FLORIDA, OR, NAMELY THIS CITATION IS FOR A CRIMINAL VIOLATION. APPEARANCE IS REQUIRED, AS INDICATED BELOW. THIS CITATION IS FOR A CRIMINAL VIOLATION. APPEARANCE IS NOT REQUIRED. THIS CITATION IS FOR AN INFRACTION WHICH DOES NOT REQUIRE APPEARANCE IN. (SEE REVERSE) THIS CITATION IS FOR AN INFRACTION. APPEARANCE IS REQUIRED AS INDICATED BELOW.
IN THE DESIGNATED BELOW THE UNDERSIGNED AFFIRMS THAT HE/SHE SUMMONS (DEFENDANT'S COPY) UPON THE WATERS OF THE STATE OF FLORIDA, OR, NAMELY THIS CITATION IS FOR A CRIMINAL VIOLATION. APPEARANCE IS REQUIRED, AS INDICATED BELOW. THIS CITATION IS FOR A CRIMINAL VIOLATION. APPEARANCE IS NOT REQUIRED. THIS CITATION IS FOR AN INFRACTION WHICH DOES NOT REQUIRE APPEARANCE IN. (SEE REVERSE) THIS CITATION IS FOR AN INFRACTION. APPEARANCE IS REQUIRED AS INDICATED BELOW. ARREST-DELIVERED TO: FWCDLE 190 (01/06) APPEARANCE INSTRUCTIONS If you desire to plead NOT GUILTY to the charge, your personal appearance in court is required as indicated on the face of this notice. Posting of bail does not relieve you of the requirement of appearance and in the event of non-appearance; the court may both forfeit the bail and issue a warrant for your arrest. If you desire to plead GUILTY or NOLO CONTENDERE and you need not appear in court as indicated on the reverse of this notice, you may present this notice within 10 days at: Location Any time from Clerk of Courts Office Judge's Office Other to (Date) (Hour) (Date) (Hour) And pay a fine of in Cash Personal Check Other Name Address THE WAIVER BELOW MUST BE COMPLETED AND ATTACHED READ CAREFULLY Your failure to answer this summons in the manner prescribed will result in a warrant being issued on a separate and additional charge. APPEARANCE PLEA OF GUILTY OR NOLO CONTENDERE AND WAIVER CAUSE. Violation of Section No. Date of (State Statute) In consideration of my not appearing in court, I, the undersigned, do hereby enter my appearance on the Affidavit for the offense charged on the other side of this notice and WAIVE the reading of the Affidavit in the above named cause and the right to be present at the trial of said action. I hereby enter a plea of: (Check appropriate plea) GUILTY NOLO CONTENDERE and WAIVE the right to prosecute, appeal or error proceedings. I understand the nature of the charge against me: I understand my right to have counsel and I WAIVE this right and the right to a continuance. I WAIVE my right to trial before a Judge or jury. I enter my plea to the charge being fully aware that my signature to this plea will have the same affect as a judgment of this court. I understand that I may be required to enroll in, attend, and successfully complete an approved boating safety course and file proof with the Fish and Wildlife Conservation Commission, 620 South Meridian Street, Tallahassee, FL 32399-1600. I further understand that my privilege to operate a vessel will be suspended until I have done so, if so required. I must comply with this violator education requirement if: 1. this is a criminal charge, or 2. this charge caused a recreational accident as listed in s.327.30, F.S. or 3. I have been convicted of any boating charge listed in s. 327.731(1), F.S. within the 12 months preceding the date of this citation. Violations listed in s. 327.731(1), F.S., include : careless operation, 327.33(2); water skiing violations, 327.37; interference with navigation, 327.44;restricted areas and speed limits, 327.46, 327.22, 327.60, 379; safety equipment and lights, 327.50; muffling devices, 327.65, navigation rules, 327.33(3)(b); personal watercraft, 327.39. $ Total Fine and Costs Receipt Number Title (Clerk, Deputy Clerk, Deputy Bailiff) RESERVED FOR CLERK'S OFFICE USE Defendant's Signature Address Signature of Person Accepting Waiver
IN THE DESIGNATED BELOW THE UNDERSIGNED AFFIRMS THAT HE/SHE OFFICER / AGENCY OFFICER'S NOTES FOR TESTIFYING IN PLEASE NOTE FACTS AND CIRCUMSTANCES IN ADDITION TO THOSE CHECKED ON FACE OF COMPLAINT - THAT IS: 1. ANY SPECIFIC ACTION OF VIOLATOR WHICH INCREASED THE HAZARD OF THE VIOLATION; 2. WHERE VIOLATION OBSERVED AND CONTACT MADE; 3. TOTAL DISTANCE TRAVELED DURING PURSUIT; 4. STATEMENTS BY VIOLATOR AND GENERAL ATTITUDE; AND 5. PLACE OF EMPLOYMENT. UPON THE WATERS OF THE STATE OF FLORIDA, OR, NAMELY THIS CITATION IS FOR A CRIMINAL VIOLATION. APPEARANCE IS REQUIRED, AS INDICATED BELOW. THIS CITATION IS FOR A CRIMINAL VIOLATION. APPEARANCE IS NOT REQUIRED. THIS CITATION IS FOR AN INFRACTION WHICH DOES NOT REQUIRE APPEARANCE IN. (SEE REVERSE) THIS CITATION IS FOR AN INFRACTION. APPEARANCE IS REQUIRED AS INDICATED BELOW. WITNESSES: