20141016100655407_0001.tif I
CITY OF BLAIR, NEBRASKA i 1 3
CITATION AND COMPLAINT
City of Blair Date of Offense Hour Case No,
Nebraska vs. L �il �? 3
Last Name First Name ` M.I.
CID /AU i9
Cit Siat Zip Code
5
5 33 ► y 1�
DOB Ht. Wt, Eyes Hair Race Qrivers Lie N
ehic e o or ea Make a tote cense late ear
IN Phone
The undersigned being dui sworn, sa s the defendant, t the date and time shown, at or near
g g y r , .
(Iccation) - . c - -- �--, IN ��
In the City of Blair, County of Washington, State of Nebraska, and did unlawfully commit the following
offense:
O AnimalViolation O ImproperParking
(Specify)
Nuisance Violation 4 "��� N 2 0 N�ef e�i ng 10 ®®
(Specify) VA on �ed.s (specify)
O Minor in oss�s to o� oo ac , ,, O OtherViolation
Officer 1 No. Officer 2 No,
t o ecuto Filed & Sworn Before Me
Date
Your CourtApppe°arance Judge/Clerk
.
Dat ,/ - Time;
Court Address: Washington County Court
1555 Colfax Street, Blair, NE 68008
home 402) 426 -6833
This is an appearance only, not rial date. _
I promise that I will appear in ua tthe
above time and place,
Your signature is not a "'d mission of guilt, but a promise t appear. Failure to
comply with the terms of thts,citation is punishable by jail or fine or both and may
result in suspension of your op license.
If Juvenile: Father's Name:
Address: Phone:
(Ifdi erent than above)
Mother's Name:
Address: Phone:
(If d ferent than above)
i