Pursuant to ORS 1.002, 1.525, 137.073, 153.033 (section 8, chapter 1051, Oregon Laws 1999), 153.045 (section 13, chapter 1051, Oregon Laws 1999), and 133.066 (section 57, chapter 1051, Oregon Laws 1999), the Supreme Court of the State of Oregon orders the following:

1. The attached Uniform Citation (UC) Forms 1 through 10 are adopted for purposes of Uniform Citations required by and allowed to be used under the Oregon Revised Statutes (ORS) and are subject to the requirements and provisions of this order. (NOTE: The line numbering on the pages of the attached UC are not part of the UC as adopted, but is provided solely for purposes of making reference to the UC forms as set out in this document.)

2. Format, number, size and other matters related to printing of UC forms adopted under this order. The attached adopted UC forms are not intended as print-ready copies, but are adopted to establish spaces required to be on the forms, the relative location of those spaces, and the designations of those spaces as will allow capture of certain information and to establish the information the UC are intended to provide. Public entities or others authorized to use the UC are responsible for assuring the printing of and obtaining actual UC for their own use and, in such printing, to comply with the following:

a. Number of parts (copies, pages) of a citation. Each citation will have five parts. The parts will consist of the four parts described in ORS 153.045 (section 13, chapter 1051, Oregon Laws 1999) and one additional part.

b. Front of citation parts. The front of each part will be identical to the front of each other part (see attached UC Form 1 for an example of the front of a part) except that the upper right-hand corner shall be labeled as follows: the label on the top or first part will be "complaint" or "citation" (depending upon the attached UC form that is adopted for that citation, see subsection "3" of this order below); the label on the second part will be "abstract" (for abstract of record); the label on the third part will be "police" (for "police record"); the label on the fourth part will be "officer notes"; and the label on the last or bottom copy will be "summons".

c. Back of citation parts. The back of each of the citation parts required by this order will be a UC form as specified in subsection "3" of this order. If no form is designated for the back of a citation part in subsection "3," the part may be left blank or space to capture other information may be added as provided in paragraph "g" of this subsection .

d. Size of a citation. A citation will be 8 inches long and 5 inches wide.

f. Making adjustments. So long as the entity maintains the basic format, keeps the same language, places information with the same information groupings, and provides places to capture the same information, nothing in this order limits the ability of the entity to modify, as it determines necessary, the size (including print and line size), spacing, placement of lettering within spaces or boxes on the citation form, and location of information on citation forms for its own use in order to: accommodate the printing of citations for use on computer or other printers, provide space for the capture of additional information as permitted under paragraph "2g" below, and make adjustments necessary to comply with the size requirement under paragraph "2d" above. In making any adjustment under this paragraph or otherwise in printing a citation, the entity responsible for the printing is also responsible to assure that any printing or adjustment is done in a manner that: does not render the information captured or to be captured unreadable because of size or for other reasons, and allows sufficient room to capture information the attached forms were designed to capture. It is suggested that any additional space that is generated through adjustments made by printers to accomplish more efficient use of space may be appropriately added to: UC Form 1 as additional space for officers to describe offenses charged, UC Form 6 as additional space in the judgment for a judge to describe the disposition (maybe in adding lines or space to the "probation/other" section), or as additional space for the terms of payment in the money judgment section.

g. Adding information. So long as the entity meets other requirements established by this order and by statute, the entity, as allowed by ORS 153.045(1)(section 13, chapter 1051, Oregon Laws 1999), may add spaces to capture or provide additional information in addition to that shown on the attached approved UC forms. The entity may make adjustments under paragraph "f" of this subsection for such purposes.

h. Relationship of printing on front of citation part to printing on back of citation part. Citation parts may be printed with a legal turn from front to back of each part or otherwise at the option of the entity.

i. Requirements not established. Where this order or statute does not establish specific requirements for citation form, the entity has discretion as to the form.

3. The following describes the use and intent of the attached, adopted UC Forms 1-10 and where the forms are to be placed on the parts required by this order:

a. UC Form 1. Attached UC Form 1, as permitted by ORS 153.045(2) and 133.066(5) (sections 13 and 15, chapter 1051, Oregon Laws 1999), combines forms for violations citations required by ORS 153.045 with those for a criminal citation issued with a complaint issued under ORS 133.066 and 133.069 (section 61, chapter 1051, Oregon Laws 1999). It is the form to be used for the front of each page of all parts of the citation (see paragraphs "2a" and "2b" of this order) on all citations used for the purposes allowed by those statutes. The label in the upper right-hand corner of the first part of a citation using UC Form 1 (see paragraph "2b" above) will be "complaint".

b. UC Form 2. Attached UC Form 2, as permitted under ORS 1.525(1)(d), is a special form for UC that is approved as convenient for enforcement officers who enforce the commercial vehicle/motor carrier laws of this state. All boxes and required information on UC Form 2 shall be identical to that on UC Form 1 except that the citation shall be titled as shown on UC Form 2 and the "related information" and "offenses" boxes shown on UC Form 1 are replaced with the boxes shown on UC Form 2. In all other respects, the citations using UC Form 2 will be identical to and usable for the same purposes as UC Form 1. UC Form 2 was designed to increase convenience in and allow capture of information useful in the enforcement of the commercial vehicle/motor carrier laws of this state.

c. UC Form 3. Attached UC Form 3, as permitted under ORS 1.525(1)(d), is a special form for UC that is approved as convenient for enforcement officers who enforce the boating laws of this state. All boxes and required information on UC Form 3 shall be identical to that on UC Form 1 except that the citation shall be titled as shown on UC Form 3 and the "related information" and "offenses" boxes shown on UC Form 1 are replaced with the boxes shown on UC Form 3. Except for use of UC Form 8 as described below, citations using UC Form 3, in all other respects, will be identical to and usable for the same purposes as UC Form 1. UC Form 3 was designed to increase convenience in and allow capture of information useful in the enforcement of the boating laws of this state.

d. UC Form 4. Attached UC Form 4, as permitted under ORS 1.525(1)(d), is a special form for UC that is approved as convenient for enforcement officers who enforce the fish and wildlife laws of this state. All boxes and required information on UC Form 4 shall be identical to that on UC Form 1 except that the citation shall be titled as shown on UC Form 4 and the "related information" and "offenses" boxes shown on UC Form 1 are replaced with the boxes shown on UC Form 4. Except for use of UC Form 8 as described below, citations using UC Form 4, in all other respects, will be identical to and usable for the same purposes as UC Form 1. UC Form 4 was designed to increase convenience in and allow capture of information useful in the enforcement of the fish and wildlife laws of this state.

e. UC Form 5. The attached approved UC Form 5 is for purposes of the criminal citation issued without a complaint under ORS 133.066 and 133.068 (sections 57 and 60, chapter 1051, Oregon Laws 1999). It is the form to be used for the front of each page of all parts of the citation (see paragraphs "2a" and "2b" of this order) on all citations used for the purposes allowed by those statutes. The label in the upper right-hand corner of the first part of a citation using UC Form 5 (see paragraph "2b" above) will be "citation".

f. UC Form 6. The attached approved UC Form 6 is to be placed on the back of the "complaint/citation" and "abstract" parts (the first two parts of citations, see paragraph "2a" and "2b" above) of citations for all citations.

g. UC Form 7. The attached approved UC Form 7 is to be placed on the back of the "officer notes" part of the citation (the back of the fourth part, see paragraph "2b" above) on all citations except when Form 8 is required.

h. UC Form 8. The attached approved UC Form 8 is to be placed on the back of the "officer notes" part of the citation (the back of the fourth part, see paragraph "2b" above) on all citations when using UC Forms 3 or 4 on the front of the parts of the citations.

i. UC Form 9. The attached approved UC Form 9 is to be placed on the back of the "summons" part of the citation (the back of the last or bottom part, see paragraph "2b" above) on all citations in all instances except when UC Form 10 is required.

j. UC Form 10. The attached approved UC Form 10 is to be placed on the back of the "summons" part of the citation (the back of the last or bottom part, see paragraph "2b" above) on all citations in all instances when UC Form 5 is on the front part of the citation.

4. Rules related to use of UC. The following are requirements related to UC forms adopted by this order:

a. No enforcement officer shall cite more offenses on a single citation than the number of spaces provided on the front of the citation to describe offenses cited or than the number of spaces provided on the back of the citation to create judgments for offenses cited on that citation, whichever is fewer.

b. The "other" box designed on front of each citation part of all citation forms between the "offense" box and the box for the citing officer's signature has been made available for use strictly at the option of the citing officer to capture information related to the charges as that officer determines necessary. The information to be captured may include any or none of the following: the signature of the defendant where the citing officer determines such would be appropriate and the signature can be safely obtained; the names of witnesses; the names of persons served with the citation when a corporation is the defendant; the fact that the offense charged was committed in a safety corridor designated under and subject to the fine amounts set under section 5, chapter 1071, Oregon Laws 1999; information the agency of the citing officer is collecting for administrative purposes; any other information the citing officer determines may be appropriate to note on the citation.

c. The place designed on the back of the "officer notes" part of all citations to allow capture of defendant fingerprints is to be used at the option of the citing officer.

5. References to statute contained in the attached approved UC forms and in this order are based on information available to this Court from the Oregon Legislative Counsel's office at the time this order was considered. Such statutory references may be adjusted or changed without further order of this Court to correct references where compilation of the sections of measures that became law out of the 1999 Regular Session of the Oregon Legislative Assembly results in different ORS numbers than referenced in this order or in the attached adopted citations or where subsequent enactments of the Oregon Legislative Assembly make such adjustment or change appropriate.

6. Except as provided in subsection 9 of this order, this order, on January 1, 2000, rescinds all previously approved or adopted existing UC forms and requirements and procedures established in Supreme Court Orders (SCO) adopting or approving those forms, requirements or procedures, including those adopted or approved in Supreme Court Orders Nos 89-76, 91-107, and 93-110.

7. As of January 1, 2000, SCO 95-044 is rescinded and base fine amounts for violations cited on the citations will be those set according to the provisions of ORS 153.125 to 153.145 (sections 34 to 39, chapter 1051, Oregon Laws 1999).

8. UC forms approved by this order may be used as early as January 1, 2000, and must be used for citations issued on and after April 1, 2000.

9. As required under ORS 1.525(2), this Court approves continued use of UC forms currently approved by this Court until April 1, 2000. When using existing citation forms under this paragraph, citations on violations cited are to be completed in a way to indicate that the person cited for the violation is to follow the procedures described on the citation for infractions. The references on existing citations to infractions will be deemed to be references to violations under chapter 1051, Oregon Laws 1999. The references on existing citations to "bail" amounts on the existing citations will be deemed references to base fine amounts under chapter 1051, Oregon Laws 1999.

10. Attached UC forms are not intended to create requirements for sufficiency of complaints, citations, abstracts, judgments, summons, a record or other records/documents statutorily authorized to be included as part of uniform citations; but to provide forms that can be used to comply with statutory requirements for these records/documents when used for offenses where use of a uniform citation is statutorily authorized. Some of the spaces provided on the UC forms may not be required to comply with statutory or other legal requirements for legal sufficiency of the citation/complaint/record/document, but were added to capture information appropriate to the administration involved in processing and tracking the offenses. The legal sufficiency of the information completed and spaces filled in on a specific citation/complaint/record/document on a citation is an issue of the statutory and other legal requirements for the citation/complaint/record/ document rather than an issue of the blanks or spaces created or provided on the UC forms adopted by this order.

Dated this                     day of December, 1999.

Wallace P. Carson, Jr.

Chief Justice

1999 Oregon Uniform Citation (UC) Form 1 (Ticket size needed 8" by 5)

OREGON UNIFORM CITATION AND COMPLAINT Use for All Violations or Crimes Where Separate Complaint Will Not Be Filed/ ORS 153.045 or 133.069

CRIME(S) (See A on Back)

OR (Not Both)

VIOLATION(S) (See B on Back)

Traffic Other Wildlife Boating Commercial Fishing

STATE OF OREGON CITY/ OTHER PUBLIC BODY _ _ _ _ _ _ _ _ _ _ _ _ _ _ COUNTY OF _ _ _ _ _ _ _ _ _ _ _ _ _ _

) ) )

Docket No. _ _ _ _ _ _ _ _ _ _ _ _ _ Court: Municipal Justice Juvenile Circuit

THE UNDERSIGNED CERTIFIES AND SAYS THAT THE FOLLOWING PERSON:

ID Type:

ID No:

State:

Tel.No:

Name: Last First MI

Address:

License Class

Employed to drive

City: State: Zip Code:

Def. is: Passenger _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Sex:

Race:

DOB:

Height:

Weight:

Hair:

Eyes:

AT THE FOLLOWING TIME AND PLACE IN THE ABOVE-MENTIONED STATE AND COUNTY:

Offense Date Month Day Year Time AM PM on or about:

Highway _ _ _ _ _ _ Premises open to public

At or near Location:

INVOLVING THE FOLLOWING:

Type:

Regis/VIN/ID No

State

Accident Injury Property damage Endanger others

Vehicle year, make, model, style, color; OR Other, describe:

Driver not Reg. Owner Haz Material Commercial Veh.

Other:

DID THEN AND THERE COMMIT THE FOLLOWING OFFENSE(S):

1. Violated (cite ORS/ ORD/rule)

Describe Alleged spd Designated Spd Posted Limit VBR

Radar Pace Laser _ _ _ _ _ _

Intentional knowing reckless criminal negligence No culpable mental state

Pstd Sch Zn Hwy Wk Zn

1. Base fine:

2. Violated (cite ORS/ ORD/rule)

Describe

Intentional Knowing Reckless Criminal negligence No culpable mental state

2. Base fine:

3. Violated (cite ORS/ ORD/rule)

Describe

Intentional Knowing Reckless Criminal negligence No culpable mental state

3. Base fine:

Expl.

I certify under ORS 153.045 and 153.990 and under other applicable law and under penalties for false swearing, do swear/affirm that I have sufficient grounds to and do believe that the above-mentioned defendant/person committed the above offense(s) and I have served the defendant/person with this complaint: _ _ _ _ _ _ _ __ _ _ _ __ _ _ __ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ___ _ _ _ _ _ _ _ _ _ _ _ Date Issued 1st Officer Signature

Officer(s) Agency ID: 1st Officer ID No: 2nd Officer ID No:

Print 1st Officer name:

2nd Officer or arresting person (if not officer): Signature Print name:

YOUR COURT APPEARANCE DATE, TIME AND LOCATION ARE:

Mo/Day/Year

Time: AM PM

Location:

1999 Oregon Uniform Citation (UC) Form 2 (Ticket size needed 8" by 5")

	OREGON UNIFORM MOTOR CARRIER CITATION AND COMPLAINT Use for All Violations or Crimes Where Separate Complaint Will Not Be Filed/ ORS 153.045 or 133.069
	CRIME(S) (See A on Back)			OR	VIOLATION(S) (See B on Back)		Traffic Other Wildlife Boating Commercial Fishing
	STATE OF OREGON CITY OF _ _ _ _ _ _ _ _ _ _ _ _ _ _ COUNTY OF _ _ _ _ _ _ _ _ _ _ _ _ _ _					) ) )	Docket No. _ _ _ _ _ _ _ _ _ _ _ _ _ Court: Municipal Justice Juvenile Circuit
		The Undersigned Certifies and Says That The Following Person:
		ID Type:		ID No:			State:	Tel.No:
		Name: Last First MI
		Address:						License Class	Employed to drive
		City: State: Zip Code:							Passenger _ __ _ _ _ _ _
		Sex:		Race:	DOB:	Height	Weight	Hair	Eyes
		At the Following Time and Place in the Above-mentioned State and County:
		Offense Date Month Day Year Time AM on or about: PM						Highway _ _ _ _ _ _ Premises open to public
		At Location:
		INVOLVING THE FOLLOWING:
		Veh. Registration No.		State	Veh.Yr.	Make	Model	Accident Injury Property Damage Endanger Others Hwy work Zone
		ODOT NO: Haz. Mat. CDL Related				Commodity
		Owner Address City State Zip Code
		DID THEN AND THERE COMMIT THE FOLLOWING OFFENSE(S):
		1. Violated (cite ORS/ ORD/rule)			Describe
		Overload Axle Tandem Group Alleged Wt: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Permit Violation Vehicle Combination Wt. Limit:						1. Base fine:
		2. Violated (cite ORS/ ORD/rule)			Describe
		Oversize Width Height Length Alleged Size: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Permit violation No ODOT Permit Size Limit:						2. Base fine:
		3. Violated (cite ORS/ ORD/rule)			Describe
								3. Base fine:
	OTHER							Expl.
	I certify under ORS 153.045 and 153.990 or other applicable law that I have sufficient grounds to and do believe that the above-mentioned defendant/person committed the above offense(s) and I have served the defendant/person with this complaint: _ _ _ _ _ _ _ __ _ _ _ __ _ _ __ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ___ _ _ _ _ _ _ _ _ _ _ _ Date Issued Officer Signature								Officer(s) Agency ID:
	Print Officer name:							Officer ID No:
	2nd Officer or arresting person (if not officer): Signature Print name:
	YOUR COURT APPEARANCE DATE, TIME AND LOCATION ARE:
	Mo/Day/Year			Time: AM PM	Location:

1999 Oregon Uniform Citation (UC) Form 3 (Ticket size needed 8" by 5")

	OREGON UNIFORM BOATING CITATION AND COMPLAINT Use for All Violations or Crimes Where Separate Complaint Will Not Be Filed/ ORS 153.045 or 133.069
	CRIME(S) (See A on Back)			OR	VIOLATION(S) (See B on Back)		Traffic Other Wildlife Boating Commercial Fishing
	STATE OF OREGON CITY OF _ _ _ _ _ _ _ _ _ _ _ _ _ _ COUNTY OF _ _ _ _ _ _ _ _ _ _ _ _ _ _					) ) )	Docket No. _ _ _ _ _ _ _ _ _ _ _ _ _ Court: Municipal Justice Juvenile Circuit
		The Undersigned Certifies and Says That The Following Person:
		ID Type:		ID No:			State:	Tel.No:
		Name: Last First MI
		Address:						License Class	Employed to drive
		City: State: Zip Code:							Passenger _ __ _ _ _ _ _
		Sex:		Race:	DOB:	Height	Weight	Hair	Eyes
		At the Following Time and Place in the Above-mentioned State and County:
		Offense Date Month Day Year Time AM on or about: PM						Highway _ _ _ _ _ _ Premises open to public
		At Location:
		INVOLVING THE FOLLOWING:
		Vessel Registration No:			Regis Expires: Mo Day Year			Defendant not registered owner
		Make		Length	Hull Id No:			Accident Injury Property damage Endanger others
		DID THEN AND THERE COMMIT THE FOLLOWING OFFENSE(S) (UP TO 3 OFFENSES):
		Off# _ _ _ _ _ Speed/wake/motor 830.180 830.185 Radar 250. _ _ _ _ _ _ _ _ - _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _						Designated:	Alleged:
		Towing without an observer Water skiing or similar activity, 830.365 Skier down flag
		Off# _ _ _ _ _ Personal flotation device, 830.215 Insufficient number Not approved Not accessible Defective No throwable						Persons:	PFDs:
		Navigation lights, 830.225 Operating without Improper
		Mufflers/excessive noise, 830.260 Measured level None/inadequate						Noise Level:	OAR 250-10-121
		Fire extinguisher, 830.220 Insufficient no. Discharged Not approved Not accessible
		Off# _ _ _ _ _ Certificate of Number 830.770: Not aboard Expired Identifying Number 830.780: Incorrect display Not displayed Not applied for 830.785							1. Base Fine 1st off: $
		Validation stickers, 830.795: Incorrect or not displayed Expired							2. Base Fine 2nd off: $
	Off# _ _ _ _ _ Other (cite ORS/ ORD/rule)			Describe					3. Base Fine 3rd off: $
	OTHER							Expl.
	I certify under ORS 153.045 and 153.990 or other applicable law that I have sufficient grounds to and do believe that the above-mentioned defendant/person committed the above offense(s) and I have served the defendant/person with this complaint: _ _ _ _ _ _ _ __ _ _ _ __ _ _ __ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ___ _ _ _ _ _ _ _ _ _ _ _ Date Issued Officer Signature								Officer(s) Agency ID:
	Print Officer name:							Officer ID No:
	2nd Officer or arresting person (if not officer): Signature Print name:
	YOUR COURT APPEARANCE DATE, TIME AND LOCATION ARE:
	Mo/Day/Year			Time: AM PM	Location:

1999 Oregon Uniform Citation (UC) Form 4 (Ticket size needed 8" by 5")

	OREGON UNIFORM FISH/WILDLIFE CITATION AND COMPLAINT Use for All Violations or Crimes Where Separate Complaint Will Not Be Filed/ ORS 153.045 or 133.069
	CRIME(S) (See A on Back)			OR	VIOLATION(S) (See B on Back)		Traffic Other Wildlife Boating Commercial Fishing
	STATE OF OREGON CITY OF _ _ _ _ _ _ _ _ _ _ _ _ _ _ COUNTY OF _ _ _ _ _ _ _ _ _ _ _ _ _ _					) ) )	Docket No. _ _ _ _ _ _ _ _ _ _ _ _ _ Court: Municipal Justice Juvenile Circuit
		The Undersigned Certifies and Says That The Following Person:
		ID Type:		ID No:			State:	Tel.No:
		Name: Last First MI
		Address:						License Class	Employed to drive
		City: State: Zip Code:							Passenger _ __ _ _ _ _ _
		Sex:		Race:	DOB:	Height	Weight	Hair	Eyes
		At the Following Time and Place in the Above-mentioned State and County:
		Offense Date Month Day Year Time AM on or about: PM						Highway _ _ _ _ _ _ Premises open to public
		At Location:
		INVOLVING THE FOLLOWING:
		Boat/Vehicle Regis or License No:				State	Accident Injury Property damage Endanger others
		Describe: (year, make, model, length, color, other)
		Hunting/Angling License No:				Unit No.		Stream No.
		DID THEN AND THERE COMMIT THE FOLLOWING OFFENSE(S):
		1. Violated (cite ORS/ ORD/rule)			Describe
		Intentional Knowing Reckless Criminal negligence No culpable mental state						1. Base fine:
		2. Violated (cite ORS/ ORD/rule)			Describe
		Intentional Knowing Reckless Criminal negligence No culpable mental state						2. Base fine:
		3. Violated (cite ORS/ ORD/rule)			Describe
		Intentional Knowing Reckless Criminal negligence No culpable mental state						3. Base fine:
	OTHER							Expl.
	I certify under ORS 153.045 and 153.990 or other applicable law that I have sufficient grounds to and do believe that the above-mentioned defendant/person committed the above offense(s) and I have served the defendant/person with this complaint: _ _ _ _ _ _ _ __ _ _ _ __ _ _ __ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ___ _ _ _ _ _ _ _ _ _ _ _ Date Issued Officer Signature								Officer(s) Agency ID:
	Print Officer name:							Officer ID No:
	2nd Officer or arresting person (if not officer): Signature Print name:
	YOUR COURT APPEARANCE DATE, TIME AND LOCATION ARE:
	Mo/Day/Year			Time: AM PM	Location:

1999 Oregon Uniform Citation Form 5 (Ticket size needed 8" by 5")

	OREGON UNIFORM CRIMINAL CITATION Use for All Citable Crimes Where Separate Complaint Will Be/Has Been Filed /ORS 133.068
	See Back of Summons			Traffic Other Wildlife Boating Commercial Fishing
	STATE OF OREGON CITY/ OTHER PUBLIC BODY _ _ _ _ _ _ _ _ _ _ _ _ _ _ COUNTY OF _ _ _ _ _ _ _ _ _ _ _ _ _ _				) ) )	Docket No. _ _ _ _ _ _ _ _ _ _ _ _ _ Court: Municipal Justice Juvenile Circuit
		THE UNDERSIGNED CERTIFIES AND SAYS THAT THE FOLLOWING PERSON:
		ID type:	ID No:			State:	Tel. No.
		Name: Last First MI
		Address:					License Class	Employed to drive
		City: State: Zip Code:					Def. Is: Passenger _ _ _ _ _ _ _ _ _ _ _ _ _ _
		Sex:	Race:	DOB:	Height	Weight	Hair	Eyes
		AT THE FOLLOWING TIME AND PLACE IN THE ABOVE-MENTIONED STATE AND COUNTY:
		Offense Date Month Day Year Time AM PM on or about:				Highway _ _ _ _ _ _ _ _ _ _ _ _ _ _ Premises open to public
		At or near Location:
		DID THEN AND THERE COMMIT THE FOLLOWING OFFENSE(S):
		1. Violated (cite ORS/ ORD/rule)		Describe
		Intentional Knowing Reckless Criminal negligence No culpable mental state
		2. Violated (cite ORS/ ORD/rule)		Describe
		Intentional Knowing Reckless Criminal negligence No culpable mental state
		3. Violated (cite ORS/ ORD/rule)		Describe
		Intentional Knowing Reckless Criminal negligence No culpable mental state
						Expl.
	I certify and swear/affirm under applicable law that I have sufficient grounds to and do believe that the above-mentioned defendant/person committed the above offense(s) and I have served the defendant/person with this citation: _ _ _ _ _ _ _ __ _ _ _ __ _ _ __ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Date Issued 1st Officer Signature							Officer(s) Agency ID: 1st Officer ID No:
	Print 1st Officer name:							2nd Officer ID No:
	2nd Officer or arresting person (if not officer): Signature Print name:
	Complaint or information filed at time of citation: Yes No BY:
	YOUR COURT APPEARANCE DATE, TIME AND LOCATION ARE:
	Mo/day/year		Time: AM PM	Location:

1999 Oregon Uniform Citation (UC) Form 6 Back of complaint/abstract pages of ALL citations.

Ticket size needed 8" by 5"

RECORD AND: Circuit Court Register Justice Court Docket Municipal Court Docket

HANDLED BY: VIOLATIONS BUREAU BASED ON: WRITTEN SUBMISSION

COURT APPEARANCE

DATE	EVENT/NOTES	INITIAL
	COMPLAINT FILED
	WRITTEN RESPONSE RECEIVED
	ARRAIGNED MISD. VIOL. 161. 566 OR 161.568 (reduction)
	SECURITY RELEASE AT: $ RECEIPT NO:
	COURT/JURY TRIAL ( WAIVED)
	CRIMINAL RIGHTS GIVEN
	ATTORNEY: OSB#: ( WAIVED)
	WARRANT ORDERED: ISSUED:
	DIVERSION AGREEMENT:
	CONTINUED TO: REASON:
	ORS 135.355 CONDITIONAL PLEA
The attached additions to this record/register are incorporated by reference, see page(s): 1 (by _ _ _ _); 2 (by _ _ _ _).

JUDGMENT OF THE COURT (SUBMIT ABSTRACT COPY UNDER ORS 153.111)

OFF #	RESPONSE/PLEA	CHANGE PLEA	FINDING	DETERMINATION	OFFENSE CITE	TYPE	CLASS
1	G NG NC FTA		G NG	C A Dism		V M	A B C D Oth
2	G NG NC FTA		G NG	C A Dism		V M	A B C D Oth
3	G NG NC FTA		G NG	C A Dism		V M	A B C D Oth

DISPOSITION: 137.533 Deferred Sentence Sent.Imp.Sus. Dr. Priv. Susp. _ _ _ _ _ _ _ _ _ _ _ _ (Time) Conv. Spd. _ _ _ _ _ _ JAIL: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Probation/Other: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

The attached additions to this judgment are incorporated by reference, see page(s): 1 (by _ _ _ _); 2 (by _ _ _ _); 3 (by _ _ _ _).

MONEY JUDGMENT	OFFENSE 1		OFFENSE 2		OFFENSE 3
MONEY OBLIGATION	IMPOSE	SUSPEND	IMPOSE	SUSPEND	IMPOSE	SUSPEND
FINE
COSTS
137.309 ASSESSMENT
UNITARY ASSESSMENT
RESTITUTION
TOTALS
TOTAL AMOUNT TO PAY THAT IS NOT SUSPENDED (FROM OFFENSES, 1, 2, AND 3) $ _ _ _ _ _ _ _ _ _ _ _ _ _
TERMS OF PAYMENT: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ All moneys, including suspended moneys, become due immediately under ORS 153.090(4) if nonsuspended moneys not paid in accordance with terms of payment.
The attached additions to this MONEY judgment are incorporated by reference, see page(s): 1 (by _ _ _ _); 2 (by _ _ _ _).
Judgment Creditor: State of Oregon Other _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Judgment Debtor: Defendant Other _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

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Date Signature of: Judge ( Violations Clerk, where allowed)

1999 Oregon Uniform Citation (UC) Form 7. Ticket size needed 8" by 5".

ISSUING OFFICER'S AFFIDAVIT I hereby depose and state the following:
			Defendant Finger Print: R L T 2 3 4 5
			Defendant Finger Print: R L T 2 3 4 5
RELEVANT CONDITIONS:		Traffic: Light Medium Heavy
Bad Road Surface: Wet Snow Ice		At Intersection: Controlled Uncontrolled Drwy./Alley
Limited Visibility: Night Rain Snow Fog		Area: Business School Residential
Other:
I swear/affirm to the above-stated facts _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Date Officer Signature ID No.
Subscribed and sworn to before me this _ _ _ _ _ _ day of _ _ _ _ _ _ _ _ _ _ _ _ _ _ , 2 _ _ _ _ _
		_ _ _ _ _ _ _ _ __ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Clerk/Notary Public for Oregon My Commission expires _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Date

1999 Oregon Uniform Citation (UC) Form 8. Ticket size needed 8" by 5".

ISSUING OFFICER'S AFFIDAVIT I hereby depose and state the following:
			Defendant Finger Print: R L T 2 3 4 5
			Defendant Finger Print: R L T 2 3 4 5
WATER TRAFFIC Light Medium Heavy	GENERAL CONDITIONS		SITUATIONS Person Struck Boat Nearly struck Other _ _ _ _ _ _ _ _ _ _ _
	LOCALE Open Restricted	VISIBILITY Clear Fog Dark Rain
I swear/affirm to the above-state facts _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Date Officer Signature ID No.
Subscribed and sworn to before me this _ _ _ _ day of _ _ _ _ _ _ _ _ _ _ _ _ _, 2 _ _ _ _ _
		_ _ _ _ _ _ _ _ __ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Clerk/Notary Public for Oregon My Commission expires _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Date

1999 Oregon Uniform Citation (UC) Form 9, Back of summons copy of all uniform citation forms except Form 5, Ticket size needed 8" by 5"

A COMPLAINT ON THIS CITATION WILL BE FILED AGAINST YOU IN THE COURT INDICATED ON THE FRONT OF THIS SUMMONS.

If the front of this ticket shows you are charged with a:

A. CRIME, YOU MUST APPEAR at the time and place set by this summons.

B. VIOLATION, You must do one (and only one) of the violation options listed below.

VIOLATION OPTIONS TO RESPOND TO VIOLATION(S) CHARGED ON THIS SUMMONS, YOUR OPTIONS ARE:
OPTION 1	PERSONALLY APPEAR at the court at the appearance time indicated to enter a plea OR, before that time, to orally request a trial. You have a right to trial, and if you plead not guilty when you appear, the court will set a date and time for trial.
OPTION 2	ENTER A PLEA OF GUILTY OR NO CONTEST by written appearance. To choose this option do all the following before the time this summons requires you to appear:
1. Check AND initial one (and only one) of the following pleas: I Plead GUILTY _ _ _ _ _ _ (initial) I Plead NO CONTEST _ _ _ _ _ _ (initial) 2. Sign/date here: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ (signature), _ _ _ _ _ _ _ _ (date), AND 3. Deliver to the court this summons (see notice "4" below) and attach a written statement explaining or in mitigation of the violation(s) charged (if your plea is GUILTY, the written statement is optional), AND 4. With this summons, send or take the court a check or money order for the full base fine amount as shown on this summons ($ _ _ _ _ _ _ _ _ _ _ _ indicate amount enclosed). IMPORTANT: Choosing this option makes a written appearance and waives your right to trial. If you plead GUILTY, you agree to the penalties for your offense. If you plead NO CONTEST, you consent to any court judgment based on your plea and statement and the officer's report. If it finds you guilty, the court may keep all or part of the money you pay, but will return any left after taking out the sanction amount. If you choose this option, the court will not fine you more without giving you notice to come to a hearing.
OPTION 3	ENTER A PLEA OF NOT GUILTY by written appearance. To choose this option do all the following before the time this summons requires you to appear:
1. Sign/date here: _ _ _ _ _ _ _ _ _ _ __ _ _ _ _ _ _ _ _ _ _ _ _ (signature), _ _ _ _ _ _ _ _ (date), AND 2. Deliver to the court this summons by itself or with a written request for trial (see notice "4" below). IMPORTANT: Choosing this option makes a written request for hearing. The court will give you notice of the time and place when you MUST appear. The court may impose penalties if you do not appear at the time given in the notice. The court may require you to deposit money to assure your appearance if you have failed to appear on any offense charges in the past.
OPTION 4	Contact the Court Clerk, before the time this summons requires you to appear, and determine if you qualify for a trial by affidavit under ORS 153.080.
If so, the trial will be based upon sworn, written statements and future court appearances may not be necessary. It is possible that you may not qualify for trial by affidavit or that the local court may not offer the option. In those cases, you must comply with one of the other options.

1. In any case, the court, AFTER NOTICE, MAY REQUIRE YOU TO APPEAR FOR A HEARING.

2. For traffic offenses, this record will be sent to the Licensing Authority of this state (or where you received your license to drive) to decide if a license suspension is appropriate.

3. For violations, if you are going to have an attorney represent you, you must notify the court and the prosecutor's office in advance.

4. YOU MAY MAIL WRITTEN APPEARANCES to the court under Violation Options 2 or 3 above, but the mail must arrive at the court before your appearance date shown on this summons.

1. IF YOU FAIL TO FOLLOW THESE INSTRUCTIONS, THE COURT MAY ISSUE A WARRANT FOR YOUR ARREST and/or, for traffic offenses, may order your license suspended.

2. For violations, if you do not pay the full base fine in advance and do not appear, the court, without further hearing, may enter a conviction and a judgment against you for more than the base fine and up to the maximum penalty allowed by law for the charged offense(s) including the maximum fines, assessments, restitution and other costs (which may be substantially more than the base fine).

MAIL CORRESPONDENCE OR WRITTEN APPEARANCE AND MAKE CHECKS PAYABLE TO:

1999 Oregon Uniform Citation (UC) Form 10, Back of summons copy of Form 5

You have been issued a citation for a crime as indicated on the front of this summons.

This citation is not a complaint or an information. A complaint or an information may be filed and you will be provided a copy thereof at the time of your first appearance. You MUST appear in court at the time set in the citation. IF YOU FAIL TO APPEAR AND A COMPLAINT OR INFORMATION HAS BEEN FILED, THE COURT WILL IMMEDIATELY ISSUE A WARRANT FOR YOUR ARREST.

The date and time when and location where you must appear are shown on the front of this summons.

Updated: 01/05/2000 Web authoring by Publishing & Distribution