Were Is The Citation Number On A Maryland Civil Citation Form – Fill Out and Use This PDF

UNIFORM CIVIL CITATION

WITNESS

RELATED CITATION

District Court of Maryland for

County/Municipality/State of Maryland						Agency
vs.
Defendant's (Last) Name			First			Middle
Current Street Address						Apt. No.
City			State			Zip Code
DOB	Height	Weight	Sex	Race	Hair	Eyes
Telephone No. Day:				Telephone No. Night:
Based on	personal knowledge of the undersigned officer				the attached affidavit, the defendant is
charged with

at	AM	PM on	/	/
Time		Month	Day	Year

at

Location

County, MD in violation of: Md. Ann. Code Municipal Infraction/County Ordinance/Public Local Law/Local Code COMAR

Document/Article	Section	Sub Section	Paragraph
Each day a violation continues is a separate infraction subject to an additional citation.

I sign my name as a receipt of a copy of this Citation and not as an admission of guilt. I will comply with the requirements set forth in this Citation.

XDefendant's Signature

INSTRUCTIONS

YOU MUST APPEAR IN COURT. A notice of trial date will be mailed to you.

YOU MAY PAY A FINE of $	by	to the	District Court
		Date
Payment of the fine will not close the case if abatement action is pending.
Agency/Municipality		at
	Payment Location		and AVOID TRIAL.
This will be deemed an admission of guilt and a trial date will not be set.
YOU MAY ELECT TO STAND TRIAL. DO NOT SEND PAYMENT OF FINE. Notify
		in writing by
Agency/Municipality			Date
at

Address

The District Court will mail you a notice of your trial date and location. AT TRIAL the Court may impose

a fine up to $	plus court costs.
IN ADDITION,	is seeking abatement of this infraction.
	Agency/Municipality

You may be ordered to abate this infraction or be assessed the costs for the abatement, as well as a fine of up to $1,000, plus court costs. Payment of the preset fine will not satisfy the abatement action and an Order of Abatement may still be entered against you.

FAILING TO APPEAR OR PAY THE FINE MAY RESULT IN A WARRANT BEING ISSUED FOR YOUR ARREST.

FAILING TO PAY THE FINE OR REQUEST A TRIAL DATE: will deem you liable for the fine assessed; the fine may be doubled and/or a judgment on affidavit may be entered against you including an order of abatement.

FAILURE TO APPEAR FOR A REQUESTED TRIAL DATE: the fine may be doubled and a judgment on affidavit entered against you.

I solemnly affirm under the penalties of perjury, and based upon personal knowledge or the attached affidavit, that the contents of this citation are true and that I am competent to testify on these matters. The defendant is not now in the military service, as defined in the Servicemembers Civil Relief Act.

Officer's Signature		Officer's Printed Name	Date
Agency	Sub-Agency	I.D. No.	Phone

Front of Citation:

Copy #1: Municipality/Court Copy

Copy #2: Prosecutor's Copy

Copy #3: Defendant's Copy

Copy #4: Municipality's Copy

Copy #5: Officers's Copy

Reverse of Citation:

Copy #1: Witness List

Copy #2: (BLANK)

Copy #3: Notice

Copy #4: (BLANK)

Copy #5: Officer's Notes

Note to Law Enforcement: Remove this first copy of Citation before entering witness information.

TO THE DISTRICT COURT:

NAME

ADDRESS

CITY		STATE	ZIP
DAY PHONE		ROOM #
NIGHT PHONE		APT. #
If Law Enforcement	Agency	Sub-Agency	I.D.
NAME
ADDRESS
CITY		STATE	ZIP
DAY PHONE		ROOM #
NIGHT PHONE		APT. #
If Law Enforcement	Agency	Sub-Agency	I.D.
NAME
ADDRESS
CITY		STATE	ZIP
DAY PHONE		ROOM #
NIGHT PHONE		APT. #
If Law Enforcement	Agency	Sub-Agency	I.D.
NAME
ADDRESS
CITY		STATE	ZIP
DAY PHONE		ROOM #
NIGHT PHONE		APT. #
If Law Enforcement	Agency	Sub-Agency	I.D.
NAME
ADDRESS
CITY		STATE	ZIP
DAY PHONE		ROOM #
NIGHT PHONE		APT. #
If Law Enforcement	Agency	Sub-Agency	I.D.
NAME
ADDRESS
CITY		STATE	ZIP
DAY PHONE		ROOM #
NIGHT PHONE		APT. #
If Law Enforcement	Agency	Sub-Agency	I.D.

Reverse of Part #1 Municipality/Court Copy

NOTICE TO DEFENDANT

Certain violations require that you MUST APPEAR for trial, while other violations give you the option to appear in court or to pay a preset fine.

IMPORTANT INFORMATION: It is your obligation to know your trial date and appear on that date. The Court will mail a courtesy notice to the name and address shown on the front of the citation. If your name or address on this citation is not correct you must in writing notify the Court or agency/municipality listed on the front of this citation of any changes. The Post Office does not forward Court mail. To request a foreign language interpreter or a reasonable accommodation under the Americans with Disabilities Act, please contact the court immediately. Possession and use of cell phones and other electronic device may be limited or prohibited in designated areas of the court facility.

IF CITATION IS MARKED "YOU MUST APPEAR IN COURT . . ."

Appear on the date and at the court location indicated in the notice provided to you by the District Court. You may be represented by an attorney obtained at your own expense before the trial date. A trial will not be postponed to allow you to obtain an attorney. Please read "Important Information" above.

IF CITATION IS MARKED "YOU MAY ELECT TO STAND TRIAL . . ."

•Send a written notice of your intent to the name and address of the agency/municipality, by the date listed, on the front of this citation. Indicate the citation number printed on the front of the citation under the bar code. Please read "Important Information" above.

•The Court will mail you a notice of your trial date and location.

•Appear on the date, time, and at the court location indicated in the notice provided to you by the District Court.

•DO NOT SEND PAYMENT OF THE FINE.

IF YOU ELECT TO PAY THE FINE

•Write a check or money order payable to the Court or agency/municipality listed on the front of the citation. Indicate the citation number printed on the front of the citation under the bar code.

•Send or deliver the payment to the payment location indicated on the front of this citation by the date specified.

•DO NOT SEND CASH.

IF YOU FAIL TO STAND TRIAL OR PAY THE FINE

•You may be arrested.

•The fine may be doubled up to $1,000.

•A judgment on affidavit may be entered against you for the amount due and the costs of correcting conditions that caused the violation. If the fine remains unpaid for thirty (30) days following entry of judgment, the judgment may be enforceable the same as any other civil judgment.

IF ABATEMENT IS REQUESTED

The Court may order you to eliminate the condition causing the infraction or may direct the governmental agency to remove the condition and bill you for the costs. If the bill is not paid a judgment will be entered against you.

IF THIS IS A VIOLATION OF WASHINGTON SUBURBAN SANITARY COMMISSION REGULATIONS

In some circumstances, each day a violation continues may be considered a separate infraction subject to additional citations and fines.

Reverse of Part #3 Defendant's Copy