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F ENTERED <br />CASE #:.12 � 887 <br />ROUTED BY: 547 <br />CAD #: 074385 <br />r CUSTODY <br />F LODGED <br />F C <br />r M <br />FV cP <br />r j <br />Pat Assign <br />VACLA TION <br />®OPTIONAL APPEARANCE (SEE BACK.} <br />- <br />OTHER:. <br />CHARGE POSS LT OZ MJ <br />I err er ❑. d� Page of <br />® P . 7 0 � <br />OREGON UNIFORM CITATION AND COMPLAINT <br />° .p. <br />® CRIMINAL <br />® MANDATORY APPEARANCE (SEE BACK) _T <br />®NON- TRAFFIC <br />9 <br />a � <br />VACLA TION <br />®OPTIONAL APPEARANCE (SEE BACK.} <br />®TRAFFIC <br />STATE OF OREGON Wlunicipal !; Q ® Juvenile -2727 Centennial Blvd. <br />CITY OF EUGENE ® Circuit -125 E. 8th Ave. See (Reverse Side.) <br />BOUNTY OF LANE ® Central Lane Justice -220 5th, Spfld ® Other court, see below <br />- - THE UNDERSIGNED CERTIFIES AND.SAYS THAT: <br />— s ` <br />NA T F! 5T MIDDLE <br />-_ <br />ADORESS <br />PH ORE <br />Z. <br />�...w <br />/� <br />CITY <br />STATE <br />ZIPC <br />Z SSN OR OTHER !D <br />EMPLOYMENTISCHOC}L <br />Z DRIVER LICENSE NO. <br />STATE <br />®C :'`" <br />-N EMPLOYED TO DRIVE <br />_ ` <br />"ON -CDL <br />®PASSENGER <br />=_ =� <br />DATE OF BIRTH <br />qEX <br />6LQHTf <br />f E <br />6 741q <br />m <br />?AT THE FOLLOW ING AND PLAC IN THE BCJVE MENTIONED. STATE. AND COUNTY:: <br />a <br />OFFENSE DATE MONTH DAY YEA TI ®AM <br />P M <br />- - <br />' ON OR ABOUT: I <br />AT OR NEA 08AFETY <br />CORRIDOR <br />_;' =3 {• -_ <br />Y <br />i DID :OPERATE THE FOLLOWING I.EHICLE ON. A.HIGHWAYIPREMISES,OPEN TO THE PUBLIC: <br />VEHICLE LICENSE NO. <br />ATE <br />® DRIVER NOT ACCIDENT: <br />®PERSONAL INJURY <br />` <br />1 C <br />REG. OWNER <br />® PROPERTY DAMAGE <br />= ' <br />M <br />VEH. YR. <br />MA FC>, `: MODEL <br />STYLE <br />COLOR <br />m <br />AN EDESTRIAN ® HAZ MAT <br />r. <br />_ <br />_ <br />(CYCLE ®CDL RELATED <br />: t'= <br />? < <br />`: <br />- - _ ` blb THEN AND, COMMIT THE FOLLOWING OFFENSES <br />- • • '1• THERE CD <br />' 1 VIOLATED <br />EORS1 <br />®VIO. BASIC RULE <br />®VIO. DES SP D <br />ALLEGED SPD <br />Z SPD <br />®RADAR <br />® LIDAR <br />C <br />r. .RULE)' <br />®PACE <br />LFA RGE <br />0 <br />PRES. FI <br />7w <br />71' 2. VIOLA MD <br />CHARGE <br />� <br />.4 <br />.Z 6 <br />M clrE ORSr <br />Z ORQRULE) <br />t <br />LI7 <br />PRES. FINE/SEC. <br />-` <br />3. VIOLATED <br />CHARGE <br />-r <br />_ {CITE ORS <br />(CITE <br />ORD RULE} <br />vs, <br />PRES. FINE/SEC. <br />I CERTIFY UNDER ORS 153.045 AND 153.990 THAT ! HAVE SUFFICIENT G NDS TO AND DO BELIEVE THAT THE ABOVE <br />MENTIONED PERSON COMMITTED THE ABOVE OFFENSE(S) AND I H SERVED THE PERSON WITH THIS COMPLAINT. <br />DATE ISSUED OFFICER'S NATURE OFF( EA 1D <br />COMPLAINT/ INFORMATION <br />NAME OF ARRESTING PERSON 1F NO7 OF CEA <br />= =s: FILED AT TIME -OF CJTATION? <br />. 1}y z; - <br />t <br />Y _ _ URT►4PPEARA FDA E,= AND`L0CAT1ON:: <br />YOUR =O _ <br />MO <br />DAY <br />YEAR <br />TIME AM <br />LOC LI5 T I T E�[�g <br />R I N F E �d-04 i ?t <br />•`• '7'i <br />•£' <br />'� <br />• <br />PM <br />L <br />.'g <br />_ <br />F� <br />642646 <br />Shelton turnbull EUGENE, OR (541) 687 - 1214.1 -800 -543 -9062 - <br />