Indiana Code Title 9. Motor Vehicles § 9-30-3-6

Sec. 6. (a) This section does not apply to electronic traffic tickets.

(b) In traffic cases, the information and summons shall be in substantially the following form:

In the _______ Court of _______ County

Cause No._______ Docket No. _______

Page No. _______

State of Indiana

SS:  No._

County of _______

INFORMATION AND SUMMONS

The undersigned having probable cause to believe and being duly sworn upon his oath says that:

On the _______ Day of _______, 20 ____ at ____ M

Name _______

Last First Middle

Street _______

City _______ State _______ Zip Code _______

Race ___ Sex ___ Age ___ D.O.B._______ HT ____ WT _______

Oper. Lic. #_______ St.____ Did Unlawfully

Operate Veh. Color _______ Veh. Yr.___ Veh. Make _______

Veh. Lic. Yr. ____ Veh. Lic. St.____ Veh. Lic. #_______

Upon, (Location) _______

_______

A PUBLIC STREET OR HIGHWAY IN _______

COUNTY, INDIANA, AND COMMIT, THE OFFENSE OF:

_______

_______

CONTRARY TO THE FORM OF THE ( ) STATE STATUTE

( ) LOCAL ORDINANCE IN SUCH CASE MADE AND PROVIDED.

OFFICER'S SIGNATURE _______

I.D.  No.  _______ Div. Dist.  _______

POLICE AGENCY _______

Subscribed And Sworn to Before Me

(Deputy Clerk) _______

This _______ Day of _______, 20 ____

COURT APPEARANCE

I PROMISE TO APPEAR IN COURTROOM

_______

ADDRESS:  _______

ON _______ THE _______ DAY OF_______, 20 ___ AT __ M. OR BE SUBJECT TO ARREST.

SIGNATURE _______

“YOUR SIGNATURE IS NOT AN ADMISSION OF GUILT”

The information and summons shall consist of four (4) parts:

(1) the original copy, printed on white paper, which shall be the abstract of court record for the Indiana bureau of motor vehicles;

(2) the court copy, printed on white paper;

(3) the police record, which shall be a copy of the information, printed on pink paper;  and

(4) the summons copy, printed on white stock.

The reverse sides of the information and abstract of court record shall be substantially as follows, with such additions or deletions as are necessary to adapt the form to the court involved:

RECEIPT #_______

DATE _______

COURT ACTION AND OTHER ORDERS

BAIL $_______

REARREST BOND $_______ DATE _______

1. CONTINUANCE TO ___ 4.  CONTINUANCE TO ____

2. CONTINUANCE TO ___ 5.  CONTINUANCE TO ____

3. CONTINUANCE TO ___ 6.  CONTINUANCE TO ____

Motions Date Ruling Date

1.  ____________

2.  ____________

3.  ____________

4.  ____________

PLEA ( ) GUILTY

  ( ) NOT GUILTY

FINDING ( ) GUILTY

  ( ) NOT GUILTY

THE COURT THEREFORE, ENTERS

THE FOLLOWING ORDER

FINE $_______ AMOUNT SUSP. $_______

(STATE) $_______

COSTS

(CITY) $_______

_______ DAYS IN _______ DAYS SUSP. _______

( ) RECOMMENDED LICENSE SUSPENDED FOR _______

( ) PROBATIONARY LICENSE AUTHORIZED FOR ONE YEAR PROBATION

____

JUDGE:  _______

DATE:  _______

ATTORNEY FOR DEFENDANT _______

ADDRESS_______ TELEPHONE _______

WITNESSES

__

The notice, the appearance, the plea of either guilty or not guilty, and the waiver shall be printed on the summons.  The trimmed size of the paper and stock on which the form is printed shall be nominally four and one quarter (4 1/4 ) inches by eight and one quarter (8 1/4 ) inches.

(c) In civil traffic cases, the complaint and summons shall be in substantially the following form:

In the _______ Court of _______ County

Cause No._______ Docket No. _______

Page No._______

State of Indiana

SS:  No._______

County of _______

COMPLAINT AND SUMMONS

The undersigned having probable cause to believe and being duly sworn upon his oath says that:

On the _______ Day of_______, 20 ____ at __ M

Name _______

Last First Middle

Street _______

City _______ State _______ Zip Code _______

Race ___ Sex ___ Age __ D.O.B._______ HT ____ WT ___

Oper. Lic. #_______ St._______ Did Unlawfully

Operate Veh. Color _______ Veh. Yr. ___ Veh. Make _______

Veh. Lic. Yr. ____ Veh. Lic. St.____ Veh. Lic. #_______

Upon, (Location) _______

_______

A PUBLIC STREET OR HIGHWAY IN _______

COUNTY, INDIANA, AND COMMIT, THE OFFENSE OF:

___

CONTRARY TO THE FORM OF THE ( ) STATE STATUTE

( ) LOCAL ORDINANCE IN SUCH CASE MADE AND PROVIDED.

OFFICER'S SIGNATURE _______

I.D.  No.  _______ Div. Dist.  _______

POLICE AGENCY _______

Subscribed And Sworn to Before Me

(Deputy Clerk) _______

This _______ Day of _______, 20___

COURT APPEARANCE

I PROMISE TO APPEAR IN _______

COURTROOM _______

ADDRESS:  _______

ON _______ THE _______ DAY OF ____, 20 ___

AT __ M. OR BE SUBJECT TO ARREST.

SIGNATURE _______

“YOUR SIGNATURE IS NOT AN ADMISSION OF A VIOLATION”

The complaint and summons shall consist of four (4) parts:

(1) the original copy, printed on white paper, which shall be the abstract of court record for the Indiana bureau of motor vehicles;

(2) the court copy, printed on white paper;

(3) the police record, which shall be a copy of the complaint, printed on pink paper;  and

(4) the summons copy, printed on white stock.

The reverse sides of the complaint and abstract of court record shall be substantially as follows, with such additions or deletions as are necessary to adapt the form to the court involved:

RECEIPT #_______

DATE _______

COURT ACTION AND OTHER ORDERS

BAIL $_______

REARREST BOND $_______ DATE _______

1.  CONTINUANCE TO _______ 4.  CONTINUANCE TO _______

2.  CONTINUANCE TO _______ 5.  CONTINUANCE TO _______

3.  CONTINUANCE TO _______ 6.  CONTINUANCE TO _______

Motions Date Ruling Date

1.  ____________

2.  ____________

3.  ____________

4.  ____________

PLEA ( ) ADMIT

  ( ) DENY

  ( ) NOLO CONTENDERE

FINDING ( ) JUDGMENT FOR PLAINTIFF

  ( ) JUDGMENT FOR DEFENDANT

THE COURT THEREFORE, ENTERS

THE FOLLOWING ORDER

FINE $_______AMOUNT SUSP. $_______

(STATE)  $_______

COSTS

(CITY)  $_______

( ) RECOMMENDED LICENSE SUSPENDED FOR _______

( ) PROBATIONARY LICENSE AUTHORIZED FOR ONE YEAR PROBATION

_____

JUDGE:  _______

DATE:  _______

ATTORNEY FOR DEFENDANT _______

ADDRESS _______ TELEPHONE _______

WITNESSES

__

The notice, appearance, plea of either admission, denial, or nolo contendere shall be printed on the summons.  The trimmed size of the paper and stock on which the form is printed shall be nominally four and one quarter (4 1/4 ) inches by eight and one quarter (8 1/4 ) inches.

(d) The complaint form shall be used in traffic cases, whether the charge is made by a law enforcement officer or by any other person.

(e) Each judicial officer or police authority issuing traffic complaints and summons: