Criminal Statutes, Court Rules Jury Charges NJ : REVISIONS TO THE SPECIAL FORM OF COMPLAINT AND SUMMONS (“SPECIAL FORM”)

NOTICE TO THE BAR

MUNICIPAL COURTS – REVISIONS TO THE SPECIAL FORM OF

COMPLAINT AND SUMMONS (“SPECIAL FORM”)

The Special Form of Complaint and Summons (“Special Form”) prescribed

by Court Rule 7:2-1 has been revised, effective September 17, 2009, to reflect

recent rule amendments by the Supreme Court. The revised version of the

Special Form, which accompanies this notice, is available for immediate use.

Also accompanying this notice are the revised Instructions for use with the new

version of the Special Form. To permit existing inventory to be exhausted, the

previous version of the Special Form and Instructions may continue to be used

though February 28, 2010. However, beginning March 1, 2010, only the new

version of the Special Form and Instructions may be used.

/s/ Glenn A. Grant

__________________________________

Glenn A. Grant, J.A.D.

Acting Administrative Director of the Courts

Date: September 17, 2009

ADMINISTRATIVE OFFICE OF THE COURTS

INSTRUCTIONS AND SPECIAL FORM OF

COMPLAINT AND SUMMONS, EFFECTIVE

SEPTEMBER 17, 2009

To: Judges, Directors and Administrators of the

Municipal Courts:

Attached is a specimen of the revised Special Form

of Complaint and Summons (Special Form) with

accompanying Instructions that is prescribed,

pursuant to Rule 7:2-1(g), for use in the municipal

courts for certain offenses committed on or after

September 17, 2009. The previously prescribed

Special Form (effective December 1, 2001) may

continue to be used until your present supply is

exhausted or until March 1, 2010.

Effective March 1, 2010, only the attached revised

form of the Special Form of Complaint and Summons

is authorized to be used.

For the purpose of complying with the provisions of

N.J.S.A. 39:4-139.4 (The Parking Offenses

Adjudication Act), this Special Form is also

prescribed, pursuant to R. 7:2-1(f)(1), as a Uniform

Traffic Ticket for use in connection with parking and

traffic offenses where a private citizen is the

complaining witness.

Only this revised Special Form may be used for any

of the following non-indictable offenses venued in the

municipal courts: disorderly/petty disorderly persons

offenses, except for (a) those involving domestic

violence and (b) those with a companion indictable

matter; local ordinance violations; code enforcement

actions; penalty enforcement proceedings; boating

offenses; and parking and traffic offenses where a

private citizen is the complaining witness.

All petty disorderly persons offense(s) charged in

conjunction with an indictable matter and all domestic

violence matters must be prepared on the approved

CDR form.

Other versions of Special Forms containing distinct

design features and promulgated by the

Administrative Director of the Courts for use in

connection with offenses charged by state law

enforcement officers that involve, for example, fish

and game and state park penalty enforcement

actions or boating offenses, continue to be authorized

for use as approved alternatives to this Special Form.

Please note that modifications to this Special Form

may only be made with the expressed written

approval of the Administrative Director of the Courts.

Any proposed changes must be submitted in writing.

The following INSTRUCTIONS are intended to

facilitate the procurement and standardized use of

this Special Form. These instructions are an integral

part of this prescribed Special Form.

INSTRUCTIONS TO MUNICIPAL COURT

JUDGES AND OTHER USERS

OF THIS SPECIAL FORM

I. USE OF THIS SPECIAL FORM OF

COMPLAINT AND SUMMONS

Pursuant to R. 7:2-1(f) & (g), this Special Form is

intended for use in cases, venued in the municipal

courts, involving:

• disorderly/petty disorderly persons offenses,

except those involving domestic violence and

those with a companion indictable matter;

• local ordinance violations;

• code enforcement actions;

• penalty enforcement proceedings;

• boating offenses; and

• parking and traffic offenses where a private

citizen is the complaining witness.

II. PROCEDURES FOR THE ISSUANCE OF

PROCESS

A. Law Enforcement Officers

Pursuant to R. 7:2-2(a)(2), a summons on a

complaint made by a law enforcement officer may be

issued by that officer without a finding of probable

cause by an independent judicial officer. In that

event, the box in the shaded “Law/Code Enforcement

Use Only” portion of the summons must be checked.

B. Code Enforcement Officers

Pursuant to R. 7:2-2(a)(3), a summons on a

complaint made by a code enforcement officer

charging any offense within the code enforcement

officer’s subject matter and territorial jurisdiction may

be issued without a finding of probable cause by an

independent judicial officer. In that event, the box in

the shaded “Law/Code Enforcement Use Only”

portion of the summons must be checked. Pursuant

to R. 7:2-2(a)(3), a code enforcement officer is

defined as “a public employee who is responsible for

enforcing the provisions of any state, county or

municipal law, ordinance or regulation which the

public employee is empowered to enforce.”

C. Use of the Special Form when the Officer

Prepares but does not Issue the Complaint

There are times when an officer decides to prepare a

complaint, but elects not to issue process on it (the

summons). When this occurs, the complaint initiated

should be processed pursuant to R. 7:2-2(a)(1)

(Citizens Complaint). The officer should complete

only the complaint portion of this Special Form,

provide the defendant (when in the presence of the

officer) with the optional green courtesy copy and

submit the court’s blue and defendant’s yellow (hard

copy) copies of this Special Form to the court. It will

then be the court’s responsibility to determine

probable cause. The officer may retain the officer’s

pink copy.

If it is determined by the court that the complaint and

summons will be issued, the completed defendant’s

yellow copy of this Special Form is to be served on

the defendant, pursuant to R. 7:2-4(a)(1). The

municipal court is responsible for notifying the

defendant of the outcome of the judicial probable

cause determination and for providing the completed

agency white copy to the appropriate enforcement

agency.

D. Parking and Traffic Complaints where a

Private Citizen is the Complaining Witness

Whenever any person prepares a complaint, the

municipal court administrator or deputy court

administrator shall accept that complaint for filing,

pursuant to R. 7:2-1(b). However, although private

citizens may make and sign complaints, they are not

authorized by law to issue process (the summons).

As a result, in all private citizen complaints, a judicial

officer must make a probable cause determination as

to the issuance of process, pursuant to R. 7:2-2(a)(1).

Only this Special Form is to be used when a private

citizen is the complaining witness for complaints

charging any parking or traffic offense. In all other

private citizen initiated complaints, either this Special

Form or the appropriate CDR form is to be utilized.

For the purpose of complying with the provisions of

N.J.S.A. 39:4-139.4 (The Parking Offenses

Adjudication Act), this Special Form has also been

prescribed as a Uniform Traffic Ticket. Therefore,

when this Special Form is used for charging a

parking offense, the private citizen is to describe the

vehicle (including license plate number and state) as

part of the charge narrative, located in the area

marked “DESCRIPTION OF OFFENSE”. After the

complaint portion of the Special Form is completed,

the private citizen, as the complaining witness, must

sign either the Oath or Certification, pursuant to R.

7:2-1(a). If the Oath is selected, the private citizen

must sign on the line marked “Signature of

Complaining Witness” and the court administrator or

deputy court administrator, if authorized pursuant to

N.J.S.A. 2B:12-21a, must administer the oath and

date and sign the acknowledgment, where indicated.

If the private citizen elects to complete the

Certification, the citizen must sign and date the

Certification, where indicated.

All copies of this Special Form are to be submitted by

the complaining witness to the court for filing and

processing. Upon filing, the court shall provide the

officer’s pink copy to the complaining witness.

The probable cause determination for the issuance of

process, made pursuant to R. 7:2-2(a)(1), and the

judicial officer’s signature must be recorded in the

shaded area marked “Court Use Only”. If there is a

judicial determination of probable cause, the judicial

officer must then complete the summons portion.

Thereafter, the defendant’s yellow hard copy of this

Special Form should be served, pursuant to R. 7:2-

4(a)(1). The municipal court is also responsible for

notifying the defendant as to the outcome of the

judicial probable cause determination and providing

the complaining witness with the completed white

agency copy of this Special Form.

III. CONTROL, RESPONSIBILITY, PURCHASE

AND INVENTORY

A. Municipal Courts

Each judge of a central, joint or other municipal court

is responsible for the inventory and control of all

Special Forms used by local law enforcement officers

and local code enforcement officers in accordance

with applicable county or municipal purchasing

procedures. Each judge (or court director or court

administrator under the direction of the judge) shall

arrange for the acquisition of the needed supply of

the Special Forms in accordance with county or

municipal purchasing procedures. Upon delivery, the

judge (or court director or court administrator under

the direction of the judge) shall inspect the Special

Forms for correctness. The Special Forms are to be

inventoried and stored in a safe place, under the

exclusive control of the court, until distributed for use

by local law or code enforcement officers.

Additionally, courts are required to maintain a

detailed control record of each Special Form,

consistent with the Automated Special Form Control

Record procedures.

B. State, County, Local or Other Authorized

Law Enforcement Agencies

With the written authorization of and in the manner

prescribed by the Administrative Director of the

Courts, the head of any State, county, local or other

authorized agency having law enforcement

responsibilities, may purchase and control the

distribution and use of this Special Form. The

authorized control records are subject to periodic

examination by the Administrative Office of the

Courts.

C. Inventory

To assist the judge in periodically determining the

quantity of forms to order, the appropriate officials of

the county, municipality or other authorized agency

responsible for law or code enforcement should be

requested to project the number of forms that will be

necessary for a six to nine month period. Due to

possible future changes to this Special Form, it is

recommended that a municipal court, State, county,

local or other authorized agency not maintain more

than a six to nine month supply.

IV. SPECIFICATIONS AND PRINTING

A. General

This Special Form, in the form of the attached

specimen, is to be top bound, numbered

consecutively (Alpha prefixes and suffixes are

optional) and contain the following four parts: (1) the

court’s original record; (2) the agency record; (3) the

officer’s copy; and (4) the defendant’s copy. An

optional defendant’s courtesy copy may also be

included and bound as a part of this Special Form.

The following additional requirements also apply:

1. The colors of each part and the top to bottom

binding sequence are as follows:

(a) Court’s original copy - blue

(b) Agency copy - white

(d) Defendant’s Courtesy Copy (optional) - green

(e) Defendant’s copy (hard copy) - yellow

2. The text of each part of this Special Form is to be

printed in black ink, except as noted in subsections 3,

4 and 9 below. The shaded and bold text portions of

the specimen are to be duplicated on all parts of the

printed form.

3. The text of the paragraph entitled, “PLEA OF

NOT GUILTY”, located on the back of the defendant’s

copy, is to be printed in red ink.

4. The consecutive numbers on the face of this

Special Form may be printed in red or black ink.

5. The size of the forms shall be 4" x 9 1/2" (plus 1/2"

for top binding into books).

6. All Special Forms must be numbered

consecutively. This Special Form should be bound in

books of at least ten. It is also permissible for the

municipal court to maintain a limited supply of

unbound Special Forms that may, when necessary,

be issued to enforcement officers.

7. Use only "No Carbon Required" paper.

8. For the convenient reference of defendants, an

optional listing of frequent ordinance offenses and

penalties may be printed on the back of the

defendant’s yellow copy, provided that the court's

Local Supplemental Violations Bureau Schedule

(approved by the Assignment Judge, pursuant to R.

7:12-4(c)), includes those offenses and penalties.

That listing should be located only in the space

provided above the “Appearance, Guilty Plea and

Waiver” section. Please note that offenses and

penalties listed on the Statewide Violations Bureau

Schedule may also be listed in this area.

9. The language and box on the Defendant’s copy

pertaining to the “New Jersey Municipal Court Direct”

Internet Payment Project is to be printed in red ink.

10. If the optional defendant’s courtesy copy is to be

a part of this Special Form, the entire shaded “Notice”

area, located on the bottom of the form, must be

desensitized

B. Outside Cover Information

The following information must be printed on the back

of the outside cover of each book of this Special

Form:

INSTRUCTIONS TO LAW ENFORCEMENT

AND CODE ENFORCEMENT OFFICERS

Specific Instructions to Law Enforcement

1. At all times, be COURTEOUS, FAIR and

HONEST. Remember that public opinion of your

actions is judged almost entirely by your conduct.

2. When issuing every Special Form:

DO -

􀀹 Introduce yourself to the defendant by saying: "I

am (give your rank, name and the name of the

enforcement agency you represent)."

􀀹 Ask for the defendant's driver’s license.

􀀹 Advise the defendant of the offense committed.

􀀹 Advise the defendant that you are going to issue

a Special Form for that offense.

􀀹 Ask for any additional information necessary to fill

out this Special Form.

Following this, complete the Special Form and hand

the yellow copy to the defendant.

Always check the box, "Court Appearance Required,"

if appropriate, pursuant to R. 7:12-4(d).

DO NOT -

􀀹 Use this Special Form for any matter involving

domestic violence.

􀀹 "Lecture" defendants.

􀀹 Quiz defendants on their knowledge of the law.

􀀹 Indulge in personal remarks or altercations.

General Instructions to Law Enforcement and

Code Enforcement Officers

1. In filling out this Special Form, preferably use a

ball point pen, applying steady pressure so that all

copies will be legible. Print all information so that it is

legible. And remember, only one offense may be

charged per Special Form completed.

2. File the court’s original blue copy of this Special

Form with the court without delay.

3. File the agency’s white copy in accordance with

your departmental regulations.

4. Keep the officer's pink copy, in the event that

testimony in court is required.

5. If you are the complaining witness and are issuing

the complaint, provide the defendant with the yellow

hard copy of this Special Form. The defendant’s

optional green courtesy copy and the court’s blue

copy are to be submitted to the court for filing.

6. If you are electing not to issue the complaint, but

are instead taking a private citizen complaint, you are

to complete only the complaint portion of this Special

Form, then provide the defendant with the optional

green courtesy copy. The court’s blue, defendant’s

yellow and agency white copies are to be submitted

to the court for filing so that an independent judicial

probable cause determination can be made. You

may retain the officer’s pink copy for your records.

Officer’s Comments (See Back of Officer's Copy)

It is very important to fill in the “OFFICER'S

COMMENTS” section provided on the back of the

officer's pink copy of this Special Form. Use this

space to describe briefly the circumstances of the

offense. There are always one or more relevant

comments, which the officer should note. Include

every fact which will assist you in testifying.

C. Inside Cover Information

The following information must be printed on the

inside cover of each book of Special Forms:

RESPONSIBILITY FOR THE SPECIAL FORM

OF COMPLAINT AND SUMMONS

Each municipal court judge is responsible for all

Special Forms issued to local law enforcement and

other enforcement officers and for their proper

disposition. The court or other authorized official is

required to keep a control record for such Special

Forms, in accordance with procedures prescribed by

the Administrative Director of the Courts. Officers

must sign a receipt for the Special Forms issued to

them.

ERRORS/MISTAKES – PROCEDURES FOR

OFFICERS TO REQUEST THAT A SPECIAL

FORM BE VOIDED OR DISMISSED

If the officer determines that an error has been made

in writing this Special Form, the officer should

immediately stop writing. The officer may not cross

out or erase any erroneous information. Additionally,

the officer may have Special Forms that have been

pocket worn, damaged, lost or superseded.

In these instances, the officer is to follow the

procedures outlined in the Court’s Administrative

Directive #2-08, entitled “Procedures for the

Dismissal of Municipal Court Complaints and Voiding

Uniform Traffic Tickets and Special Forms of

Complaints.” With the exception of superseded

tickets, the officer’s request to void or dismiss these

Special Forms will require completion of the “Request

to Dismiss or Void Complaint” form. Officers may

obtain a copy of the Directive and/or form from their

local municipal court.

ADDITIONAL INFORMATION (Optional)

Additional information may be approved by the

municipal court judge or by the appropriate State,

county, local or other authorized agency head for

printing on the top of the flap of each Special Form

book. Appropriate information might include:

• Offenses and penalties information from the

Statewide or Local Violations Bureau Schedules.

• Common local ordinance offenses and penalties.

• Calendars.

• Emergency telephone numbers.

• Schedule of court sessions.

• Other useful information.

V. COMMENTS OR SUGGESTIONS

Any comments concerning the contents of this form

or suggestions for its improvement are welcomed and

encouraged. They may be forwarded to:

ADMINISTRATIVE OFFICE OF THE COURTS

R. J. Hughes Justice Complex

Municipal Court Services Division

P.O. Box 986

Trenton, New Jersey 08625

VI. APPROVED:

/s/ Glenn A. Grant

___________________________________

Glenn A. Grant, J.A.D.

Acting Administrative Director of the Courts

DATE: September 17, 2009

E:\UTT&SVBS\SFINSTRU - Sept 2009

EXEMPLAR – NOT ACTUAL SIZE

COURT I.D. PREFIX

COMPLAINT NUMBER Municipal Court of Anytown

123 Main Street

Anytown, NJ 00000

The State of New Jersey

vs.

Defendant’s Name: First Initial Last

Address City

State

Zip Code Telephone

Birth

Date

Mo. Day Yr. Sex Eyes Weight Height Restrictions

Driver’s

Lic. No.

State Exp. Date

STATE OF NEW JERSEY

COUNTY OF_____ XXX________________________________________________ )ss

Complaining Witness: __________________________________________________

(Name)

of__________________________________________________________________

(Identify Dept./Agency Represented) (Badge No.)

Residing at___________________________________________________________

by certification or on oath, says that to the best of his/her knowledge or information

and belief, the named defendant on or about the _____________________________

Month Day Year Time

in _________________________________ Code No. County of ________________,

N.J. did commit the following offense:

in violation of (one charge only) _________________________________________

(Statute, Regulation or Ordinance Number)

LOCATION OF

OFFENSE

C O D E Describe Location

OATH: Subscribed and sworn to

before me this _________ day

of________________, yr. ________.

(Signature of Complaining Witness)

(Sig. of Person Administering Oath)

CERTIFICATION: I certify that the foregoing

statements made by me are true. I

am aware that if any of the foregoing

statements made by me are willfully false,

I am subject to punishment.

(Date)

(Signature of Complaining Witness)

PROBABLE CAUSE DETERMINATION FOR ISSUANCE OF PROCESS:

COURT USE ONLY LAW / CODE ENFORCEMENT USE

ONLY

Probable cause is found for the issuance of this

Complaint-Summons

__________________________

(Signature of Judicial Officer)

__________________________

(Signature of Judge)

􀀀 The complaining witness is a law

enforcement officer or a code

enforcement officer with territorial and

subject matter jurisdiction and a judicial

probable cause determination is not

required prior to the issuance of this

Complaint-Summons.

YOU ARE HEREBY SUMMONED TO APPEAR

BEFORE THIS COURT TO ANSWER THIS COMPLAINT IF YOU FAIL TO APPEAR ON THE DATE AND AT

THE TIME STATED, A WARRANT MAY BE ISSUED FOR YOUR ARREST

NOTICE TO APPEAR

􀀀 COURT APPEARANCE

REQUIRED

COURT

DATE

Month Day Year Time : AM

: PM

_______________________ _____________________________________

(Date Summons Issued) (Signature of Person Issuing Summons)

Court’s Copy – Blue SF (September, 2009)

New Wording

YES

MMO

MPL

EXEMPLAR – NOT ACTUAL SIZE

BENCH WARRANT BAIL INFORMATION

Failed to Appear Date: ___/___/___

Warrant Date: ___/___/___ Ordered by:_______________________________

(Signature and Title of person issuing warrant)

Bail Amount: $________ Set by:_____________________________________

(Signature and title of person setting bail)

􀀀 Forfeited 􀀀 Return 􀀀Reinstated __/__/__ ___________________________

(Date) (Signature of Judge)

FIRST APPEARANCE, ARRAIGNMENT AND COUNSEL

INFORMATION

First Appearance Date:___/___/___ Arraignment Date:___/___/___

􀀀 Advised Defendant

of Rights: By:______________ Desires Counsel: 􀀀 Yes 􀀀 No

Counsel assigned: 􀀀 Yes 􀀀 No ____________________________________

(If yes, name of counsel)

Counsel retained: 􀀀 Yes 􀀀 No ___________________________________

(If yes, name of counsel)

Counsel waived: 􀀀 Yes 􀀀 No ___________________________________

(If yes, name of Judge accepting waiver)

Name of Prosecuting Attorney:_______________________________________

Affiliation: 􀀀 Municipal 􀀀 County 􀀀 State 􀀀 Other (list)_____________

MISCELLANEOUS INFORMATION

Additional Information and Judge’s Notes:

Adjournment Requested by: Reason To

/ /

􀀀 See attached sheet for additional Judge’s notes or other information

COURT ACTION

Complaint Amended to:

Plea and Date: 􀂅 G 􀂅 NG / /

Finding or Dismissal Date: 􀂅 G 􀂅 NG 􀂅 DISMISSED / /

Fine $ Costs $ Contempt $

VCCO $ DWI $ SNSF $

D.A.E.F. $ Other $ Total $

Period of D.L. Suspension:

IDRC: Comm. Serv.:

Jail Term/Jail Credit: Credit For:

Signature of Judge: ____________________________ Date: ___/___/___

Court’s Copy Back

New

Wording

COURT I.D. PREFIX

COMPLAINT NUMBER Municipal Court of

Anytown

123 Main Street

Anytown, NJ 00000

The State of New Jersey

vs.

Defendant’s Name: First Initial Last

Address City

State

Zip Code Telephone

Birth

Date

Mo. Day Yr. Sex Eyes Weight Height Restrictions

Driver’s

Lic. No.

State Exp. Date

STATE OF NEW JERSEY

COUNTY OF_____ XXX________________________________ )ss

Complaining Witness: __________________________________________________

(Name)

of__________________________________________________________________

(Identify Dept./Agency Represented) (Badge No.)

Residing at___________________________________________________________

by certification or on oath, says that to the best of his/her knowledge or information

and belief, the named defendant on or about the _____________________________

Month Day Year Time

in _________________________________ Code No. County of ________________,

N.J. did commit the following offense:

in violation of (one charge only) _________________________________________

(Statute, Regulation or Ordinance Number)

LOCATION OF

OFFENSE

C O D E Describe Location

OATH: Subscribed and sworn to

before me this _________ day

of________________, yr. ________.

(Signature of Complaining Witness)

(Sig. of Person Administering Oath)

CERTIFICATION: I certify that the foregoing

statements made by me are true. I

am aware that if any of the foregoing

statements made by me are willfully false,

I am subject to punishment.

(Date)

(Signature of Complaining Witness)

PROBABLE CAUSE DETERMINATION FOR ISSUANCE OF PROCESS:

COURT USE ONLY LAW / CODE ENFORCEMENT USE

ONLY

Probable cause is found for the issuance of this

Complaint-Summons

__________________________

(Signature of Judicial Officer)

__________________________

(Signature of Judge)

􀀀 The complaining witness is a law

enforcement officer or a code

enforcement officer with territorial and

subject matter jurisdiction and a judicial

probable cause determination is not

required prior to the issuance of this

Complaint-Summons.

YOU ARE HEREBY SUMMONED TO APPEAR

BEFORE THIS COURT TO ANSWER THIS COMPLAINT IF YOU FAIL TO APPEAR ON THE DATE AND AT

THE TIME STATED, A WARRANT MAY BE ISSUED FOR YOUR ARREST

NOTICE TO APPEAR

􀀀 COURT APPEARANCE

REQUIRED

COURT

DATE

Month Day Year Time : AM

: PM

_______________________ _____________________________________

(Date Summons Issued) (Signature of Person Issuing Summons)

Agency Copy - White SF (September, 2009)

New Wording

YES

NO S

MMO

DISPOSITION OF CASE

DATES OF ADJOURNMENTS:

FROM:________/________/________

TO: ________/________/_______

REASON: ________________________________________________________

FROM:_______/_______/_______ TO:______/_______/________

REASON:_________________________________________________________

DISPOSITION DATE: _______________________________________________

BY: 􀀀 COURT 􀀀 VIOLATIONS BUREAU

PLEA: _________________________ FINDING:_______________________

BAIL INFORMATION

BAIL AMOUNT $_____________ 􀀀 CASH 􀀀 BOND

POSTED WITH:

_______________________________________________________________________

(NAME & TITLE)

􀀀 BAIL

FORFEITURE: AMOUNT $___________ DATE _____/_____/_____

SENTENCE

FINE $ JAIL:____________ DAYS:___________

COSTS $ DR. LIC. REVOKED: ________ DAYS

$ _____________________________ REVOCATION DATE: _____/_____/_____

$ _____________________________ $ _____________________________

OFFICER’S COMMENTS

(See Instructions on Cover)

_______________________________________________________________________

WITNESSES: (NAME & ADDRESS) SUBPOENA ISSUED

1. ______________________________________ YES NO

______________________________________ 􀀀 􀀀

2. ________________________________________ 􀀀 􀀀

________________________________________

3. ___________________________________________ 􀀀 􀀀

_____________________________________________

Officer’s Copy Back - White

COURT I.D. PREFIX

COMPLAINT NUMBER Municipal Court of

Anytown

123 Main Street

Anytown, NJ 00000

The State of New Jersey

vs.

Defendant’s Name: First Initial Last

Address City

State

Zip Code Telephone

Birth

Date

Mo. Day Yr. Sex Eyes Weight Height Restrictions

Driver’s

Lic. No.

State Exp. Date

STATE OF NEW JERSEY

COUNTY OF_____ XXX________________________________ )ss

Complaining Witness: __________________________________________________

(Name)

of__________________________________________________________________

(Identify Dept./Agency Represented) (Badge No.)

Residing at___________________________________________________________

by certification or on oath, says that to the best of his/her knowledge or information

and belief, the named defendant on or about the _____________________________

Month Day Year Time

in _________________________________ Code No. County of ________________,

N.J. did commit the following offense:

in violation of (one charge only) _________________________________________

(Statute, Regulation or Ordinance Number)

LOCATION OF

OFFENSE

C O D E Describe Location

OATH: Subscribed and sworn to

before me this _________ day

of________________, yr. ________.

(Signature of Complaining Witness)

(Sig. of Person Administering Oath)

CERTIFICATION: I certify that the foregoing

statements made by me are true. I

am aware that if any of the foregoing

statements made by me are willfully false,

I am subject to punishment.

(Date)

(Signature of Complaining Witness)

PROBABLE CAUSE DETERMINATION FOR ISSUANCE OF PROCESS:

COURT USE ONLY LAW / CODE ENFORCEMENT USE

ONLY

Probable cause is found for the issuance of this

Complaint-Summons

__________________________

(Signature of Judicial Officer)

__________________________

(Signature of Judge)

􀀀 The complaining witness is a law

enforcement officer or a code

enforcement officer with territorial and

subject matter jurisdiction and a judicial

probable cause determination is not

required prior to the issuance of this

Complaint-Summons.

YOU ARE HEREBY SUMMONED TO APPEAR

BEFORE THIS COURT TO ANSWER THIS COMPLAINT IF YOU FAIL TO APPEAR ON THE DATE AND AT

THE TIME STATED, A WARRANT MAY BE ISSUED FOR YOUR ARREST

NOTICE TO APPEAR

􀀀 COURT APPEARANCE

REQUIRED

COURT

DATE

Month Day Year Time : AM

: PM

_______________________ _____________________________________

(Date Summons Issued) (Signature of Person Issuing Summons)

Officer’s Copy - Pink SF (September, 2009)

New Wording

YES

MMO

MPL

DISPOSITION OF CASE

DATES OF ADJOURNMENTS:

FROM:________/________/________ TO: ________/________/_______

REASON: ________________________________________________________

FROM:_______/_______/_______ TO:______/_______/________

REASON:_________________________________________________________

DISPOSITION DATE: _______________________________________________

BY: 􀀀 COURT 􀀀 VIOLATIONS BUREAU

PLEA: _________________________ FINDING:_______________________

BAIL INFORMATION

BAIL AMOUNT $_____________ 􀀀 CASH 􀀀 BOND

POSTED WITH: ____________________________________________________________

(NAME & TITLE)

􀀀 BAIL

FORFEITURE: AMOUNT $___________ DATE _____/_____/_____

SENTENCE

FINE $ JAIL:____________ DAYS:___________

COSTS $ DR. LIC. REVOKED: ________ DAYS

$ _____________________________ REVOCATION DATE: _____/_____/_____

$ _____________________________ $ _____________________________

OFFICER’S COMMENTS

(See Instructions on Cover)

_______________________________________________________________________

WITNESSES: (NAME & ADDRESS) SUBPOENA ISSUED

1. ________________________________________ YES NO

________________________________________ 􀀀 􀀀

2. __________________________________________ 􀀀 􀀀

__________________________________________

3. ___________________________________________ 􀀀 􀀀

____________________________________________

Officer’s Copy Back – Pink

COURT I.D. PREFIX

COMPLAINT NUMBER Municipal Court of Anytown

123 Main Street

Anytown, NJ 00000

The State of New Jersey

vs.

Defendant’s Name: First Initial Last

Address City

State

Zip Code Telephone

Birth

Date

Mo. Day Yr. Sex Eyes Weight Height Restrictions

Driver’s

Lic. No.

State Exp. Date

STATE OF NEW JERSEY

COUNTY OF_____ XXX________________________________ )ss

Complaining Witness: __________________________________________________

(Name)

of__________________________________________________________________

(Identify Dept./Agency Represented) (Badge No.)

Residing at___________________________________________________________

by certification or on oath, says that to the best of his/her knowledge or information

and belief, the named defendant on or about the _____________________________

Month Day Year Time

in _________________________________ Code No. County of ________________,

N.J. did commit the following offense:

in violation of (one charge only) _________________________________________

(Statute, Regulation or Ordinance Number)

LOCATION OF

OFFENSE

C O D E Describe Location

OATH: Subscribed and sworn to

before me this _________ day

of________________, yr. ________.

(Signature of Complaining Witness)

(Sig. of Person Administering Oath)

CERTIFICATION: I certify that the foregoing

statements made by me are true. I

am aware that if any of the foregoing

statements made by me are willfully false,

I am subject to punishment.

(Date)

(Signature of Complaining Witness)

NOTICE

THIS IS A COURTESY COPY OF THE COMPLAINT THAT WILL BE

FILED WITH THE MUNICIPAL COURT, CHARGING YOU WITH THE

OFFENSE LISTED ABOVE. NO ACTION IS REQUIRED BY YOU UNTIL

THE MUNICIPAL COURT PROVIDES YOU WITH FURTHER

INFORMATION. IF THE COURT DETERMINES THAT A SUMMONS

SHOULD BE ISSUED WITH THIS COMPLAINT, THE COURT WILL

ADVISE YOU WHEN AND WHERE TO APPEAR IN ADDITION, YOU

WILL BE INFORMED THAT A WARRANT FOR YOUR ARREST MAY

BE ISSUED IF YOU DO NOT APPEAR IN COURT.

PLEASE NOTIFY THE COURT OF DISABILITY ACCOMMODATION NEEDS

Agency Copy - White SF (September, 2009)

THIS SPACE HAS BEEN LEFT

BLANK INTENTIONALLY

EXEMPLAR – NOT ACTUAL SIZE

COURT I.D. PREFIX

TICKET NUMBER Municipal Court of Anytown

123 Main Street

Anytown, NJ 00000

The State of New Jersey

vs.

Defendant’s Name: First Initial Last

Address

City State Zip Code Telephone

Birth Date Eyes Sex Weight Height Restrictions

Driver’s

Lic. No.

Exp. Date

State 􀀀 Commercial

License

STATE OF NEW JERSEY

COUNTY OF_____ XXX________________________________ )ss

Complaining Witness: __________________________________________________

(Name)

of__________________________________________________________________

(Identify Dept./Agency Represented) (Badge No.)

Residing at___________________________________________________________

by certification or on oath, says that to the best of his/her knowledge or information

and belief, the named defendant on or about the _____________________________

Month Day Year Time

in _________________________________ Code No. County of ________________,

N.J. did commit the following offense:

in violation of (one charge only) _________________________________________

(Statute, Regulation or Ordinance Number)

LOCATION OF

OFFENSE

C O D E Describe Location

OATH: Subscribed and sworn to

before me this _________ day

of________________, yr. ________.

(Signature of Complaining Witness)

(Sig. of Person Administering Oath)

CERTIFICATION: I certify that the foregoing

statements made by me are true. I

am aware that if any of the foregoing

statements made by me are willfully false, I

am subject to punishment.

(Date)

(Signature of Complaining Witness)

PROBABLE CAUSE DETERMINATION FOR ISSUANCE OF PROCESS:

COURT USE ONLY LAW / CODE ENFORCEMENT USE

ONLY

Probable cause is found for the issuance of this

Complaint-Summons

_____ __________________________

(Signature of Judicial Officer)

__________________________

(Signature of Judge)

􀀀 The complaining witness is a law

enforcement officer or a code

enforcement officer with territorial and

subject matter jurisdiction and a judicial

probable cause determination is not

required prior to the issuance of this

Complaint-Summons.

YOU ARE HEREBY SUMMONED TO APPEAR

BEFORE THIS COURT TO ANSWER THIS COMPLAINT IF YOU FAIL TO APPEAR ON THE DATE AND

AT THE TIME STATED, A WARRANT MAY BE ISSUED FOR YOUR ARREST

NOTICE TO APPEAR

􀀀 COURT APPEARANCE

REQUIRED

COURT

DATE

Month Day Year Time : AM

: PM

_______________________ _____________________________________

(Date Summons Issued) (Signature of Person Issuing Summons)

New Wording

YES

PLEASE READ CAREFULLY

1. PLEA OF NOT GUILTY

If you intend to plead not guilty to the offense in this Complaint-Summons and have a

trial in court, you must notify the Municipal Court Administrator, whose address and

telephone number are shown below, of your intention at least 7 days prior to the court

date shown on the reverse side. If you fail to notify the Court Administrator of your

intention, it may be necessary for you to make 2 court appearances.

Anytown Borough Municipal Court

123 Main Street, Any City, NJ xxxxx

(xxx) xxx-xxxx

2. COURT APPEARANCE REQUIRED

If “Court Appearance Required” is checked on the bottom of the reverse side, you must

appear in court at the time and place indicated, even if you wish to plead guilty. If “Court

Appearance Required” is not checked, you must still appear in court if: a. you wish to

have a trial; or b. the charge is not listed on the State or Local (Supplemental) Violations

Bureau Schedule.

3. PLEA OF GUILTY; PAYMENT THROUGH VIOLATIONS BUREAU

If you wish to plead guilty and give up your rights to have a lawyer and a trial, you may

do so provided “Court Appearance Required” has not been checked on the reverse side

and provided the charge is listed on the State or Local Violations Bureau Schedule. The

more frequently charged offenses and prescribed penalties are listed below If your

offense is not listed, you may telephone the Violations Clerk to determine whether it is

listed on either Schedule and the amount of the penalty. If it is permissible for you to

plead guilty without a court appearance, you may do so by paying the indicated amount

and by completing in full the APPEARANCE, GUILTY PLEA AND WAIVER section

(below) and by bringing or mailing this Complaint-Summons, together with payment in

the amount of the prescribed penalty, to the Violations Bureau at the address indicated

below prior to the court date listed on the reverse side.

Anytown Municipal Court

P.O Box 123, Anytown, NJ 01234

(201) 555-5555

To make payment via the Internet or for more information, logon to:

www.njmcdirect.com

If payment is made by mail, do not send cash, but send check or money

order payable to this Municipal Court. Please write the Complaint-Summons

number on the face of the check or money order. If payment is received by

the Violations Bureau after your court date, you may be assessed additional

penalties. A receipt will be sent to you only if your payment is accompanied

by a self-addressed, stamped envelope.

VIOLATIONS BUREAU SCHEDULE(S)-

Statute/Ord. No Offense Penalty-

APPEARANCE, GUILTY PLEA AND WAIVER

By signing and dating this document, I enter my appearance before the Court

to answer the charge contained in this Complaint-Summons. I give up my

rights to have a lawyer and a trial. I admit that I committed the offense

charged, plead guilty and make payment of the prescribed penalty. I

understand that, if the offense charged is a traffic matter, a record of this

conviction will be sent to the Motor Vehicle Commission that issued my

license.

_______________________________ ______________________

(Defendant’s Signature) (Date)

NOTICE

IF YOU FAIL TO APPEAR IN RESPONSE TO THIS SUMMONS OR TO PAY THE

PRESCRIBED PENALTY, ADDITIONAL PENALTIES MAY RESULT, A WARRANT

MAY BE ISSUED FOR YOUR ARREST AND YOUR DRIVING PRIVILEGES IN NEW

JERSEY MAY BE REVOKED.

IF YOU HAVE BEEN CHARGED WITH A PARKING OFFENSE, YOUR FAILURE TO

APPEAR OR PAY THE PRESCRIBED PENALTY SHALL BE CONSIDERED AN

ADMISSION OF LIABILITY AND A DEFAULT JUDGMENT MAY BE ENTERED

AGAINST THE OWNER OF THE VEHICLE.

PLEASE NOTIFY COURT OF DISABILITY ACCOMMODATION NEEDS

Defendant Copy SF (September 2009)

Send payment to: Hours of operation:

Criminal Statutes, Court Rules Jury Charges NJ

Saturday, October 10, 2009

REVISIONS TO THE SPECIAL FORM OF COMPLAINT AND SUMMONS (“SPECIAL FORM”)

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