2:03:01 :02. Forms for misdemeanor offense complaints and summons. The following form, or one which substantially complies with it, shall be used as a misdemeanor offense summons and complaint for traffic offenses. A power of attorney form in substantial compliance with § 2:03:01:03 shall be attached to the form. The promise to appear option may not be utilized for offenses set forth in SDCL 32-33-2.1 and 32-33-4 , or in contradiction to SDCL 32-33-2.

1. (Defendant) No. _____________HP

   THE UNDERSIGNED PEACE OFFICER COMPLAINS AND STATES THAT

   ON OR ABOUT

   AT OR NEAR (LOCATION/MILE POST)

   AT TIME

   A.M.

   P.M.

   _________________

   ____________________________________

   ________

   WITHIN THE COUNTY AND STATE AFORESAID

   NAME

   HEIGHT

   SEX

   _____________________________

   ________

   _____

   ADDRESS

   WEIGHT

   _____________________________

   ________

   CITY

   STATE

   BIRTH DATE

   _____________________________

   ________

   ____________

   DRIVER'S LICENSE NO.

   STATE

   _____________________________

   ________

   DID UNLAWFULLY

   OPERATE

   _________

   PARK

   ______

   VEHICLE MAKE

   _______________

   BODY STYLE

   _____________

   STATE LICENSE NO.

   YEAR

   STATE

   FR______Y

   _____________________________

   ______

   _______

   ______N

   AND THEN AND THERE COMMIT THE FOLLOWING OFFENSE TO WIT:

   PETTY OFF _____

   MIS ______

   DESCRIBE VIOLATION:

   _________________________________________________

   CDL ____Y____N

   C Veh.____Y____N____E

   _________________________________________________

   Haz. Materials ____Y____N

   in violation of SDCL_________________________________

   _____Municipal

   SPEEDING

   _____Interstate

   _____Other

   ______M.P.H. IN

   ______M.P.H. ZONE

   OFFICER ISSUING SUMMONS

   NO.

   CITY

   COUNTY

   STATE

   ___________________________

   _____

   ______________

   _________

   _______

   ABOVE COMPLAINT IS TRUE AS I VERILY BELIEVE

   DATE

   OFFICER SIGN IN PRESENCE OF COURT OR NOTARY

   __________________________________________________________________

   _______

   SUBSCRIBED AND SWORN TO ME THIS DATE (NAMEANDTITLE)

   DATE

   __________________________________________________________________

   _______

   SUMMONS and PROMISE TO APPEAR

   Defendant is ordered and does promise to appear in the above Court located in the city of

   ________________________________

   on

   _________________________________ at

   a.m.

   p.m.

   _______

   X __________________________________________________________________________

   Defendant's signature

   (Signing this form is a promise to appear - not an admission of guilt. Violation of promise to

   appear is a Class 2 misdemeanor, and a warrant may be issued.)

   _____Yes _____No

   Court appearance required.

   _____Yes _____No

   Power of attorney in lieu of appearance. Amount $______________

If a law enforcement agency designated in § 2:03:01:04 determinations to use the declaration option set forth in SDCL 23-1A-5 and SDCL 23A-2-1, the form or one which substantially complies with it, may be modified by inserting the statutorily approved declaration above the officer's signature in addition to or in lieu of the oath acknowledgment.

UNIFORM TRAFFIC TICKET

SUMMONS-COMPLAINT

PCN ______________

State of South Dakota

In Circuit Court

Magistrate Division

County of_______________

____________Judicial Court

State of South Dakota (Plaintiff)

vs

___________________________________

Source: 27 SDR 53, effective December 4, 2000; 41 SDR 218, effective July 1, 2015.

General Authority: SDCL 23-1A-2.

Law Implemented: SDCL 23-1A-2 , 32-33-2 , 32-33-2.1 , 32-33-4 , 23-1A-5 , 23A-2-1.

Prior versions effective: 2000-12-04.