Either Form A or B, or any other form that substantially complies with Form A or B, shall be used as a summons and complaint for juvenile cited violations.

1. (1) Form A:

   JUVENILE CITATION

   COMPLAINT-SUMMONS

   State of South Dakota

   In Circuit Court

   Juvenile Division

   County of _________________

   _____ Judicial Circuit

   State of South Dakota (Plaintiff)

   vs.

   ___________________________

   (Juvenile / Defendant)

   THE UNDERSIGNED PEACE OFFICER COMPLAINS AND STATES THAT

   ON OR ABOUT

   AT OR NEAR

   AT TIME

   A.M.

   _____________________

   ______________________

   __________P.M.

   WITHIN THE COUNTY AND STATE LISTED ABOVE

   NAME

   DATE OF BIRTH

   _____________________________________

   ______________________

   ADDRESS

   ______________________________________

   ______________________________________

   DID THEN AND THERE COMMIT THE FOLLOWING OFFENSE(S)

   _____ Second Degree Petty Theft ($400 or less), in violation of SDCL 22-30A-17.3

   _____ Intentional Damage to Property ($400 or less), in violation of SDCL 22-34-1

   _____ Purchase, Possession, or Consumption (_____ PBT) of Alcoholic Beverage by Person

   under 18, in violation of SDCL 35-9-2

   _____ Habitual Absence from School by Child of Compulsory School Age, in violation of

   SDCL 26-8B-2(1)

   I DECLARE AND AFFIRM UNDER THE PENALTIES OF PERJURY THAT THIS COMPLAINT/SUMMONS HAS BEEN EXAMINED BY ME, AND TO THE BEST OF MY KNOWLEDGE AND BELIEF, IS IN ALL THINGS TRUE AND CORRECT.

   ____________________________________

   _________________________________

   Officer Signature

   Officer ID

   ____________________________________

   _________________________________

   Agency

   Date

   SUMMONS AND PROMISE TO APPEAR

   Juvenile/Defendant is ordered and does promise to appear in the above named court located in the city of ______________________________ on __________________________, 20 ____, at __________________ a.m./p.m.

   ____________________________________________

   Juvenile/Defendant signature

   (Signing this form is a promise to appear – Not an admission of guilt. However, failure to appear may be considered an admission to the allegation(s) listed above and a judgement for payment may be entered.)

   ____ Parent(s)/Guardian Notification ________________________________________

   Parent(s)/Guardian information

   Name: ____________________________________ _________________________________

   Address: __________________________________ _________________________________

   City/State/Zip: ______________________________ _________________________________

   Phone: _____________________________________

2. (2) Form B:

   UNIFORM TRAFFIC TICKET

   SUMMONS-COMPLAINT

   PCN ______________

   State of South Dakota

   ____Juvenile Citation*

   In Circuit Court

   County of _________________

   _____Judicial Court

   State of South Dakota (Plaintiff)

   Vs.

   __________________________________

   No. __________________HP

3. (Defendant) 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

   _____________________________________________________ _____________

   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. However, failure to appear may be considered an admission to the allegation(s) listed above and a judgment for payment may be entered.

   ___ Yes ___ No Court appearance required.

   ___ Yes ___ No Power of attorney in lieu of appearance. Amount $ ___________

   ____Parent(s)/Guardian Notification ____________________________________________

   *FOR VIOLATIONS OF SDCL 22-30A-17.3, 22-34-1 (less than $400); 35-9-2; and 26-8B-2(1)

Source: 42 SDR 101, effective January 11, 2016.

General Authority: SDCL 23-1A-2.1 , 23-1A-2.

Law Implemented: SDCL 23-1A-2.1