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MARYLAND UNIFORM COMPLAINT AND CITATION WITNESS RELATED CITATION DRIVER'S LICENSE / SOUNDEX NUMBER CLASS STATE DEFENDANT'S (FIRST) (MIDDLE) (LAST) (SUFFIX) CURRENT IN FULL CITY COUNTY STATE ZIP CODE HEIGHT WEIGHT RACE ETHNICITY SEX BIRTH DATE TELEPHONE NUMBER VEHICLE REGISTRATION STATE VEHICLE YEAR, MAKE, MODEL, TYPE, AND COLOR VIOLATION DATE MONTH DAY YEAR TIME AM PM PI PD CONTRIBUTED TO ACCIDENT SAFETY BELTS Yes No HAZMAT VEHICLE Yes No CDL (LICENSE) FATAL ACC A/R SUSP REV LOCATION OF OFFENSE CITY/COUNTY MD GPS AT LOCATION OF OFFENSE (IF AVAILABLE) COUNTY CODE AREA ARREST TYPE DOT NUMBER MVL DID UNLAWFULLY VIOLATE: CIRCLE VIOLATION BELOW: (ONE VIOLATION ONLY) 01) 21-8011 Exceed Max Speed MPH 23) 21-301(a) Failure to Drive Right of Center in Zone 24) 21-304(c) Driving off Road While Passing Vehicle 02) 13-401(b)(1) Operating Unregistered Motor Vehicle 25) 21-308(a) Driving Wrong Direction on One Way Road 03) 13-401(h) Driving with Suspended Registration 26) 21-309(b) Unsafe Lane Changing 04) 13-409(b) Fail to Display Reg Card on Demand 27) 21-310(a) Following Vehicle Too Closely 05) 13-411(a) Fail to Attach Plates at Front & Rear 28) 21-402(a) Fail to Yield to Oncoming Traffic on Left Turn 06) 13-411(d) Driving w/o Current Tags 29) 21-707(a) Failure to Stop at Stop Sign 07) 13-411(f) Display Expired Reg Plates 30) 21-801(a) Speed Greater Than Reasonable 08) 13-411(g) Display Reg Plate Issued to Another 31) 21-801(b) Failure to Control Speed to Avoid Collision 09) 13-703(g) Unauthorized Disp & Use of Reg Plate 32) 21-9011(a) Reckless Driving 10) 16-101(a) Driving Without License 33) 21-9011(b) Negligent Driving 11) 16-112(c) Fail to Display License on Demand 34) 21-902(a)(1)(i) Driving Under Influence of Alcohol 12) 16-113(h) Violating Lic Restriction 35) 21-902(a)(1)(i)(i) Driving Under Influence of Alcohol Per Se 13) 16-115(g) Driving With an Expired License 36) 21-902(b)(1)(i) Driving While Impaired by Alcohol 14) 16-116(a) Failure Notify Adm Address Change 37) 21-902(c)(1)(i) Driving While So Impaired by (Drug(s), Drug(s) 15) 16-303(c) Driving on Suspended Lic & Priv and Alcohol) Incapable of Driving Safely 16) 16-303(d) Driving on Revoked Lic & Priv 38) 21-902(d)(1)(i) Driving While Impaired by Controlled 17) 16-303(f) Driving on Suspended Out of State Lic Dangerous Substance 18) 16-303(h) Driving While Lic Susp Under (16-203, 16-206a2 39) 21-1117(c) Driver Spinning Wheels Fail to Attend DIP, 17-106, 26-204/206, 27-103) 40) 22-4122(d) Failing to secure child under age 8 in child 19) 17-107 Driving Uninsured Vehicle safety seat when transporting in motor vehicle 20) 21-201(a)(1) Failure to Obey Traffic Device 41) 22-4123(b) (Operator, Occupant Under 16) Not Restrained 21) 21-202(h)(1) Fail to Stop at Steady Circular Red Signal by (Seat Belt, Child Safety Seat) 22) 21-202(i)(1) Fail to Stop at Red Signal Before Right Turn 42) 22-4123(c)(2) Front Passenger 16 or More without Seat Belt VIOLATION NOT ART TITLE SUB-TITLE PARAGRAPH CODE LISTED ABOVE TA BR LO MR 27 TG CHARGE: PREPAYABLE $50 $70 $83 $90 $110 $120 $130 FINE AMOUNT $140 $150 $160 $290 $330 $530 $580 Other $ NOTICE TO APPEAR YOU MUST APPEAR WHEN REQUIRED BY THE COURT THIS IS A PAYABLE CITATION, YOU HAVE A RIGHT TO REQUEST TRIAL TO CONTEST YOUR GUILT OR REQUEST A WAIVER HEARING REGARDING THE SENTENCE AND DISPOSITION YOU MAY WAIVE ANY TRIAL OR WAIVER HEARING AND PAY THE FINE SHOWN (SEE REVERSE) I SOLEMNLY AFFIRM UNDER PENALTY OF PERJURY THAT THE CONTENTS OF THE FOREGOING DOCUMENT ARE TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE, INFORMATION, AND BELIEF OFFICER'S SIGNATURE: ISSUE DATE: TRIAL: DISTRICT LOC OFFICER: AGENCY SUB-AGENCY ID NO RADAR/BREATHALYZER OPERATOR'S (PRINT) AGENCY SUB-AGENCY ID NO WARNING - FAILURE TO SIGN MAY LEAD TO YOUR ARREST I SIGN MY AS A RECEIPT OF A COPY OF THIS CITATION AND NOT AS AN ADMISSION OF GUILT BUT MY FAILURE TO APPEAR MAY RESULT IN THE ISSUANCE OF A WARRANT FOR MY ARREST X DEFENDANT'S SIGNATURE: DR-049 (Rev 10/2017) Front Side of Citation To Be Pre-Numbered on Bottom Right Margin (White "Court Copy" and White "Return to Court Copy" to have Bar-Code Displayed above Citation Number)

Note to Law Enforcement: Remove this first copy of citation before entering witness information You may enter address of defendant as shown on driver's license if that address is different from current address TO THE DISTRICT COURT: PLEASE SUMMONS THE FOLLOWING WITNESSES: Sub- Sub- Sub- Sub- Sub- Sub- Reverse Side of Copy #1 "Court Copy" White

IN CAR PATROLLING ON ROUTE WITH OBSERVED DEF GOING ON ROUTE AT PACED DEF FROM OPERATING TO VEHICLE COLOR GOT BEHIND DEF AT STOPPED DEF TOTAL DISTANCE SPEED OTHER VIOLATIONS WEATHER ROAD TRAFFIC WITH DEF AT TIME SPEEDOMETER TESTED RADAR UNIT USED RADAR REST TIMES REMARKS CONDITION Reverse Side of Copy #3 "Officer's Copy" Pink

NOTICE TO DEFENDANT CAREFULLY AND COMPLETELY READ ALL NOTICES ON BOTH THE RETURN TO COURT AND DEFENDANT'S COPIES OF THE CITATION INCLUDING THE "IMPORTANT INFORMATION" SECTION ON THE BLUE COPY THE DEFENDANT'S COPY IS FOR YOUR RECORDS IF THIS CITATION IS MARKED "THIS IS A PAYABLE CITATION" YOU MUST COMPLY WITH ONE OF THE FOLLOWING OPTIONS WITHIN 30 DAYS AFTER RECEIPT OF CITATION: 1) PAY THE FULL AMOUNT OF THE PRESET FINE, INSTEAD OF 2) APPEARING IN COURT Pay the full amount of the fine at any District Court of Maryland location, or with a credit card at the Maryland Judiciary Website or by phone (see information at the top of the blue copy of the citation), or by mail as shown below To pay by mail: Make your check or money order payable to the DISTRICT COURT OF MARYLAND Write each citation number on the front of the check or money order Place your check and the RETURN TO COURT (white) copy of the citation in the attached envelope and mail it to the Court If you received more than one citation you may place all citations in the same envelope An additional $10 service fee will be imposed for each dishonored check REQUEST A WAIVER HEARING REGARDING SENTENCING AND DISPOSITION INSTEAD OF TRIAL - PLEAD GUILTY WITH AN EXPLANATION Check the "Request a Waiver Hearing" box, sign and date below If you received more than one citation sign the statement on each citation Return this copy of the citation to the Court within 30 days in the attached envelope If you received more than one citation you may place all citations in the same envelope DO NOT SEND PAYMENT 3) REQUEST A TRIAL DATE AT THE DATE, TIME, AND PLACE ESTABLISHED BY THE DISTRICT COURT BY WRIT OR TRIAL NOTICE Check the "Request a Trial" box, sign and date below You will be mailed a notice of trial date Return this copy of the citation to the Court within 30 days in the attached envelope If you received more than one citation you may place all citations in the same envelope DO NOT SEND PAYMENT IF YOU FAIL TO COMPLY WITHIN 30 DAYS AFTER RECEIPT OF THIS CITATION, THE MOTOR VEHICLE ADMINISTRATION WILL BE NOTIFIED AND MAY TAKE ACTION TO SUSPEND YOUR DRIVER'S LICENSE DRIVING ON A SUSPENDED LICENSE IS A CRIMINAL OFFENSE FOR WHICH YOU COULD BE INCARCERATED Request a Waiver Hearing as to Disposition (see #2 above): I admit I committed the violation in this citation, and I request a waiver hearing to explain the circumstances to a judge I understand this is not a trial, the officer and witnesses will not be present, and my appearance in court is for sentencing only Request a Trial (see #3 above): I request a trial date for the violation charged Please check box on front of envelope that corresponds to the option you chose and mail payment or request for trial/waiver hearing DATE SIGNATURE Reverse Side of Copy #4 "Return to Court Copy" White

FOR MORE INFORMATION AND TO PAY CITATIONS Visit the MD Judiciary Website at wwwmdcourtsgov/district or call the Interactive Voice Response (IVR) System for trial dates, court locations, and directions From all areas including out-of-state call: 1-800-492-2656 TTY users call Maryland RELAY: 711 TO THE PERSON CHARGED IMPORTANT INFORMATION: It is your obligation to know your trial/waiver hearing date and appear on that date You can visit the MD Judiciary Website at wwwmdcourtsgov/district or call the IVR System (see above) to find out your trial/waiver hearing date It may take a few weeks before a trial/waiver hearing date is set The Court will mail a courtesy notice to the name and address shown on the front of the citation If your name or address on this citation is not correct you must notify the Court in writing of any changes The Post Office does not forward Court mail IF CITATION IS MARKED "YOU MUST APPEAR FOR TRIAL" This citation is a summons to appear The Court will automatically mail you a notice of your trial date Please read "Important Information" above You must appear in court as directed IF CITATION IS MARKED "THIS IS A PAYABLE CITATION" YOU MUST COMPLY WITH ONE OF THE FOLLOWING OPTIONS WITHIN 30 DAYS AFTER RECEIPT OF CITATION: 1 PAYMENT - Pay the full amount of the fine at any District Court of Maryland location, or with a credit card at the Judiciary Website or by using the IVR system (see above) or by mailing your check (made payable to the District Court of Maryland) and the RETURN TO COURT (white) copy in the attached envelope 2 GUILTY WITH AN EXPLANATION - If you wish to plead guilty and have a waiver hearing as to disposition, check the appropriate box on the RETURN TO COURT (white) copy of the citation, sign, date and return in the attached envelope DO NOT SEND PAYMENT AT THIS TIME You will be mailed a notice of your waiver hearing Since there will not be a trial, the officer and witnesses will NOT be summoned At the waiver hearing the Court will hear from you only for the purposes of imposing a sentence 3 TRIAL - If you wish to stand trial and have the officer present at the trial, check the appropriate box on the RETURN TO COURT (white) copy, sign, date and return in the attached envelope You will be mailed a notice of your trial date DO NOT SEND PAYMENT AT THIS TIME IF YOU FAIL TO COMPLY WITHIN 30 DAYS AFTER RECEIPT OF THIS CITATION, THE MOTOR VEHICLE ADMINISTRATION WILL BE NOTIFIED AND MAY TAKE ACTION TO SUSPEND YOUR DRIVER'S LICENSE DRIVING ON A SUSPENDED LICENSE IS A CRIMINAL OFFENSE FOR WHICH YOU COULD BE INCARCERATED 1 This paper charges you with committing a crime 2 If you have been arrested and remain in custody, you have the right to have a judicial officer decide whether you should be released from jail until your trial 3 If you have been served with a citation or summons directing you to appear before a judicial officer for a preliminary inquiry at a date and time designated or within five days of service if no time is designated, a judicial officer will advise you of your rights, the charges against you, and penalties The preliminary inquiry will be cancelled if a lawyer has entered an appearance to represent you 4 You have the right to have a lawyer 5 A lawyer can be helpful to you by: (A) explaining the charges in this paper; (B) telling you the possible penalties; (C) explaining any potential collateral consequences of a conviction, including immigration consequences; (D) helping you at trial; (E) helping you protect your constitutional rights; and (F) helping you to get a fair penalty if convicted 6 Even if you plan to plead guilty, a lawyer can be helpful 7 If you are eligible, the Public Defender or a court-appointed attorney will represent you at any initial appearance before a judicial officer and at any proceeding under Rule 4-2162 to review an order of a District Court commissioner regarding pretrial release If you want a lawyer for any further proceeding, including trial, but do not have the money to hire one, the Public Defender may provide a lawyer for you To apply for Public Defender representation, contact a District Court commissioner 8 If you want a lawyer but you cannot get one and the Public Defender will not provide one for you, contact the court clerk as soon as possible 9 DO NOT WAIT UNTIL THE DATE OF YOUR TRIAL TO GET A LAWYER If you do not have a lawyer before the trial date, you may have to go to trial without one Contact information for District Court Commissioner's Offices can be found at: http://wwwmdcourtsgov/district/directories/commissionermaphtml If you require further information about qualifying for a Public Defender, call 1-833-453-9799 Reverse Side of Copy #5 "Defendant's Copy" Blue