SAMPLE. Front Side of Citation To be Pre-Numbered in Top Right Margin (White "Court Copy" to have Bar-Code Displayed above Tracking Number)

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UNIFORM CRIMINAL CITATION State of Maryland vs. Defendant's (Last) Name First Middle Current Address in Full City County State Zip Code DOB Height Weight Sex Race Ethnicity Hair Eyes Related Citations Arrest Number (if applicable) Telephone No. Day: Night: It is formally charged that the above named person on, at In violation of: Md. Ann. Code COMAR/Agency Code Common Law of Md. Ordinance Public Local Law Document/Article Section CJIS Code Penalty: M at TO ANSWER THE ABOVE CHARGE LODGED AGAINST YOU: YOU ARE HEREBY SUMMONED AND COMMANDED TO APPEAR FOR TRIAL IN THE DISTRICT COURT OF MARYLAND FOR (Location) Check if Fingerprinted, City/County, Maryland did (CITY/COUNTY) LOCATED AT MARYLAND, ON AT. Date WHEN REQUIRED BY THE COURT. YOUR FAILURE TO OBEY THIS CITATION MAY RESULT IN THE ISSUANCE OF A WARRANT FOR YOUR ARREST. To request a foreign language interpreter or a reasonable accommodation under the Americans with Disabilities Act, please contact the court immediately. I sign my name as a receipt of a copy of this citation and not as an admission of guilt. I hereby submit to the jurisdiction of the Court. X Defendant's Signature I solemnly affirm under the penalties of perjury that the contents of the foregoing citation are true to the best of my knowledge, information, and belief. Issuing Peace Officer's Signature DC-CR-045 (Rev. 10/2017) Date Agency Sub-Agency ID No. Year Front Side of Citation To be Pre-Numbered in Top Right Margin (White "Court Copy" to have Bar-Code Displayed above Tracking 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: Reverse Side of Copy #1 Court Copy White

Note to Law Enforcement: The following is a statement for the State's Attorney describing the events surrounding the issuance of this Citation. Reverse Side of Copy #2 State's Attorney Copy Green

BALTIMORE CITY CRIMINAL CITATION This Citation constitutes prima facie evidence of the facts contained if trial is waived or where the presence of the issuing officer is not requested at trial. Failure to obey any requirement of the Citation could result in the issuance of an arrest warrant and increased fines and penalties. NOTICE OF ADVICE OF RIGHT TO COUNSEL FOR ALL JUDICIAL PROCEEDINGS To the Person Charged: 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 4-216.2 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 DAY 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://www.mdcourts.gov/district/directories/commissionermap.html If you require further information about qualifying for a Public Defender, call 1-833-453-9799. NOTICE A trial date notice will be sent to the address shown on the Citation. If you reside at an address different from that shown, or you change your address, you must immediately notify the Court of the correct address. Reverse Side of Copy #3 Defendant's Copy Canary

OFFICER'S NOTES Reverse Side of Copy #4 Law Enforcement Copy Pink

CRIMINAL CITATION Law enforcement agencies should refer to Criminal Procedure 4-101 for the list of qualifying offenses, exceptions, and criteria for the issuance of the Uniform Criminal Citation. Copies of this citation should be distributed as shown below. DISTRIBUTION White: Green: Canary: Pink: Court State's Attorney Defendant Law Enforcement *****NEW FIELDS ON CITATION***** Arrest Number - optional; for agency arrest number if applicable Check if Fingerprinted - check this box if defendant was arrested and fingerprinted on this charge before being issued citation and released Outside Back Cover & Flap of Citation Book Imprint Name of Distribution Group on the Bottom of Each Page, all Caps, Red Ink