Ala. R. Jud. Admin. 20 app. A

A ___________________

State of Alabama

Unified Judicial System

ARJA-20 7/94

UNIFORM NON-TRAFFIC CITATION

AND COMPLAINT

(For Scheduled Non-Traffic Violations or Misdemeanors

Case Number

IN THE _______________________ COURT OF _____________________ COUNTY

Law Enforcement Agency/Organization or Department

□ AM

Month Day Year □ PM

The undersigned complainant, being duly sworn, deposes and says that the person

herein named committed the offense hereinafter set forth in that on or about

At

Approx.

Time

:

□ MT

First Middle/Maiden Last

Street

C i t y S t a t e Z i p

Expiration Date Birth Date State Month Date Year Month Date Year

Driver’s License Number

Height Weight Eyes Hair Social Security Number

Sex Race

Name of Employer Address of Employer

Did Violate: Ordinance Number __________________, which incor porates or encompasses Section __________________, Code of Alabam a

1975 within the city limits or police jurisdiction of ___________________________, and /or Section ___________________, Cod e of

Alabama 1975 or Rule/Regulation Number ______________________________, within ______________________________ Country at or

near the following location (describe) _________________________________________________________ more particularly described in the

DESCRIPTION OF OFFENSE section below

DESCRIPTION OF OFFENSE

Office or Short Description of Offense:

State Specific Facts Relating to Offense:

Months Day Year Sworn to and acknowledged

before me this date

Complainant’s (Officer’s) Signature

Agency O.R.I. Signature and Title of Judicial Officer Officer I.D.

AL

COURT APPEARANCE INFORMATION □ Court Appearance Required

By signing this citation, I am promisi ng to appear in court on the date and at the times specified below if a court appearance is not required, I

may choose to plead guilty before a magistrate or by mail or in person, paying the required fine and court costs prior to my sc heduled court

date, in which event I do not have to appear in court. If I do not appear in court on the scheduled date and if I do not plead guilty and pay the

required fine and costs prior to that. I promise to pay an amount prescribed by law.

I also understand that failure to appear or to plead guilty and pay the fine and costs may result in a warrant being issued for my arrest on the

present charge and I may also be charged with second degree bail jumping.

Court Appearance Date (if applicable )

Month Day Year Time □ AM

: □ PM

Court Address Telephone Number

Defendant’s Signature Telephone Number

NOTICE: FAILURE TO APPEAR IN COURT AND/OR FAILURE TO REMIT FINE AND COSTS WILL RESULT IN AN ARREST WARRANT BEING ISSUED

1. White – Court 2. Pink – Law Enforcement 3. Canary – Defendant

Sample Form ARJA –20

(back)

PLEA OF GUILTY/WAIVER OF RIGHTS

Plea Received by or Entered Before Magistrate

(Non-Traffic or Misdemeanor Offenses)

NOTICE TO DEFENDANT:

You are charged with the offense of _______________________________________ as described on

the front page. In accordance with Rule 20(d) of the Al abama Rules of Judicial Administration, if the offense

charged is included in an approved fine schedule, then in stead of appearing in court, you may elect to plead

guilty by appearing in person before a magistrate and paying the fine and costs or you may return this form,

either by mail or in person, along with the fine and co sts and any applicable victim compensation assessment to

the court clerk within seven (7) days of receiving this citation, or, if you are notified, not later than 72 hours prior

to the court appearance date shown on the front of this form. The amount due, should you choose to plead

guilty, is $ ________________ (fine), plus court costs of $ _________________________, plus a victim’s

compensation assessment of ___________________, for a total of $ ___________________.

PLEA OF GUILTY – WAIVER OF RIGHTS

YOU ARE HEREBY ADVISED OF YOUR RIGHTS AS A DEFENDANT IN THIS CRIMINAL CASE

Please Read Carefully

I, the undersigned, do hereby enter my appearance on the citation and complaint for the offense stated

above. I understand that I have certain constitutional rights, which I will waive if I plead guilty, namely: the right to

a trial before the court; the right to an attorney of my choice, or one appointed by the court at no charge if I

cannot afford one; the right at trial to subpoena wi tnesses on my behalf, to confront and cross examine

witnesses against me, and to argue and make objections; and the right to testify in my own behalf. I also

understand that I cannot be forced to testify against my self, that I am presumed innocent and that this

presumption can be overcome only if the prosecuti on convinces the judge of my guilt beyond a reasonable

doubt.

I understand my constitutional rights set out above and the punishment that will be imposed if I elect to

plead guilty before a magistrate. I also understand that my plea of guilty will have the same force and effect as a

judgment of conviction by the court, which may result in enhanced penalties for subsequent convictions and from

which I have the right to appeal. I further understand that the judgment of conviction will be noted on the court’s

records, which are open to public inspection. I understand my rights and the matters set out above and hereby

voluntarily and knowingly waive those rights by pleading guilty, as evidenced by my signature below.

_____________________________________________

Defendant’s Signature Date

_____________________________________________

Defendant’s Name ( print or type)