CRIMINAL COMPLAINT VERIFICATION Last page of pages (12/99) VERIFICATION ___________________________ CIRCUIT COURT CASE NUMBER _______________________________________________ JURISDICTION NAME / CODE _______________________________________________ REPORT NUMBER _______________________________________________ SAO NUMBER I have read this complaint containing _______________ counts, and all allegations herein are true and correct. NEXT COUR T DATE:______________________________ _____________________________________________ ___________ Complainant COURT TIME :_____________________________________ Subscribed and sworn to before me This_______day of__________________________, 20____ COURT L OCATION: 2200 N. Seminary Avenue Woodstock, Illinois JUDGE - CIRCUIT COURT CLERK - NOTARY PUBLIC Arresting Officer: Copy of Complaint delivered to said Defendant, rights explained and Probable Cause found (if warrantless arrest) ___________________________________________ TOTAL BOND $ Badge #__________________________ This_________ day of ___________________, 20_____ JUDGE DEFENDANT INFORMATION: LAST NAME FIRST NAME MIDDLE NAME DEFENDANTS ADDRESS CITY STATE ZIP CODE TELEPHONE MONTH DAY YEAR DRIVERS LICENSE NUMBER STATE SOCIAL SECURITY NUMBER Date of Birth WARRANTLESS ARREST? YES NO SEX __________ RACE ____________ DATE/TIME OF ARREST ____________________ AT __________ HRS CO-DEFENDANT(S): YES NO (If YES, list) _______________________________________________________ CIRCUIT CLE RK-ORIGINAL COPIES TO: STATES ATTORNEY/PROSECUTOR POLICE DEPART MENT DEFENDANT