NOTICE OF VIOLATION You are being charged with a violation of law as indicated below. Minors Misrepresenting Age, Procuring, Possessing or Consuming Alcoholic Beverages (7 V.S.A. Section 656) Complaint # AND OR Marijuana Possession by a Person under 21 Years of Age, one ounce or less (18 V.S.A. Section 4230b) Complaint # 1. As required by law, you must provide this officer with your correct name and address. 2. Within 15 Youth Substance Abuse Safety Program (YSASP) at the address or phone number circled to your left. 3. Do not send any money to pay any legal penalty at this time. There is a program fee required by the YSASP. 4. Until you have finished all conditions of the program, you must inform the YSASP office of any changes in your name or address. If you contact the Youth Substance Abuse Program within 15 days and complete all conditions of the program, this violation will be voided and no penalty will be imposed. If you fail to contact the Youth Substance Abuse Program within 15 days or fail to complete all conditions of the program , the ticket for this violation will be issued. At that time, you may contest the charge with the Judicial Bureau. If the Judicial Bureau finds you in violation, you will have to pay a fine and your privilege to operate a motor vehicle in Vermont will be suspended. The cost of your car insurance may increase substantially. If you hold a license fr om another state, that state will revoke your privilege to operate a vehicle also. You may have other tickets or citations. For example, if you were driving, you may have been given a ticket or criminal citation for operating a vehicle under the influence. Address your those documents. Law Enforcement Officer Phone # Department Name Date of violation County Diversion Programs ADDISON 282 Boardman Street PO Box 881 Middlebury, VT 05753 802 - 388 - 3888 BENNINGTON 439 Main Street Bennington, VT 05201 802 - 447 - 1595 CALEDONIA 24 Bagley Stree t St. Johnsbury, VT 05819 802 - 748 - 8732 CHITTENDEN 18 Burlington, VT 05401 802 - 864 - 1585 ESSEX FRANKLIN 120 N. Main St. St. Albans, VT 05478 802 - 524 - 7006 GRAND ISLE 120 N. Main St. St. Albans, VT 05478 802 - 524 - 7006 LAMOILLE 221 Main Street PO Box 148 Hyde Park, VT 05655 802 - 888 - 5871 ORANGE PO Box 58 Chelsea, VT 05038 802 - 685 - 3172 ORLEANS Newport, VT 05855 802 - 33 4 - 8224 RUTLAND 50 Center Street Rutland, VT 057 01 802 - 7 86 - 3840 WASHINGTON 322 North Main Street, Suite 5 Barre, Vermont 05641 Phone: 802 479 - 1900 WINDHAM 32 Walnut Street Brattleboro, VT 05302 802 - 257 - 0361 WINDSOR 211 North Main Street PO Box 474 White River Jct, VT 05001 802 - 295 - 5078 American LegalNet, Inc. www.FormsWorkFlow.com