COPIERS NW

CRIMINAL TRAFFIC \f NON-TRAFFIC IBC 186292IN THE E DISTRICT MUNICIPAL COURT OF BELLEVUE STATE OF WASHINGTON. PLAINTIFF VS. NAMED DEFENDANTD COUNTYOF KING

^CITmOWN OFBELLEVUE

BELLEVUE, WASHINGTON

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THE UNDERSIGNED CERTIFIES AND SAYS THAT IN THE STATE OF WASHINGTONDRfiSfTS LICENSENO.^4. , ^ __ ,- Alt JAJ& PHOJOU). MATCHEDYES D NO

D YES Q NOfinxwP.,1^ ^MAM.P. qP/JAi"^fei -rtoVr Avfc #-"> FNEWAOORESSJ*

"fe/^fcfr VV^SaT-T^.g.*, kZh'Pyzss m Y&J> rz>u*RESIDENTIAL PHONE NO. . , _ _ CELUPAGER NQ,^ - , | .5 ... WORK PHONE NO.

VIOLATION DATE

ON OR ABOUT &W . \o- iHllo -ft/fc Ate

TIME

24 HOUR H*>o INTERPRETER NEEDED

LANG:

cmncouNTYOfBELLEVUE/KING

> DID OPERATE THE FOLLOWING VEHICLE/MOTOR VEHICLE ON A PUBLIC HIGHWAY AND

EXEMPT Q FARM Q FIREVEHICLE R.V. Q OTHER J

DID THEN AND THERE COMMIT EACH OF THE FOLLOWING OFFENSES

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