Legal Criminal Complaint Form

LEGAL CRIMINAL COMPLAINT FORM

Jurisdiction:    Case Number:

Plaintiff (Prosecuting Authority):

Defendant Name:    Date of Birth:

Defendant Address:

RECITALS

WHEREAS, the undersigned complainant has personal knowledge of the facts alleged herein and is competent to testify thereto; and

WHEREAS, probable cause exists to believe that the person identified as Defendant committed the criminal acts set forth below within the jurisdiction of this court; and

WHEREAS, the complainant makes this complaint to initiate prosecution and to request issuance of process as authorized by law;

NOW THEREFORE, the complainant charges that the Defendant committed the following offenses and alleges the facts establishing probable cause.

CHARGES

Count 1 — Offense Title:    Statute/Citation:

Date/Time of Offense:    Location:

Classification: Felony Misdemeanor Infraction

Count 2 — Offense Title:    Statute/Citation:

Date/Time of Offense:    Location:

PROBABLE CAUSE STATEMENT

State the facts and circumstances leading the complainant to believe that the Defendant committed each charge. Include witness observations, admissions, physical evidence, forensic results, and other pertinent facts below. The undersigned attests that these facts are true to the best of their knowledge and belief.

WITNESSES AND EVIDENCE

List witnesses, physical evidence, relevant records, or electronic evidence that corroborate the allegations. Identify whether evidence is in custody of law enforcement or third parties and whether any preservation requests have been made.

ARREST WARRANT / SUMMONS REQUEST

The complainant requests (select one): Arrest warrant Summons for appearance Detention without bail

Legal basis for requested process:

BAIL / RELEASE RECOMMENDATION

Bail recommended:    Type:

Special conditions of release recommended:

AFFIANT INFORMATION AND CERTIFICATION

Complainant Name and Title:

Agency / Employer:

Badge / Employee No.:    Contact Phone:

I, the undersigned complainant, declare under penalty of perjury under the laws of the jurisdiction identified above that the facts set forth in this complaint are true and correct to the best of my knowledge and belief. I understand that knowingly making a false statement in a criminal complaint may constitute perjury or other criminal offense.

NOTICES

Service address for Defendant (if known):

Victim(s) notified:    Victim contact info:

GOVERNING LAW

This complaint is brought pursuant to the criminal statutes and procedural rules of the jurisdiction identified above. All matters arising from this complaint shall be governed by those laws and rules.

ENTIRE AGREEMENT; SEVERABILITY

This document constitutes the complete statement of the allegations and requests made by the complainant in this criminal action. If any provision of this complaint is found to be invalid or unenforceable, the remainder shall continue in full force and effect.

AMENDMENTS AND WAIVER

The complainant may amend or supplement this complaint as permitted by law. Failure by any party to insist upon strict compliance with any provision of this complaint shall not be deemed a waiver of any right or remedy.

ADDITIONAL INFORMATION

Additional remarks or attachments relevant to the complaint (attach separately if needed):

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