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State of Minnesota Criminal Complaint Form


 
 
STATE OF MINNESOTA   DISTRICT COURT
COUNTY OF <NAME>   <NUMBER> JUDICIAL DISTRICT
    COURT FILE NO.      
    PROSECUTOR FILE NO.      
 

State of Minnesota,

 

      Plaintiff,

 
v.  

<Name of Defendant>(dob: <Defendant DOB>)

Summons   Warrant

<Defendant Address Line 1>   Order of Detention
<Defendant City>, MN  <Defendant Postal Code>,  
   Amended
Defendant.  Tab Charge Previously Filed
   
 

The Complainant, being duly sworn, makes complaint to the above-named Court and states that there is probable cause to believe that the Defendant committed the following offense(s):

 

COUNT I

 

Charge: <Charge Name>

Minnesota Statute:  �� <Statutes_Charge>

Maximum Sentence:  <Max Sentence Description> 

COUNT II

 

Charge: <Charge Name>

Minnesota Statute:  �� <Statutes_Charge>

Maximum Sentence:  <Max Sentence Description>

COUNT III

 

Charge: <Charge Name>

Minnesota Statute:  �� <Statutes_Charge>

Maximum Sentence:  <Max Sentence Description>

 

 

STATEMENT OF PROBABLE CAUSE

 

The Complainant states that the following facts establish probable cause:

 

     

 


   
Complainant requests that Defendant, subject to bail or conditions of release, be:

(1) arrested or that other lawful steps be taken to obtain Defendant��s appearance in court; or

(2) detained, if already in custody, pending further proceedings; and that said Defendant otherwise be dealt with according to law.

  COMPLAINANT��S NAME:   COMPLAINANT��S SIGNATURE:  
  <Name>      
  Subscribed and sworn to before the undersigned this       day of           , 20     .
  NAME/TITLE:   SIGNATURE:  
             
         
 
Being authorized to prosecute the offenses charged, I approve this complaint.
Date:     PROSECUTING ATTORNEY'S SIGNATURE:
           
      Name: <Prosecutor Name>  
      <Prosecutor Title>  
      <Prosecutor Address>  
      <Prosecutor Phone Number>  
      Attorney Registration #        

 

 
FINDING OF PROBABLE CAUSE

From the above sworn facts, and any supporting affidavits or supplemental sworn testimony, I, the Issuing Officer, have determined that probable cause exists to support, subject to bail or conditions of release where applicable, Defendant��s arrest or other lawful steps be taken to obtain Defendant��s appearance in court, or Defendant��s detention, if already in custody, pending further proceedings.  Defendant is therefore charged with the above-stated offense.

  SUMMONS

THEREFORE YOU, THE ABOVE-NAMED DEFENDANT, ARE HEREBY SUMMONED to appear on the <#> day of <month>, 20 at <00:00> before the above-named court at <location detail> to answer this complaint.

 

IF YOU FAIL TO APPEAR in response to this SUMMONS, a WARRANT FOR YOUR ARREST shall be issued.

        
  WARRANT

To the Sheriff of the above-named county; or other person authorized to execute this warrant: I hereby order, in the name of the State of Minnesota, that the above-named Defendant be apprehended and arrested without delay and brought promptly before the above-named court (if in session), and if not, before a Judge or Judicial Officer of such court without unnecessary delay, and in any event not later than 36 hours after the arrest or as soon as such Judge or Judicial Officer is available to be dealt with according to law.

 

Execute in MN Only  Execute Nationwide      Execute in Border States

  ORDER OF DETENTION

Since the above-named Defendant is already in custody, I hereby order, subject to bail or conditions of release, that the above-named Defendant continue to be detained pending further proceedings.

Bail: $     
Conditions of Release:      
 
This complaint, duly subscribed and sworn to, is issued by the undersigned Judicial Officer this _____ day of ___________, 20            .
 
JUDICIAL OFFICER:       SIGNATURE:
NAME:        
TITLE:          
 
Sworn testimony has been given before the Judicial Officer by the following witnesses:
         
COUNTY OF <NAME>

STATE OF MINNESOTA

Clerk��s Signature or File Stamp:
   
STATE OF MINNESOTA RETURN OF SERVICE

I hereby Certify and Return that I have served a copy of this upon the Defendant herein named.

Plaintiff,
vs.
<Name>
Defendant
      Signature of Authorized Service Agent:
       

 

 

DEFENDANT DATA / charge SHEET - Attachment A

 
 
DEFENDANT NAME: <LAST NAME>, <FIRST NAME> <MIDDLE NAME>
Defendant alias name(s): <Alias Names>
Defendant DOB: <Defendant DOB>
Alias DOB(s): <Alias DOBs>
Defendant last known address: <Defendant Address Line 1>
  <Defendant City> MN, <Postal Code>
State ID: <SID Number>
   
   
Other Defendant / Case Identifiers:
Fingerprinted? No    Yes
Handgun permit? No    Yes (Issuing Agency:      )
Location of Violation:      
   
IF DRIVING OFFENSE:
Driver's License Number:       Issuing State:      
         
License Plate Number:       Issuing State:      
         
Accident Type: 
check all that apply
  No injury/no damage   Property Damage
  Personal Injury   Fatality
   
Blood Alcohol Concentration (BAC):      
   
 

 

STATUTE AND OFFENSE GRID

 
Cnt Nbr Statute Type Offense Date(s) Statute Nbrs and Text Descriptions Offense Level MOC GOC Controlling Agencies Control Numbers
1 Charge  
           

     

     

              <Book ORI Nbr> 
Booking

<Arrest ORI Nbr> 
Arresting

<Ctrl Nbr> 
Booking

<Ctrl Nbr> 
Arresting

2 Charge  
           

     

     

              <Book ORI Nbr> 
Booking

<Arrest ORI Nbr> 
Arresting

<Ctrl Nbr> 
Booking

<Ctrl Nbr> 
Arresting

3 Charge  
           

     

     

              <Book ORI Nbr> 
Booking

<Arrest ORI Nbr> 
Arresting

<Ctrl Nbr> 
Booking

<Ctrl Nbr> 
Arresting

4 Charge  
           

     

     

              <Book ORI Nbr> 
Booking

<Arrest ORI Nbr> 
Arresting

<Ctrl Nbr> 
Booking

<Ctrl Nbr> 
Arresting

5 Charge  
           

     

     

              <Book ORI Nbr> 
Booking

<Arrest ORI Nbr> 
Arresting

<Ctrl Nbr> 
Booking

<Ctrl Nbr> 
Arresting

6 Charge  
           

     

     

              <Book ORI Nbr> 
Booking

<Arrest ORI Nbr> 
Arresting

<Ctrl Nbr> 
Booking

<Ctrl Nbr> 
Arresting

7 Charge  
           

     

     

              <Book ORI Nbr> 
Booking

<Arrest ORI Nbr> 
Arresting

<Ctrl Nbr> 
Booking

<Ctrl Nbr> 
Arresting

8 Charge  
           

     

     

              <Book ORI Nbr> 
Booking

<Arrest ORI Nbr> 
Arresting

<Ctrl Nbr> 
Booking

<Ctrl Nbr> 
Arresting


Form Revised August 2006 (ITD_SP_0339c)         Page of 6

Form Revised August 2006 (ITD_SP_0339c)                       Page of 6

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