________________________________ COURT

______________________ County, Arizona

STATE OF ARIZONA Plaintiff

[CASE/COMPLAINT NO.]

-vs-

SUMMONS

(Fingerprint Not

Required)

Defendant (FIRST, MI, LAST)

TO:

YOU ARE SUMMONED to appear before this court for the following reason:

[(List reason for summons; e.g., filing of indictment, information or complaint (list charges or other reasons)].

YOU ARE ORDERED TO REPORT on _______________, 20 ___ at ___ a.m./p.m.

LOCATED AT:

IF YOU FAIL TO APPEAR AS ORDERED, A WARRANT MAY BE ISSUED FOR YOUR ARREST.

Date: _______________

Judicial Officer

Requests for reasonable accommodation for persons with disabilities must be made to the court by parties at least 3 working days in advance of a scheduled court proceeding.

CERTIFICATE OF PERSONAL SERVICE

I swear that I personally served this summons as follows:

Date Received:___________________

Date Served: __________________

Time Served: __________

Person Served: ___________________________________________________

Location Where Served: _______________________________________________-

_________________________________________________________________ County.

Officer Serving Summons

CERTIFICATE OF SERVICE BY MAILING

I certify that a copy of this document was sent by Registered or Certified mail, return receipt requested, to the defendant at the above-listed address.

Dated: ______________________________

_____________________________________________

CLERK