Form Ao 83 - Summons In A Criminal Case - United States District Court

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AO 83 (Rev. 06/09) Summons in a Criminal Case
U
S
D
C
NITED
TATES
ISTRICT
OURT
for the
__________ District of __________
United States of America
)
v.
)
)
)
Case No.
)
)
Defendant
)
SUMMONS IN A CRIMINAL CASE
YOU ARE SUMMONED to appear before the United States district court at the time, date, and place set forth
below to answer to one or more offenses or violations based on the following document filed with the court:
’ Indictment
’ Superseding Indictment
’ Information ’ Superseding Information
’ Complaint
’ Probation Violation Petition
’ Supervised Release Violation Petition ’ Violation Notice
’ Order of Court
Place:
Courtroom No.:
Date and Time:
This offense is briefly described as follows:
Date:
Issuing officer’s signature
Printed name and title
I declare under penalty of perjury that I have:
’ Executed and returned this summons
’ Returned this summons unexecuted
Date:
Server’s signature
Printed name and title

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