Criminal Complaint Form
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1AO 91 (Rev. 08/09) Criminal Complaint
U
S
D
C
NITED
TATES
ISTRICT
OURT
for the
__________ District of __________
United States of America
)
v.
)
)
Case No.
)
)
)
Defendant(s)
CRIMINAL COMPLAINT
I, the complainant in this case, state that the following is true to the best of my knowledge and belief.
On or about the date(s) of
in the county of
in the
District of
, the defendant(s) violated:
Code Section
Offense Description
This criminal complaint is based on these facts:
’ Continued on the attached sheet.
Complainant’s signature
Printed name and title
Sworn to before me and signed in my presence.
Date:
Judge’s signature
City and state:
Printed name and title
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Parent category: Legal