Uniform Complaint And Notice To Appear

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K.S.A. 19-4738
Uniform Complaint & Notice to Appear
(12-1-06)
IN THE DISTRICT COURT OF
COUNTY, KANSAS
UNIFORM COMPLAINT AND NOTICE TO APPEAR
State of Kansas
County of ______________
The undersigned complains that on the ____ day of __________, 2___, at __________
p.m. (a.m.)
Name ___________________________________________________________
(Please Print)
Street Address _________________________________________________
County ________________
State _________________
Birth Date ______________*
Sex _______________
Did unlawfully at
All in violation of Section(s) _________________________________
of Code or Resolution No. __ of __________ County, Kansas.
Signature of Officer or Complainant __________________ No. ____
**Sworn to positively before me this ____ day of ________, 2___.
_____________________________________________
Judge
*Pursuant to Supreme Court Rule 123(e), if an individual’s date of birth must be included in a
pleading filed with the court, only the year shall be used and the remainder shall be redacted.
**This complaint is not required to be sworn if it is signed by a law enforcement officer or code
enforcement officer.

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