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NOTICE OF
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NAME OF OFFENDER:
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CITATION NO.: 'YAR
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DATE OF VIOLATION:
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YOU HAVE BEEN OBSERVED VIOLATING-
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EMPLOYEE NUMBER:
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I HEREBY ACKNOWLEDGE RECEIPT OF CITATION
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YOU HAVE THE FOLLOWING ALTERNATIVES IN THIS MATTER: Either option (1) or option 121 will operate as a final disposition, with no resufiing criminal record.
(1) You may choose to pay the above fine, whether by appearing in person or through a duly autiprized agent or by mailing a check money order, or postal now WITHIN 21 DAYS OF THE DATE OF THIS NOTICE to:
Town Clerk, Town of Yannouth, 1146 Route 28, South Yamtouet, MA 02664.
0 It you desire to oomestthis matter, you may do so by making a wriaen request for a noncriminal hearing, and enclosing a copy of this citation, WITHIN 21 DAYS OF THE DATE OF THIS NOTICE to: Clerk Magistrate,
District Court Dept., First Barnstable Division, Main Street, Barnstable, MA 02M.
(3) 0 you fall to pay the above fine, or to request a hearing wthn 21 days, or ti you fail to appear for the hearing a to pay any late determined at the hearing to be due, a criminal complaint may be issued against you.
I HEREBY ELECT THE FIRST OPTION above, confess the offense charged, and enclose payment in the amount of S
I HEREBY REOUESTA NONCRIMINAL HEARING on tltis matter.
Signature Date
■ Complete items 1, 2, and 3.
■ Print your name addEac o2_6110 d�M 3
so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
ill
Rosa Caloiero
23 BEMffR_ DR
SUDBLTRA 0 1 776
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B. efved by (Printed Name)
C. Da D very
D. Is delivery address different from item 1? ❑ Yes
If YES, enter delivery address below: ❑ No
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I�I IIIII IIII III I II (I� I � III IIII I I I I III l(l 3. Service Type ❑ Pricirlty ExpressO
❑ Adult Signature ❑Registered MailT❑ Adult Signature Restricted Delhrery ❑ Retriatered Mail ResMcrti
9590 9402 5072 9092 6033 73 a0cem��d Mai ietctea Delivery ❑ Re iu Receipt for
_ Cl Collect on DoWery
2. Article Number (Tnywier from service label) ❑ Collect on Del" Restricted Del" ❑ Signature C-firl1tetigrtn
^ Insured Mail ❑ Signature Conflnnatian
7022 24111 0001 1264 5807 t� Restricted acted Delivery �tricted Winery
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PS Form 3811, July 2015 PSN 7530-02-000-9053 Domestic Return Receipt