Mv4017 PDF Template

Mv4017 PDF Template

The Mv4017 form is an official notification that requires the recipient to appear in court, often related to traffic citations or other municipal violations. This form includes essential details such as the court date, location, and nature of the alleged offense, as well as pertinent information about the defendant. For individuals needing to address citations listed on the Mv4017 form, completing the necessary steps can be crucial; fill out the form by clicking the button below.

Overview

The MV4017 form serves as a critical document within the municipal court system, specifically in Madison, Wisconsin. This form typically requires individuals to appear in court regarding traffic violations or other offenses. It outlines essential details such as the defendant's information, citation number, violations, and the specific date and time of the scheduled court appearance. For instance, the form may indicate an estimated point value for the violation, a required deposit, and any related administrative actions. In the case of Jeff A. Okafor, two citations are documented on the MV4017, revealing violations for hit-and-run and operating a vehicle after revocation. Additionally, the form includes identification numbers for the defendant's vehicle and license details, reinforcing its role in tracking legal proceedings. Navigating the information presented on the MV4017 can be daunting for those unfamiliar with the legal system, necessitating careful attention to detail to ensure compliance with court requirements. Through an understanding of the form's facets, defendants can better prepare for their court appearances and address the stated violations effectively.

Mv4017 Preview

You Are Notified to Appear

Date

 

Time

 

 

Form No. and Version CTL

CITATION NO.

 

 

 

 

APR-07-2010

08:30 AM

 

 

MV4017

0901

N168141 -

1

Appearance Required:

NO

 

 

 

 

 

Estimated Points

DEPOSiT

Cash - Card

 

 

 

 

 

 

 

 

 

MADISON CITY MUNICIPAL COURT

 

 

 

 

 

6

 

$364.50

N

N

 

 

 

 

 

 

 

 

 

 

210 MARTIN LUTHER KING JR BLVD RM 203

 

 

 

 

Court Use

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

MADISON,

WI

53703

 

 

 

 

 

 

 

 

 

 

 

 

Defendant(Last Name. First. Middie). Street Address. P.O. Box, City. State. Zip

Birth Date

Sex

Race

 

 

 

 

 

 

 

 

 

10/8/1976

 

M

W

 

OKAFO JEFF A

 

 

 

 

 

 

 

 

 

 

 

 

 

910 MAGNOLIA LANE 3

 

 

 

 

 

 

HT

WT

 

Hair

Eyes

 

MADISON,

WI

53713

 

 

 

 

 

 

600

280

lbs

BLK

BRO

Driver License/Identification Card Number

 

State

Exp. Yr.

 

License Class

License Endorsements

 

02104217636807

 

 

WI

2010

 

D

 

 

 

 

 

 

License Plate Number

Plate Type

State

Exp. Yr.

OPERATING AS:

 

 

 

 

 

FJ8471

 

 

LTK

 

WI

2010

 

DRIVER

 

 

 

 

 

 

Vehicle Identification Number

US DOT No.

 

Hazmat No.

 

Vehicle Class

Vehicle Endorsements

 

IGCEC14Z4PEI06654

 

 

 

 

 

D

 

 

 

 

 

 

Vehicle Year

 

Make

Type

 

Color

 

CMV

 

CDL Waiver

 

 

 

1993

 

CBEY

PK

 

SIL

 

 

N

 

 

 

 

 

 

Plaintiff

 

 

 

Ordinance Violated

 

 

 

Adopting State Statute

 

CITY OF MADISON

 

 

 

 

 

 

 

 

346.67 (1) (a)

 

Violation Description

 

 

 

BAC

 

OvelWeight

 

Agency Space

 

 

 

 

 

 

 

 

 

 

 

 

 

HIT AND RUN

 

 

 

 

 

 

 

 

 

 

 

 

 

Week Day

 

Date

Time

 

Actual Speed Legal

 

Over

 

2010-25036

 

 

 

 

 

 

 

 

 

 

 

 

 

 

WEDNESDAY

 

JAN-13-2010

03:04 AM

 

 

 

 

 

 

 

 

 

 

County

 

 

CityNiliagefTown

 

 

 

 

 

 

 

 

 

DANE - 13

 

MADISON - 73,

CITY

 

 

 

 

 

 

 

 

ON Hwy No. and/or Street Name

 

 

 

 

Estimate Distance

 

 

 

 

 

W WASHINGTON AVE

 

 

 

 

 

 

 

 

 

 

 

 

From/AT Hwy No. and/or Street Name

 

 

 

GPS Coordinates

 

 

 

 

 

 

 

 

 

 

 

Minor Passenger

 

 

 

 

 

 

 

 

 

 

 

 

 

 

UlIAUL

 

 

 

 

 

 

 

 

 

N

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Officer Name

 

 

 

 

 

Zone: RR

Utmty

w School -

Const

Accident Severity

 

PO CHANDA DOLSEN

 

 

 

N

 

N

N

N

PROP DAMAGE

 

Officer ID

Department

 

 

 

 

 

Date Citation Served,

Method

 

 

3896

MADISON POLICE DEPARTMENT

 

 

 

MAR-06-2010

 

IN PERSON

 

Lanes

 

Road Condition

 

POLICE RECORD

---cT"'=a"ff=ic------.L"ig"'h=t'C"o"n"'di"'ti"on=-----

 

 

UNKNOWN

 

 

 

 

 

L -

LIGHT

 

DARK-LIGHTED

 

Highway

 

 

 

 

 

 

Weather Condition

 

 

 

 

 

PARKING-LOT-OR-PRIVATE-PROPERTY

 

 

 

CLEAR

 

 

 

 

 

 

PLEASE REFER TO CASE 2010-25036

T331 9/2001 WDOT

s345.11 Wis. Stats

WISCONSIN UNIFORM CITATION

YQU Are Notified to Appear

Date

 

Time

 

 

Form No, and Version CTL

CITATION NO.

 

 

 

 

APR-07-2010

08:30 AM

 

 

MV4017

0901

N168142 -

2

Appearance Required:

YES

 

 

 

 

Estimated Points

DEPOSIT

Cash - Card

 

 

 

 

 

 

 

 

 

MADISON CITY MUNICIPAL COURT

 

 

 

 

3

 

$264.50

N

N

 

 

 

 

 

 

 

 

 

 

210 MARTIN LUTHER KING JR BLVD RM 203

 

 

 

 

Court Use

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

MADISON,

WI

53703

 

 

 

 

 

 

 

 

 

 

 

 

Defendant<Last Name, First, Middie), Street Address, P,O, Box, City, State, Zip

Birth Date

Sex

Race

 

 

 

 

 

 

 

 

 

10/8/1976

 

M

W

 

OKAFO JEFF A

 

 

 

 

 

 

 

 

 

 

 

 

 

910 MAGNOLIA LANE 3

 

 

 

 

 

 

HT

WT

 

Hair

Eyes

MADISON,

WI

53713

 

 

 

 

 

 

600

280

lbs

BLK

BRO

Driver License/Identification Card Number

State

Exp, Yr.

 

License Class

License Endorsements

 

02104217636807

 

 

WI

2010

 

D

 

 

 

 

 

 

License. Plate Number

Plate Type

State

Exp. Yr.

 

OPERATiNG AS:

 

 

 

 

 

FJ8471

 

 

 

LTK

WI

2010

 

DRIVER

 

 

 

 

 

 

Vehicle Identification Number

 

US DOT No.

Hazmat No.

 

Vehicle Class

Vehicle Endorsements

 

lGCEC14Z4PE106654

 

 

 

 

 

D

 

 

 

 

 

 

Vehicle Year

 

Make

Type

Color

 

 

CMV

 

COL Waiver

 

 

1993

 

CHEV

 

PK

SIL

 

 

N

 

 

 

 

 

 

Plaintiff

 

 

 

Ordinance Violated

 

 

 

Adopting State Statute

 

CITY OF MADISON

 

 

 

 

 

 

 

 

343.44(1) (b)

 

Violation Description

 

 

 

BAC

 

OveIWeight

 

Agency Space

 

 

 

 

 

 

 

 

 

 

 

 

 

OPERATING AFTER REVOCATION

(2ND)

 

 

 

 

 

 

 

 

 

 

Week Day

 

Date

 

Time

Actual Speed Legal

 

Over

 

2010-25036

 

 

 

 

 

 

 

 

 

 

 

 

 

 

WEDNESDAY

 

JAN-i3-20iO

 

03:04 AM

 

 

 

 

 

 

 

 

 

 

County

 

 

 

CityNiliagerrown

 

 

 

 

 

 

 

 

 

DANE - 13

 

 

MADISON

- 73,

CITY

 

 

 

 

 

 

 

 

ON Hwy No. and/or Street Name

 

 

 

 

Estimate Distance

 

 

 

 

 

W WASHINGTON AVE

 

 

 

 

 

 

 

 

 

 

 

 

From/AT Hwy No. and/or Street Name

 

 

GPS Coordinates

 

 

 

 

 

 

 

 

 

 

Minor Passenger

 

 

 

 

 

 

 

 

 

 

 

 

 

 

UHAUL

 

 

 

 

 

 

 

 

 

N

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Officer Name

 

 

 

 

Zone: RR Utility

MSchool - Canst

Accident Severity

 

PO CHANDA DOLSEN

 

 

 

N

 

N

N

N

PROP DAMAGE

 

Officer 10

Department

 

 

 

 

 

Date Citation Served,

 

Method

 

 

3896

MADISON POLICE DEPARTMENT

 

 

 

MAR-06-2010

 

 

IN PERSON

 

Lanes

 

Road Condition

 

POLICE RECORD

Traffic

Light Condition

 

 

 

 

 

 

 

 

 

UNKNOWN

 

 

 

 

 

L -

LIGHT

 

DARK-LIGHTED

 

Highway

 

 

 

 

 

 

Weather Condition

 

 

 

 

 

PARKING-LOT-OR-PRIVATE-PROPERTY

 

 

 

CLEAR

 

 

 

 

 

 

PLEASE REFER TO CASE 2010-25036

T331 9/2001 WDOT

s345.11 Wis. Stats

WISCONSIN UNIFORM CITATION

 

MADISON POLICE DEPARTMENT

Date of Report:

3/8/2010

Case No:

2010-25036 Field Arrest

 

 

Ref. No:

 

Occurred Incident:

52 - Accident - Hit & Run

Sec/Area:

404 CENTRAL

Dispatched as:

52 - Accident - Hit & Run

Grid:

CAPITOL

Case Offense:

ARRESTED PERSONIHIT AND RUN

 

Addr of Occurrence:

602 W Washington Av

 

 

Call DatelTime:

01/28/201010:36

From DatelTime:

Dispatch DatelTime:

01/28/2010 10:50

Thru DatelTime:

Reporting Officer:

PO CHANDA M DOLSEN 3896

 

 

Special Routing:

PO CHANEY, POTREVARTHEN, LT MCCAW, VENDING (CITY CLERK)

SUSPECT

JEFF A. OKAFO

'ARRESTED

 

MIS DOB: 10108/76 (33 yrs) Height: 6.00 Weight: 280

 

HairColor: BLK EyeColor: BRO

 

 

910 MAGNOLIA LA 3 MADISON WI

H: 608-239-4186 W: 347-5417 2133 C: 608-

 

239-4186

 

DRV L1C:

0210-4217-6368-07 WI

 

OFFENSE #1: HIT AND RUN: PDO (PR, S 346.67(1)

OFFENSE #2: OPERATING AFTER REVOCATION, S 343.44

OFFENSE #3: VENDING RESTRICTION, C 9.13(4)

VICTIM

JOHN P. HANDLEY

 

MIW DOB: 08/12/55 (54 yrs) Height: 5.10 Weight: 200

 

HairColor: BRO

EyeColor: BRO

 

4705 GRANDVIEW CT MCFARLAND WI H: 608-838-6489 C: 608-334-1361

CONTACT

JAMES DAVIS

 

 

MIB DOB: 09/28/68 (41 yrs) Height: 5.08 Weight: 230

 

HairColor: BLK

EyeColor: BRO

 

8646 GREENWAY BL 202 MIDDLETON WI H: 444-1590 W: 577-4857 C: 608-444-

 

1590

 

DRV L1C:

D120-4406-8348-03 WI

PROPERTY INFO:

 

Code

Description

Value

ACCIDENT UNK YR CHEV TRK GRY

 

CHEV CHEVROLET

 

SIN: UNK

License

 

Owner: JEFF A. OKAFO (SUSPECT)

DAMAGED

FOOD CART

$200.00

 

Owner: JOHN P. HANDLEY (VICTIM)

SUSP VEH: 1993 CHEVROLET ChevyTruck (TRUK 1993) Lie Num: FJ8471-Wisconsin 1993 SILVER PICKUP TRUCK WISCONSIN REGISTRATION SILIWHTGLD Truck

NARRATIVE:

On 01-28-2010 I was dispatched to 602 W. Washington Avenue, the U-Haul store, in reference to a hit and run. Upon my arrival I met with the complainant identified by Wisconsin Driver's License as John Handley. Handley told me he stores his food cart, the FIBS cart, in the U-Haul parking lot. On

Case # 2010-25036, PO CHANDA M DOLSEN 3896

Page 2 of4

01-13-2010 Handley observed damage to his cart. The U-Haul store manager retrieved video surveillance showing the damage occurred from another vehicle unsafely backing a food cart.

The footage was taped on 01-13-2010 at approximately 3:04 AM. I reviewed the video with Handley and the store manager. The video showed a silver pickUp truck backing the JD's food cart. I could see the JD's cart strike the FIBS cart. The video clearly showed the FIBS cart forcefully slide backwards. After the damage occurred the driver exited the vehicle as if he was checking for damage.

The driver pulled forward several times, finally parking the JD's cart next to the FIBS cart. He unhooked the cart and exited the parking lot. He did not leave a note or make any attempt to contact the staff at U-Haul to report the damage. I retrieved the video footage and still photos. All were submitted as evidence.

I observed damage on the front corner of the FIBS cart. Handley told me he called the owner of the JD food cart, James Davis. Handley said Davis was not the driver of the silver pickup, it was his "employee". Davis told Handley he would talk to his employee and get back with him. Davis never called Handley back. This is when Handley contacted the police to file a report.

I gathered Handley's personal information and cart information for my report. Handley advised he had received a verbal estimate of $200.00 to repair the damage. Handley told me he never gave anyone permission/consent to damage his property and Handley is willing to pursue a criminal complaint. I provided him with my business card including the case number and my contact information.

I contacted James Davis via telephone. Davis told me he was not the one that had returned his cart to the U-Haul lot that night. He initially told me it was an employee, then he said it was Jeff Okafo. Davis said after he had been contacted by Handley he called Okafo to question him. Davis said Okafo admitted to hitting the FIBS cart but Okafo didn't think he caused much damage. Davis said Okafo agreed to contact Handley to make arrangements to pay for the damage. Davis told me he was under the impression Okafo contacted Handley until I called him. Davis provided me with a cell phone number for Okafo. I contacted Okafo via telephone. Okafo told me he was doing Davis a favor by taking his cart to the U-Haullot. He admitted he backed the cart and said, "I thought I might have hit the FIBS cart but I am not sure". Okafo then said, "I thought I hit that trailer but I didn't see it

move."

Okafo then became very irritated with me asking him questions. He asked me why Handley didn't call him. Okafo said he doesn't feel it was his responsibility to report the hit and run, and thought Handley should have contacted Okafo. I asked Okafo to provide me with his vehicle information. He told me he was at work and he didn't have it accessible. Okafo said he would get the vehicle information and call me back.

I spoke with Okafo two more times. after that initial conversation requesting he provide me with his vehicle information. He never returned my call or prOVided his vehicle information. Further investigation showed Okafo's driver's license is revoked. I completed two tracs citations. The first citation #N 168141-1 for the Hit &Run and the second citation #N 168142-2 for Operating After Revocation. I went to his address mUltiple times attempting to serve him his citations. I had no success contacting anyone and I was hesitant to leave the citations under his door or send them certified.

On 02-06-2010 I was assigned to work the Vigil for Life rally in the 700 block of State Street. When I reported to the area I noticed the Jin's Chicken Food Cart was abandoned with no vendors present.

Case # 2010-25036, PO CHANDA M DOLSEN 3896

Page 3 of 4

Per City of Madison Ordinance 9.13 there is No Storage of Vending Equipment without a Vendor Present. I completed a Municipal Citation #A0317793 and requested a case number be drawn to document the violation 2010-36124. At this point I still was having trouble contacting Okafo.

On 03-06-2010 while working in my neighborhood I observed the Jin's Chicken Food Cart abandoned in the 700 block of State Street with no vendors present. Per City of Madison Ordinance 9.13 there is No Storage of Vending Equipment without a Vendor Present. I completed a Municipal Citation #A067065 and requested a case number be drawn to document the violation 2010-59847.

At approximately 11 :00 AM this morning PO R. Hennessey and I went to 910 Magnolia #3 to serve Okafo the four citations. After several minutes of knocking Okafo came to the door. I introduced myself verbally and explained to him why I was there. I presented him with the four citations; Hit & Run, OAR, and No Storage of Vending Equipment without Vendor Present X2. I pointed out the court date, time and the location on all the citations. Okafo didn't have much to say and asked no questions. Okafo did mumble something under his breath about him getting citations for leaving his cart abandoned. He then shut his door. NFA/jrl

Supervisory Officer:

1.0.:

_

RepOl'!irg .officer: "

1.0.: 3896

 

 

PO CHANDA M DOLSEN

 

'(IIiSCQ-J;lSin Motor Vehicle 9BSLK45 Ulil 0INAl Page

Accideftt Report MV4000e 01/2005

050206

 

 

 

 

 

 

DOT Document Number

 

 

 

Reportable Accident

o On Emergency o Amended 9BSLK45

 

 

 

Agency Accident Numbe'r

 

Police Number

\.l)

 

 

CENTRAL

 

 

2010·25036

 

 

4 • Accident Date

 

 

 

CVJ

 

 

 

 

 

 

 

01/1312010

 

 

 

tel

'"

 

 

 

 

 

 

 

 

 

 

 

It.J

'"

 

 

 

 

 

on

 

 

 

 

 

 

C>

 

 

 

 

 

C'(

"!

 

 

 

 

 

 

 

 

 

 

 

C>

 

 

 

 

 

I

C>

 

 

 

 

 

N

Z

 

 

 

 

 

 

 

 

 

 

16 • FrfAI Hwy No.

 

 

 

 

0

 

 

 

 

.....-.., w

 

 

 

 

j::

 

 

 

 

 

"

 

 

 

 

 

0

«

17· Structure Type

17 - Structure Number

13 - Longitude

 

:::;

 

0

:;;

 

 

 

 

 

0-

n::

80 - Firs! Harmful Evenl

 

 

93 - Manner of Collision

 

 

0

 

 

 

 

IJ..

OTHER OBJECT·· NOT FIXED

NO COLLISION WITH MOTOR VEHICLE IN TRANSPORT

 

 

a:

 

 

oJ

112· Access Control

 

113 - Road Curvature

Surface Type

 

 

NO CONTROL

 

 

ASPHALT

 

 

 

 

 

 

W

115-TrafficWay

 

 

 

 

 

 

 

 

 

ZPARKING·LOT.OR·PRIVATE·PROPERTY

W

Cl 117 - Relation To Roadway

PARKING·LOT·OR-PRIVATE-PROPERTY

-'

114 - light Condition

Ol

DARK-NOT·LIGHTED

>-

z

 

w

 

0

 

"

 

 

 

9

 

>-

 

 

 

o Names Exchanged

z

 

 

 

w

 

 

 

c

 

 

 

79- EM SNumber

<3

 

 

 

 

 

 

o

 

0

 

 

 

 

«

 

 

 

 

 

Operator/Pedestrian

 

 

 

 

 

Unit Status

181 - Most Harmful Event: Collision With

123 -. Djr Of Travel I 24· Speed limit

H - HIT AND RUN

 

OTHER FIXED OBJECT

 

EAST

I NIA

36 - Operating as Classified

137 -Endorsements

135

 

 

o CLASS

 

0

Operating Commercial Motor Vehicle

C

/

z

S

w

o

W

J0-

D:

W

0-

o

26· Address Stre€t & Number

 

 

 

 

 

126 - PO Box

5134 CURRY COURT 3

 

 

 

 

 

 

27· City

 

 

 

127 セ State 127 -Zip Code

128. Telephone Number

FITCHBURG

 

 

 

WI

 

53713

(608)239-4186 EXT.

39 Seat Position

 

 

 

 

 

/40. Safety Equipment

FRONT-SEAT·LEFT-SIDE-(MC/BIKE DRIVER. TRAIN CONDUCTOR)

RESTRAINT·USE·UNKNOWN

38 - Injury Severity

 

141 - Airbag

 

142 "Ejected

I"

N - NO APPARENT INJURY

 

NON·DEPLOYED

 

NOT-EJECTED

0 Medical Transport

43 _ Trapped/Extricated

 

192. Pedestrian location

192. PedeSlrlan Action

 

NOT-TRAPPED

 

 

 

 

 

 

IセR セ No. of Citations Issued

119 • Itvtlat Driver Was Doing

 

1120 -Traffic Control

 

 

BACKING-MANEUVER

 

NO-CONTROL

 

I64· 4th Statute No,

I64 - 5th Statute No.

64 1st Statute No.

164. 2nd Statute No,

164 -3rd Statute No.

 

346.67(1)(A)

341.03(1)

 

 

 

 

 

122 - Driver Factors

 

 

 

 

 

 

 

UNSAFE-BACKING

 

 

 

 

 

 

 

88· Driver or Pedestrian Factors 189 -Substance Presence

 

 

 

 

NOT OBSERVED

 

UNKNOWN

 

 

 

 

90 Alcohol Test

 

 

190 -Alcohol Content

 

91 Drug Test

 

TEST NOT GIVEN

1 TEST-NOT-GIVEN

Wisconsin MotorVehicle

9BSLK45

Page

2 of 4

 

,>

Accident Report MV4000e 0112005

 

 

050206

 

 

 

91 Drugs Reported

 

 

 

124· Highway Factors

 

 

 

NOT-APPLICABLE

 

 

 

Vehicle

21 " Unit Type

I Vehicle Type

1 22 • Total occupants

TRUCK

UTILITY-TRUCK

1

 

95 • Extent Of Damage

96

197 .Vehicle Removed By

 

NONE

1 o Vehicle Towed Oue To Damage

 

OPERATOR

 

123· Vehicle Factors

 

 

 

 

NOT-APPLICABLE

 

 

 

 

Vehicle Owner

 

 

 

 

45

 

 

 

1ZI v・ィゥ」ャセ Owner Same As Operator

 

IセVG Middle Initial I46· Suffix

0

46 • Vehicle Owner Last Name

1 46· First Name

 

 

 

0:

OKAFO

JEFF

 

 

 

 

 

 

W46 • Company Name

Z

 

 

 

 

S

 

 

147. POBox

 

0

47'- Address Street & Number

 

 

:I:

5134 CURRY COU RT 3

 

 

 

W

FITCHBURG

 

イセisエ。エ・ I 53713

(608) 239-4186 EXT,

>

 

 

48· City

 

48 - lip Code

149. Telephone f'!umber

 

Insurance

 

 

 

 

 

.,

-10 Policy Holder Same As Owner

J

63 liabllity Insurance Company

 

NO INSURANCE

 

 

0

61 • Policy Holder last Name

 

I61.' Policy Holder First 'Name

..

(/)

 

 

 

 

 

 

61 - Policy Holder Company

 

School Bus

ISchool Name

IBody Make

 

Bus Travelling to/from

! seating Capacity

0

o To 0 From

 

 

 

(/)

 

 

 

School District Contracted With

 

 

::::>

 

 

 

 

 

 

lD

 

 

 

 

/

Property

 

 

 

 

Organization Type -

I 84· Properly Owner Last Name

I84 - First Name

1 - Middle Initial I 84 - Suffix

 

INDIVIDUAL

HANDLEY

.

JOHN

 

\J

V,)iisco!,!sin Motor Vehicle

9BSLK45

 

 

Page

3 of 4

 

 

 

 

Acciilerft Report MV4000e 01/2005

 

 

 

 

 

050206

 

 

 

 

 

IGovernment Property TYPE

 

84 " Company Name

 

 

 

 

 

 

 

 

 

 

....

85" Address Street & Number

 

 

85· PO Box

 

 

0

4705 GRANDVIEW COURT

 

 

 

I87· Telephone Number

a::

 

186. Stale

 

86 - City

 

 

86· Zip Code

W

 

 

 

 

Z

MCFARLAND

 

 

WI

53558

 

(698) 838-8489 EXT,

3:

83 • Government Damage Tag Number

 

 

 

 

0

 

 

 

 

 

 

 

>- Fixed Objects Struck

 

 

 

 

 

w

82 - Striking Unit

82" Object Struck

 

82 - Striking Unit

82 • Object StruCk

0.

1

OTHER-OBJECT-NOT-FIXED

 

 

 

 

.0.

 

 

 

 

82 - Striking Unlt

82 • Object Struck

 

82 - Striking Unit

82· Object Struck

 

82 - Striking Unit

82 - Object Struck

 

82 - Striking Unit

82 • Object Struck

Diagram and Narrative

105 • PHOTOS BY

w

>

i=

«

a::

a::

«

z

0

Z

«

::!:

Cl

«

0

-

 

Nセ

 

セセオョゥャャセ」Zjij、

 

 

[Non-Fixed Object

 

 

-

 

 

-

 

 

-

2010-25036

Pafking lol of U-Haul

Private Parking lol

PO eM. Dob.en

Diagram Not To Scale

THE EQUIPMENT IS A FOOD CART THAT WAS LEGAllY PARKED, THE EQUIPMENT IS HOMEMADE WITH NO VIN NUMBER OR REGISTRATION PLATE REQUIRED.

UNIT 1 VEHiCLE INFORMATION IS NOT COMPLETE. DRIVER 1 REFUSED TO PROVIDE THIS INFORMATION TO ME. UNIT 1 DRIVER WAS BACKING IN THE PRIVATE LOT OF 602 VVEST WASHINGTON AVE WHEN HE BACKED INTO THE EQUIPMENT (THE HOMEMADE FOOD CART OWNED BY HANDLEY) CAUSING DAMAGE. NFA

Witness

107· Witness las! Name

1107 セ First Name

1'07 -Middle Initial

 

 

 

0

.

 

1'09 -

(J)

108 -Address Streeet & Number

108 - PO Box

(J)

Date of Birth

 

 

W

 

Stale 1'10. Zip Code

1111 .Telephone Number

l -

 

Z

liD-City

 

 

 

 

 

§

 

WI

 

Officer Information

Wisconsin Motor Vehicle

9BSLK45

 

 

 

Page

4

of 4

"'"' ' .."

 

 

 

 

 

 

Accident Report MV4000e 01/2005

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

050206

 

1125. First Name

I

 

Middle loilial

f31 • Officer ID

 

 

セRUᄋ Officer Last n。ュセ

セUG

 

 

DOlSEN

CHANDA

 

 

 

 

3896

 

Z 129· Law Enforcement Agency No. 1130. law Enforcement Agency Name

 

 

 

 

 

 

0

314

MADISON POLICE DEPARTMENT

 

 

 

 

 

 

;::

 

 

 

 

 

 

 

 

 

«

126 • law Enforcement Agency fl.ddress Street & Number

 

 

 

 

 

 

 

セN

211 S CARROll ST

 

 

 

 

 

 

 

 

a::

127· City

j127 ".State

[127. lip Code

1128 -Telephone Number

 

0

 

U.

MADISON

WI

53703

 

 

(608) 266-4072 EXT.

 

Nセ

 

 

 

a::

132 • Date Notified

]133 - Time Notified (Military Time)

134 • Time Arrived (Military Time}

1135 -Date Of Report

 

01/28/2010

1040

1050

 

 

 

01/28/2010

 

W

 

 

 

 

0

Ag'ency Accident Number

IPolice Number

19 • Special Study

 

 

 

 

 

 

ii:

 

 

 

 

 

 

CENTRAL

 

 

 

 

 

 

 

U.

2010·25036

 

 

 

 

 

 

 

018 • Agency Space

2010-25036

R.N

::l

m

0

::l

'0::

I-

Truck and Bus

'36

 

 

 

'36

 

 

o A truck with at least two axles and six tires

o A truck with a hazardous materials placard

'36

 

 

 

 

 

 

LJ A bus designed to carry 16 or more persons. including the driver

 

 

136

1136 .

136

 

 

 

1 o Towed

 

 

 

o Fatallnjury

0

Medical Transport

 

 

 

Unit Number

 

 

 

 

 

 

137 • Hazardous Materials Class Numbers

 

 

 

 

137 - Hazardous Materials "UN" N0S'l'

 

 

 

 

 

 

Hazardous Material Placard Displayed o IHazardous Cargo Was Released 0

137 - Name Of Hazardous Materials in this Load

1137 - Name Of Hazardous Materials Released

138

 

0\ '40-US DOT No.

1140 .ICC MC No.

1 LC No.

IIC No.

1141 - sッオイ」セ

Interstate Carrier

 

 

 

 

 

139· Carrier Name

 

 

 

 

 

 

142 - Carrier Address

 

I' City

 

I Slate 1 Zip Code

 

 

 

 

143 - GVWR (Lbs)

1144. Total No. of Axles

1145 - Vehicle Configuration

 

1147 - Cargo Body Type

146" First Event

 

 

 

146 - Second Event

 

146 - Third Event

 

 

 

146 - Fourth Event

-

 

 

 

 

Printed by: Josh Marefke

Wednesday, January 20,2010 2:19:32 PM

Title: Bitmap1.bmp : uhaul

Page 1 of 1

File Properties

Fact Name Detail
Form Title Mv4017 Form
Issuing Authority Madison City Municipal Court
Citation Law City of Madison Ordinance 346.67 (1) (a)
Date of Issue April 7, 2010
Appearance Required Varies between NO and YES
Estimated Points Ranged from 3 to 6 points
Deposit Amount Varies; examples include $364.50 and $264.50

Instructions on Utilizing Mv4017

Filling out the MV4017 form requires specific information about the incident and the involved parties. This process helps ensure that all necessary details are accurately recorded and submitted for appropriate action.

  1. Start by entering the Date and Time of the notification. These should be clearly stated at the top of the form.
  2. Next, fill in the Form No. and Version. In this case, it will be MV4017 and the version number, which is 0901.
  3. Complete the Citation No. section. You’ll find the citation numbers associated with the case.
  4. Indicate if an Appearance Required is necessary by marking “YES” or “NO.” This is crucial for knowing what steps to take next.
  5. Provide information about the Defendant. Include the Last Name, First Name, and Middle Name as requested in the section.
  6. Fill in the Defendant's Street Address, City, State, and Zip Code.
  7. Enter the Defendant's Birth Date, Sex, and Race.
  8. Next, include the Defendant’s physical characteristics such as Height, Weight, Hair Color, and Eye Color.
  9. Input the Driver License/Identification Card Number, State, and expiration year in the designated fields.
  10. Fill in Vehicle Information. This will include License Plate Number, Vehicle Identification Number, Year, Make, Model, Type, and Color.
  11. Review the Plaintiff or Ordinance Violated. Enter the relevant laws or statutes related to the case.
  12. Describe the Violation. Add detailed explanation for the citation, including date and time when the incident occurred.
  13. Finally, make sure all the provided information is complete and correct. Double-check for any mistakes before submitting the form.

Important Facts about Mv4017

What is the MV4017 form?

The MV4017 form is a citation issued by the Madison City Municipal Court. It documents violations pertaining to traffic offenses. This form notifies the defendant of specific charges, including details such as the court appearance date and fines associated with the violations.

How do I know if I need to appear in court?

Your MV4017 form will indicate whether an appearance is required. Look for the “Appearance Required” section on the form. If it states "YES," you must attend the court hearing on the specified date. If it states "NO," your fines might be paid directly without appearing in court.

What happens if I do not appear in court?

If you do not attend the scheduled court date, you may face additional penalties. These can include the issuance of a warrant for your arrest or an increase in the fines you would need to pay. It's essential to take this requirement seriously and communicate with the court if you cannot attend.

What should I do if I disagree with the citation?

If you believe the citation was issued in error, you can contest it. You'll need to appear in court on the specified date to explain your case. Gather any evidence or witnesses that support your claim to present during the hearing.

How much do I need to pay for the citation?

The citation details include the specific amount you need to pay. For example, the fines mentioned could be $264.50 or $364.50, depending on the violation. Check the “Estimated Points” and “DEPOSIT” sections for these amounts. Payment can often be made in cash or by card.

Can I request a payment plan for my citation fines?

Yes, you may request a payment plan if you cannot pay the full amount at once. Contact the court directly to inquire about the options available. They can provide information on how to apply for a payment plan and the terms involved.

What if I need to change my court date?

If you need to change your court date for any reason, you must contact the Madison City Municipal Court as soon as possible. Request to reschedule your appearance and provide any necessary documentation to support your request. Please note that changes are not guaranteed and depend on court policies.

What information do I need to bring to court?

When going to court, bring your MV4017 form, any relevant evidence related to your case, and identification like your driver’s license. Be prepared to discuss your citation and any witnesses or documents that can support your defense.

Who can I contact for more information about my citation?

If you have questions regarding your citation or the MV4017 form, reach out to the Madison City Municipal Court directly. You can call their office or visit their website for contact details. They can provide guidance and answer any questions you might have.

Common mistakes

Filling out forms, particularly legal documents, can feel overwhelming. The Mv4017 form, used within the Madison City Municipal Court system, is no exception. Individuals often make several common mistakes when completing this form, which can lead to issues down the line. Awareness of these pitfalls can help you navigate the form efficiently and accurately.

One frequent mistake is personal information errors. Applicants often misspell their names or provide incorrect birth dates. Such discrepancies can create confusion during the processing of the citation and may delay court proceedings. It’s essential to double-check each detail, as using an incorrect name or birth date can complicate the case, causing unnecessary problems that could be easily avoided.

Another common issue arises from illegible handwriting. Handwriting that is difficult to read can lead to misunderstandings about the provided information. Courts rely on clear documentation, and if the details are not easily deciphered, it may result in inaccurate data entry. To combat this, it’s wise to print carefully or type the information if possible. Making the document as readable as possible ensures that your details are captured correctly.

Many people also overlook signature requirements. Some individuals mistakenly believe that if they provide their information, a signature is unnecessary. However, the signature is crucial and must match the name on the form. Omitting this can lead to the form being deemed incomplete or invalid, sometimes requiring a return to the courthouse to rectify the situation. Always remember to sign where indicated.

Moreover, failing to consult the violation description is a mistake that can have serious repercussions. Many individuals misunderstand the nature of the charges against them and forget to read through the cited ordinance carefully. Familiarity with what you are being charged with is vital; it enables better preparation for the appearance in court, articulating your defense, or understanding the implications of the citation.

Lastly, timing can be pivotal. Missing the deadline for submission or the court appearance can have significant consequences. Many individuals fill out the form without noting the required dates. It is crucial to keep track of these deadlines to avoid unnecessary fines or additional charges. Being proactive and marking these dates on your calendar can save a lot of trouble.

By avoiding these common mistakes when filling out the Mv4017 form, individuals can ensure a smoother experience in dealing with municipal court matters. Awareness and diligence are key to navigating legal documentation accurately.

Documents used along the form

The MV4017 form is a Wisconsin Uniform Citation that notifies individuals to appear in court for various violations. Along with this form, there are several other documents that may be relevant in the context of traffic violations or municipal court proceedings. Understanding these documents can aid in effectively addressing the legal situation. Here is a list of forms and documents commonly used alongside the MV4017.

  • Complaint Form: This document initiates legal action by formally stating the allegations and facts surrounding the case. It provides detailed information that the court will review.
  • Citation Notice: Similar to the MV4017, this notice specifies the violations committed and may outline the required actions or penalties, helping the recipient understand their legal obligations.
  • Traffic Accident Report: Prepared by law enforcement, this report contains details of the incident, including involved parties, witnesses, and conditions at the time of the accident. This can be crucial for establishing liability.
  • Declaration of Ownership: This document verifies who owns the vehicle involved in alleged infractions. It is often required if the defendant disputes ownership in connection with a violation.
  • Plea Agreement Form: Parties may use this form to negotiate a resolution before the case goes to trial. It can specify conditions like fines or probation in exchange for a plea of guilty or no contest.

Each of these documents plays a role in the legal process surrounding traffic violations or municipal offenses. It is essential for individuals involved to be aware of these forms and their significance in presenting a comprehensive case. Taking prompt action can lead to a more favorable resolution.

Similar forms

The MV4017 form serves as an official notice for individuals required to appear in court for traffic-related violations. Several other documents share similarities with the MV4017 form in terms of their purpose, structure, and the information they contain. Below is a list of such documents:

  • Wisconsin Uniform Citation: Like the MV4017 form, this citation provides essential details about traffic violations, including the violator's information, the nature of the offense, and the court date.
  • Traffic Incident Report: This document outlines specific details of a traffic incident, including parties involved and circumstances. It shares the MV4017's focus on factual reporting and official notification of violations.
  • Criminal Complaint: This legal document initiates a criminal proceeding against an individual. Similar to the MV4017, it details the allegations, including the relevant background information of the accused and the offenses committed.
  • Citation Summons: This summons instructs the individual to appear in court, much like the MV4017. It provides specifics regarding the court date and the nature of the offense committed.
  • Judgment and Sentence Document: Issued after a court ruling, this document details the outcome of the case, mirroring the MV4017's formal nature and its association with court proceedings.
  • Notice of Violation: Often sent by traffic enforcement agencies, this notice informs individuals of a specific violation. It includes information about the offense, similar to the way the MV4017 communicates violation details.

Dos and Don'ts

Filling out the MV4017 form accurately is crucial for a smooth judicial process. Here’s a list of key dos and don’ts to consider.

  • Do read the form carefully before starting to fill it out.
  • Do provide all required personal information, including your full name, address, and date of birth.
  • Do ensure that your driver's license information is correct, including the expiration date.
  • Do check for any errors after filling the form out and correct them.
  • Don’t leave any fields blank unless instructed by the form.
  • Don’t rush through the process; take your time to fill it out accurately.
  • Don’t forget to sign and date the form before submission.
  • Don’t ignore the deadlines associated with submitting the form.

Misconceptions

  • Misconception 1: The MV4017 form is only applicable for serious traffic violations.
  • This misconception arises from the perception that the form is exclusive to severe infractions. In reality, the MV4017 form can address a range of traffic offenses, including minor violations. Whether the citation involves an over-speeding charge or other traffic norms, the MV4017 can apply.

  • Misconception 2: Completing the MV4017 form is an admission of guilt.
  • Some individuals believe that filling out the form signifies an acknowledgment of wrongdoing. However, the MV4017 is used to inform defendants about court appearances and does not imply any admission of guilt. It is essential to understand that completing the form simply initiates the legal process.

  • Misconception 3: Once the MV4017 form is issued, the case is undeniable.
  • This statement is misleading. While the issuance of the MV4017 form establishes court involvement, it does not determine the outcome. Defendants retain the right to contest the citation and present their defense in front of a judge.

  • Misconception 4: The information on the MV4017 form is irrelevant once it is filed.
  • Many perceive the MV4017's details as non-consequential after filing. In contrast, the form contains critical information about the defendant's charges and court dates, which can significantly impact the case's progression. Retaining this information remains crucial throughout the legal proceedings.

  • Misconception 5: This form is only necessary for drivers with prior offenses.
  • This assumption suggests that only those with histories of violations would need to worry about the MV4017. However, even first-time offenders face citations that can necessitate the form's issuance. Understanding its relevance across all driving histories is vital.

Key takeaways

Understanding how to fill out and utilize the MV4017 form can significantly impact your experience with the legal system. Here are some key takeaways to consider:

  • Purpose of the Form: The MV4017 form is a citation issued for traffic violations or other offenses, prompting the individual to appear in court.
  • Appearance Requirement: The form specifies whether a court appearance is mandatory. Pay close attention to this detail to avoid consequences.
  • Deposit Information: A monetary deposit may be required when responding to a citation. This amount can vary depending on the nature of the violation.
  • Defendant's Information: Ensure that your name, address, and other personal details are correctly filled out. Errors can complicate your case.
  • Violation Details: The form includes a description of the violation, including relevant statutes. Understanding this can help you prepare your defense.
  • Officer Information: Information about the officer who issued the citation, along with their department, is documented on the form. This can be helpful if you wish to contest the citation.
  • Next Steps: After completing the form, follow the instructions provided, such as confirming your court date or paying any required deposits, to ensure compliance with the citation.

Other PDF Templates