Free Summons in a Criminal Case - Indiana

AO 83 (Rev. 01/09) Summons in a Criminal Case

UNITED STATES DISTRICT COURT
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 ' Order of Court ' Probation Violation Petition Place: ' Supervised Release Violation Petition ' Violation Notice Courtroom No.: Date and Time: This offense is briefly described as follows:

Date:
Issuing officer's signature

Printed name and title

Proof of Service This summons was received by me on (date) ' I personally served the summons on this defendant
(place)

. at on (date) ; or

' On (date) , I left the summons at the defendant's residence or usual place of abode with (name) , a person of suitable age and discretion who resides there, and mailed a copy to the defendant's last known address; or ' The summons was returned unexecuted because I declare under penalty of perjury that this information is true. Date returned:
Server's signature

.

Printed name and title

Remarks:

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