Free AO_083 - Oklahoma

AO 83 (Rev. 03/09) Summons in a Criminal Case

UNITED STATES DISTRICT COURT
for the Northern District of Oklahoma 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: Page Belcher Courthouse 333 W. 4th Street Tulsa, OK 74103 This offense is briefly described as follows: ' Supervised Release Violation Petition ' Violation Notice Courtroom No.: Date and Time:

You shall report at 9:00 a.m. on the above date to the United States Probation Office, Room 3820, for an interview in preparation for your court appearance.

Date:
Issuing officer's signature

Phil Lombardi, Clerk of Court
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: