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Qvo.%S AN1 <br /> City of Pleasanton <br /> ADMINISTRATIVE CITATION <br /> CITATION NO. • :t.•'I ( J <br /> DATE TIME DAY OF WEEK CASE NO <br /> 1i <br /> NAME (First, Middle. Last) / <br /> ADDRESS, RESIDENCE(Street,Apt. or Space No., City, State, Zip Code) <br /> ADDRESS. BUSINESS(Street, Space No., City, State, Zip Code) <br /> LOCATION (Descnplion, if no address) <br /> ..-I > l rr t -A l <br /> DRIVER'S LICENSE NO. 'STATE DATE OF BIRTH(Mo/OayNr) <br /> SEX: HAIR EYES HEIGHT WEIGHT OTHER DESCRIPTION <br /> M F <br /> VEHICLE LICENSE NO. STATE COLOR(S) YEAR MAKE MODEL <br /> REGISTERED OWNER OF VEHICLE(If Different from Above) <br /> ADDRESS OF REGISTERED OWNER(If Different from Above) <br /> VIOLATIONS <br /> PMC SECTION DESCRIPTION FINE AMOUNT DUE DATE <br /> (,/ ) <br /> 1 certify that the foregoing is true and correct and executed on the date shown above <br /> at Pleasanton, California. <br /> • <br /> Issuing Enforcement Officer: <br /> (Signature) (Please Print Name) <br /> Signature of party to whom citation issued, if available. (Without admitting responsibility, I acknowledge <br /> receipt of this administrative citation.) <br /> (Signature) (Please Print Name) <br /> SEE REVERSE SIDE FOR FURTHER INFORMATION AND INSTRUCTIONS. <br /> 'Ca admcit.sav) <br />