AS REQUIRED BY THIS NOTICE TO APPEAR, THAT I MAY BE HELD IN CONTEMPT OF COURT AND A WARRANT FOR MY ARREST SHALL BE ISSUED Signature of Defendant (or Juvenile and Parent/ Custodian) Date Signed ± 2 .0 < HOLD for other Agency . Name: Signature of Arresting Officer X Cr4---- Name Verification (Printed by Arreslee)