CRIMINAL INFORMATION SHEET
For Office Use Only
The criminal information sheet neither replaces nor supplements the filing and service of pleadings or other papers as required by law. This form is required for use by the Clerk of the District Court for the purposes of initiating the criminal docket sheet. This information will not be available to the public and this document will be stored in a separate location from the case file and then destroyed within a reasonable time. A new case will not be accepted without a cover sheet attached. (THIS FORM MUST BE TYPED OR PRINTED LEGIBLY). This form can be found at www.kscourts.org.
DEFENDANT'S INFORMATION
(ATTACH ADDITIONAL SHEET, IF NECESSARY)
COMPLAINT INFORMATION
VIOLATION DATE: ______________________ OFFICER:
DEFENDANT'S INFORMATION NAME: ADDRESS:
(ATTACH ADDITIONAL SHEET, IF NECESSARY)
_______________________
OFFICER NO: __________________________ PHONE: ____________________SEX: DL OR STATE ID NO: SSN: RACE:
White Black
State and Number
ATTORNEYS (if known) DOB:
(Firm Name, Address, Telephone Number and Supreme Court ID Number)
Asian
American Indian/Alaskan Unknown
Pacific Island
_____________________________________ _____________________________________ _____________________________________
ETHNICITY:
Hispanic
Non-Hispanic
Unknown
ALIAS NAMES USED:
KDR Transaction Number_____________________
The requirement that Social Security numbers be included on criminal cases is not mandatory. The number is used for purposes of identification and may be disclosed as permitted by law. This form is not considered to be a public record. 07-11-2006