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Get IN State Form 44213 2010-2024

Rcement officer with the (agency) , affirms that on I, , at approximately am pm the accused, (first name) (date) / / ,a Male, Female, (d/o/b) / / (middle initial) (last name) , was observed in (location) (DL number or last four digits of SSN) (license type) , Indiana operating a (vehicle description, include CMV and (county) Hazmat indicator): under the following circumstances. I. PRELIMINARY OBSERVATION/REASON FOR STOP (check all that apply) I observed the accused operate a vehicle in my prese.

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