Adjusters Supply
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Minnesota Citation & Complaint

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MINNESOTA CITATION AND COMPLAINT (Form MN-17-4) is a four-part form. (Price Group 14) The face of all four copies is shown at right.

The back of the first copy (white "Complaint") contains plea information. The back of the second copy (yellow "Abstract of Court Record") contains the Certificate of Conviction. The back of the third copy (pink "Officer's Copy") contains information for Officer's Notes. The back of the fourth copy (hard "Summons" copy) has instructions for the violator to follow.

The citation is 4.25 inches by 9 inches before being torn at the perforation and is booked in sets of twenty-five. Each book is numbered on the outside to aid you in your record keeping. As with all our tickets, there is no extra charge for consecutive numbering and up to five lines of crash imprinting. Stock tickets are shipped within seven business days from time the order is received.

To obtain a free sample, call 1-800-527-0340, submit the stock number in the Free Catalog Order Form, or email

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