Report of Citation or Arrest | FORM Report of Citation/Arrest REPORT OF CITATION/ARRESTEmployee Name* First Last Date Reported* MM slash DD slash YYYY Location Reported or Citation Received at* City State / Province / Region Was this in a personal vehicle or a company vehicle?* Personal Company CBO Number* Charter Booking Order, Trip Number, Charter NumberBus or Equipment Number* Date Cited* MM slash DD slash YYYY Violation(s) (Vehicle Code/Other)* Speed Cited* Posted Speed* Citation Number* Court Appearance Date MM slash DD slash YYYY Police InformationOfficer's Name* First Last Badge Number* What department was this?* City Police County Sherriff State or Highway Patrol Other Please explain* Police Department* City State / Province / Region Request Speedometer Check* Yes No Last four of SS Number* Signature Reset signature Signature locked. Reset to sign again