Fill - Free fillable Mc Citizen Complaint BEAUMONT MUNICIPAL COURT

Beaumont Municipal Court ONLY handles Class C misdemeanors.

Phone: (409)980-7200

Email: MC.Court@BeaumontTexas.gov

Requirements for filing a citizen’s complaint:

1. You must have the complete address of the person for which you are filing charges.

2. You must have the complete offense location address.

3. You must have the complete information for each witness.

(i.e: name, address, phone number, etc.)

4. You must have the exact date and time of the incident.

If there is more than one date, you must file a separate complaint for each date.

5. Please provide a copy of a police report, if one was made.

6. Once all information is completed, you may return the form by:

A. Mail to: Beaumont Municipal Court, PO Box 3827, Beaumont, TX 77704

B. In person or place in the night-deposit box located on Forsythe Street at:

Beaumont Municipal Court, 700 Orleans Street, Beaumont, TX.

C. Email to MC.Court@BeaumontTexas.gov.

IF THE COMPLAINT IS NOT COMPLETED CORRECTLY, INCLUDING A SIGNATURE

AND DATE, IT WILL NOT BE ACCEPTED. TYPING THE NAME OF THE

COMPLAINANT WILL SERVE AS AN ELECTRONIC SIGNATURE AND WILL BE

ACCEPTED UNTIL FORMAL CHARGES ARE REQUIRED.

For your information: If your case is accepted for prosecution, you will be required to

appear any day before 3:00 pm to file a formal complaint. You must show identification at

that time and sign the required court paperwork.

The defendant will be issued a summons to appear. If the defendant pleads no contest or

guilty, he/she will be sentenced by the judge. The defendant cannot be sentenced to pay

for any damages. If the defendant pleads not guilty, the case will be set for trial and you

will be sent a summons to appear for that date.

□ ACCEPTED Date:________

CHARGE: ________________

CODE:

□ REFUSED Date:________

BEAUMONT MUNICIPAL COURT

Citizen Complaint Information Form

Class C Misdemeanor

Complete the below information in full. You must have the COMPLETE addresses for the person against whom you are

filing and all witnesses. You must have the EXACT location, date and time of the incident. Only one incident per form is

allowed. If a police report was made, please provide a copy. IF THE INFORMATION IS NOT COMPLETED

CORRECTLY, IT WILL NOT BE ACCEPTED. If your charges are accepted, you will be required to return to file a formal

complaint. At that time, you must present your identification and sign court paperwork.

YOUR PERSONAL INFORMATION

Name: Last First Middle

Date of Birth:

Driver’s License No.:

Sex: □Male

□Female

Address (Street, City, State, Zip):

Home Phone:

Cell Phone:

Employer:

Employer Address:

Work Phone:

E-Mail Address:

DEFENDANT INFORMATION (PERSON YOU ARE FILING ON)

Defendant Name: Last First Middle

Defendant Date of Birth or Approx. Age:

Defendant Address (Street, City, State, Zip):

Defendant Employer:

Employer Phone:

Defendant Phone:

Race:

Sex:

Height:

Weight:

Hair:

Other known information:

How long have you known

the defendant?

Describe your PAST and PRESENT relationship with the Defendant (i.e: spouse, neighbor, etc.)?

Have you had problems with the defendant before this incident? If yes, what kinds of problems?

ONE OFFENSE PER FORM

Offense Alleged (Reason you are filing charges):

Were you injured? If so, how?

Did you need medical treatment?

Offense Date:

Offense Time:

Offense Location (Address):

If private residence, whose? ________________

If public place, Name?

MISCELLANOUS INFORMATION:

Did the Defendant or another party involved file charges against you regarding this incident? YES or NO If yes, explain:

Have YOU ever filed a case in this Court in the past? YES or NO If yes, explain and advise the outcome of the case:

Have you ever had a case filed AGAINST YOU in this Court in the past? YES or NO If yes, explain:

Were the police called for this incident? YES or NO

Police Case Number:

The space below is provided for you to write first-hand in detail what happened to you (including what was said) and why you think it

happened. Second-hand information or information you did not personally witness should not be included in this statement. Print

clearly as this information will be read by others in order to decide if the case will be accepted and prosecuted. Any false information

provided during the course of this investigation will be prosecuted to the full extent of the law.

The facts are as follows: _________________________________________________________________________________________

_____________________________________________________________________________________________________________

Do you have any witnesses to this incident for which you are filing in this Court? YES or NO If yes, you must complete the following:

Name

Address:

Phone

Age

I SWEAR THAT THE ABOVE INFORMATION IS TRUE, CORRECT AND COMPLETE TO THE BEST OF MY KNOWLEDGE AND I

WISH TO FILE CHARGES AGAINST THE ACCUSED. I UNDERSTAND THAT SUBMITTING FALSE INFORMATION TO THE

COURT CONSTITUTES THE CRIME OF TAMPERING WITH A GOVERNMENTAL RECORD, PUNISHABLE BY INCARCERATION

AND/OR THE IMPOSITION OF A FINE (Sec. 37.10, Penal Code).

_______________________________________________

Signature Date

ONCE THE INFORMATION IS FILLED OUT COMPLETELY AND ACCURATELY, RETURN THIS FORM TO THE BEAUMONT

MUNICIPAL COURT.

Received by and Date: ____________________

□ In Person

□ Mail/Night Deposit Box

□ Email

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