REQUEST FOR CRIMINAL COMPLAINT

To any Justice or Clerk-Magistrate of the                 Housing
Court:
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on behalf of the Commonwealth, on oath complains that:

Name and Address of Defendant:
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Statute violated:
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Possible penalties:
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and did so willfully, intentionally, recklessly or repeatedly.

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Date:

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Complainant:

Assigned for hearing on _____________________,200__, at _________ 
o’clock.

On hearing (Complainant)(Defendant)(both parties)(neither party),
I find no probable cause for the Complaint.  Process shall not
issue. 

On hearing (Complainant)(Defendant)(both parties)(neither party), 
and Complainant having sworn or affirmed that the Complaint is
true upon information and belief, I find probable cause, and 
order summons to issue returnable ____________________________.

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Date:

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Clerk-Magistrate