E-FILED 2016 DEC 5 8:16 AM SAC - CLERK OF DISTRICT COURT

IN THE IOWA DISTRICT COURT IN AND FOR

SAC COUNTY

This Complaint and Affidavit is to be:

Agency Case Number: 16-13482

Filed with Court Clerk (cc: CA)

Arrest Date: 12/04/2016

Submitted to County Attorney

Filed with JCO - Defendant is a Juvenile

THE STATE OF IOWA

VS.

OFFENDER
Last

First

Middle

RILEY

SAMANTHA

JOANN

Suffix

Address

City

State

Zip Code

406 KARR AVE

EARLY

IA

50535

Date of Birth

Gender

Race

Ethnicity

2/16/1983

FEMALE

WHITE - W

NOT OF HISPANIC ORIGIN - N

State

Height

Weight

Eye Color

Hair Color

IA

5' 06"

190 LBS

BLUE - BLU

BROWN - BRO

OFFENSE
State

County

Local

Code Section

Crime Description

Class

708.2A(2)(A)

DOMESTIC ABUSE ASSAULT- 1ST OFFENSE

SMMS

Location Type

20 - RESIDENCE/HOME
Literal Description

US 71
Address

City

State

406 KARR AVE

EARLY

IA

Is Date and Time of Incident Known?

Incident Date or Low Range

YES

12/04/2016

Upper Date Range

Incident Time or Low Range

Zip Code

50535
Upper Time Range

14:15

STATUS OF OFFENDER/JUVENILE
TAKEN INTO CUSTODY

WARRANT REQUESTED

CUSTODY

SUMMONS TO APPEAR

1 - JAILED

(Citation Issued)

NO CONTACT ORDER

RELEASED TO

REQUESTED

PARENT/GUARDIAN

NARRATIVE
Narrative of Offense Committed
On or about the above stated date and time, the Defendant did

assault ___, and both are parents of the same minor child

VICTIM INFORMATION (Optionally displayed, especially if NCO is requested)

Last

First

Middle

RILEY

SETH

ADAM

Suffix

Business/Organization/State/County/Municipality Name

Address

City

State

Zip

406 KARR AVE

EARLY

IA

50535

AFFIDAVIT

STATE OF IOWA,

SAC COUNTY

I, the undersigned, being duly sworn, state that all facts contained in this Complaint and Affidavit, known by me or told to me by other reliable persons form the basis for my
belief that the defendant committed this crime
State all facts and persons relied upon supporting elements of alleged crime

On December 4, 2016 at approximately 2:15 PM the defendant struck the victim in the face, knocking his glasses across the room. Victim suffered a
very minor abrasion. The defendant and victim are ex-spouses, parents of the same minor children and live together.

Printed At

SAC COUNTY SHERIFF'S OFFICE

12/5/2016

8:17 AM

Page 1

of 2

Form #:

16-13482

E-FILED 2016 DEC 5 8:16 AM SAC - CLERK OF DISTRICT COURT

HATTERMAN, JOHN

81-6

Signature of Complainant or Officer, Officer Name & Number

GENERAL PROBABLE CAUSE

Defendant Implicated

03 - ADMISSION/STATEMENTS, 07 - IDENTIFIED BY WITNESSES, 09 - NEAR SCENE OF CRIME, 13 - CAUSED PERSONAL INJURY

Operating Motor Vehicle in County

Other Physical Evidence

STATE OF IOWA,

Attempted To Inflict Injury

SAC COUNTY

Subscribed and sworn to before me by the person(s) signing the Complaint and Affidavit(s) on

Printed At

Notary Name

ANNA ANDERSON

Commission Number

749271

My Commission Expires

10/04/2019

SAC COUNTY SHERIFF'S OFFICE

12/04/2016

Signature of Verifying Party

Peace Officer

12/5/2016

8:17 AM

Page 2

of 2

Notary

Form #:

Prosecuting Attorney

16-13482