(a) In any case in which a peace officer has reasonable grounds to believe that a person has committed or is committing a misdemeanor, he or she may issue a summons to the person substantially in the following form:
(Summons)
STATE OF RHODE ISLAND
To ................................
You are hereby summoned to appear before a judge of the District Court for the ......................... Division, located at .................. in the (City)(Town) of .................. , in the State of Rhode Island, on the ....... day of .................. , 20 ..... at ........ o'clock ........ m., to answer to a complaint charging you with the crime of ........ in violation of [statute, ordinance, etc.]
If you fail to appear and answer, a warrant will issue for your arrest.
Dated at ........ the ....... day of ............... 20 .....
(b) Willful failure to appear in answer to this summons may be punished by a fine of not over fifty dollars ($50.00) or imprisonment for not over fifteen (15) days.