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2. ** Upon submission of this form, please do not call the Court to schedule a hearing or send in your copy of the signed ticket. Your explanation will be reviewed and you will either receive a determination from the Magistrate or a notice of plea hearing date within 14 days of your request. Complete this request for civil infractions only.
4. Name
5. Email Address
7. Address
9. City
10. State
11. Zip Code
13. Phone Number
14. Explanation
16. I am requesting a civil infraction plea hearing to discuss my ticket options with a representative from the issuing police agency. I understand that I may request an informal or formal hearing at a later date if necessary.

    1. Yes
    2. No
17. I am submitting my explanation in writing for consideration. I understand that I may request an informal or formal hearing at a later date if necessary.

    1. Yes
    2. No
19. Ticket Number
20. Ticket Issue Date
    Ticket Issue Date
Leave This Blank:


22. 1. Receive an email copy of this form.
23. Email address

    This field is not part of the form submission.

24. Submit Submit and Print

* indicates a required field