FLAT RATE $150*

Plus court assessed court costs

TRAFFIC TICKET JURISDICTIONS

Traffic Ticket Information Form

Name *

First

Last

Address *

Address Line 2

City *

State *

Zip *

Phone Number *

###

####

E-mail *

Confirm E-mail E-mail *

Ticket Number
Ex: R12345 or E678910

*This helps us make sure we match you with the correct traffic citation.

Driver's License Number

*This helps us make sure we match you with the correct traffic citation.

Birth Date

YYYY

*This helps us make sure we match you with the correct traffic citation.

Police Agency *

Are you currently on Deferred Adjudication/Disposition?

Yes

Have you taken defensive driving in the last 12 months?

Yes

Did you receive more than one citation on your ticket?

Yes

Would you prefer Deferred Adjudication or Defensive Driving?

Deferred Dispsition/Adjudication (Recommended)

Defensive Driving (Note: You must take defensive driving if under the age of 25)

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