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2. Defendant Information
4. Name*
5. Date of Birth*
   Date of Birth
7. Address*
9. City*
10. State*
11. Zip Code*
13. Cellphone Number*
14. Email Address*
18. Details of Citation(s)
20. Citation Number*
21. Charges*
22. Initial Court Date*
    Initial Court Date
24. Citation Number
25. Charges
26. Initial Court Date
    Initial Court Date
28. Citation Number
29. Charges
30. Initial Court Date
    Initial Court Date
32. Citation Number
33. Charges
34. Initial Court Date
    Initial Court Date
36. I understand the following:
    I wish to enter a plea of Not Guilty to the citation(s) indicated above. I understand that if I return this plea to the Court, before my court date, I do not have to come to court until notified by mail or email of my new court date.*

    1. I understand.
38. Defendant Signature*
    I understand that submitting my name in this box constitutes a legal signature confirming that I acknowledge and agree.
Leave This Blank:


40. 1. Receive an email copy of this form.
41. Email address

    This field is not part of the form submission.

42. Submit

* indicates a required field