PLEA FORM (Check appropriate plea. Sign & Date form.)
1. ____ NOT GUILTY and request that said cause be set for docket.
JUVENILES (AGE 16 AND YOUNGER) MUST REPORT IN PERSON WITH PARENT/GUARDIAN FOR RESOLUTION OF OFFENSES ON OR BEFORE REPORT DATE ON CITATION.
DRIVING SAFETY COURSE INFORMATION AND AFFIDAVIT
A speeding offense, not in excess of 24 miles over speed limit, may be dismissed by taking a Driving Safety Course (See requirements below) or request Deferred Disposition. Permission from the Court as follows: (1) PAYMENT OF COURT COSTS & FEES CASHIERS CHECK OR MONEY ORDER. (2) SIGNED AFFIDAVIT & PLEA (below), (3) COPY OF INSURANCE CARD, (4) SELF ADDRESSED STAMPED ENVELOPE FOR RETURN OF DRIVING SAFETY COURSE ORDER, IF MAILING IN REQUEST. Please have this request postmarked by the date on citation. A PHONE CALL DOES NOT QUALIFY AS AN APPEARANCE OR AS A REQUEST.
____ I HEREBY REQUEST A DRIVING SAFETY COURSE as a means to dismiss the offense issued against me and waive my right to a speedy trial. I have a valid Texas Drivers License, I have not taken the driving safety course within the last 12 month in lieu of dismissal and I am not currently taking a course for another citation. I will submit court cost of $112.00 unless violation was in a school zone then court cost of $137.00.
____ I HEREBY REQUEST DEFERRED DISPOSITION as a means to dismiss the offense issued against me and waive my right to a speedy trial. I must contact the court for the correct amount of court cost to be submitted no later than the date on the citation. I must not receive another citation within my 30 (thirty) day probation and at the end of my probation submit to the court the special expense fee and sworn affidavit of compliance (The court will supply the sworn affidavit).
DRIVING SAFETY COURSE REQUIREMENTS
ENCLOSED PLEASE FIND: (Check only one of the pleadings of guilty or no contest below)
____ NO CONTEST – waive my right to trial. I understand that the court will enter a guilty judgment
____ FEE ENCLOSED (cashier’s check or money order) NO PERSONAL CHECKS WILL BE ACCEPTED
____ COPY OF PROOF OF INSURANCE
____ SELF ADDRESSED STAMPED ENVELOPE (If mailing in request)
I understand I will be responsible for scheduling & paying for a State of Texas Approved Course. I will not schedule the course until granted permission from the Court. I understand should permission be granted I will be expected to supply to the Court a CERTIFIED COPY OF MY DRIVING RECORD obtained from the Department of Public Safety in Austin which will reflect all courses taken in the past and numbered CERTIFICATE OF COMPLETION of the course during the 30-day deferral period.
SIGNED THIS THE ____ DAY OF _____________________, 20__.
CITATION NUMBER: ________________________________
CITY, STATE, ZIP _______________________________
PHYSICAL ADDRESS: _______________________________