Traffic Infraction Deferral Program

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If you wish to be considered for the Traffic Infraction Deferral Program, please complete this form and a representative of the Prosecuting Attorney's Office will contact you.

* Denotes a required field

First Name*

Last Name*

Please Do Not Complete The Following Field

Date of Birth*

Driver's License # & State*

Mailing Address*

City, State & Zip Code*

Telephone*

Phone Area Code-Phone 3-Phone 4 ext Extension

Date of Ticket*

Due Date of Ticket*

Court*

Speed Cited*

Speed Zone*

Date of Last Deferral Completed (if applicable)

Traffic Infraction Deferral Program

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