Defensive Driving Request Form

Citation Number ___________________

I wish to enter a plea of: _____ Guilty _______ NO CONTEST waive my right to the pre-trial "discovery" of evidence, waive my right to trial by jury and request a 90 day extension to complete a Defensive Driving Course. I understand that this plea enters a guilty judgement and this judgement will be removed upon submitting proof of completion of the course and payment of the administrative fee and court costs. I FURTHER UNDERSTAND THAT FAILURE TO COMPLY WILL RESULT IN ASSESSMENT OF THE FINE.



Day Time Telephone Number




City, State, Zip Code


Defensive Driving Request Form

Before me, the undersigned authority, personally appeared the above named Defendant known to me to be the person whose name is subscribed hereto, who after being duly sworn upon his or her oath stated that the following statements are true. "My name is ______________________. I stand charged with the offense of _______________________. I am requesting the court to defer proceedings in this case for a period of 90 days to allow me to complete a Driving Safety Course that is approved under the Texas Driver and Traffic Safety Education Act. I have not completed a Driving Safety Course in the past 12 months and am not in the process of taking a Driving Safety Course for a moving traffic violation.


Defendant's Signature


SWORN TO AND SUBSCRIBED before me, the undersigned authorit, on this the ______ day of _________________, 19____.




(Notary Seal)

Notary Public

Print and fill out this form and return to:
Attn: Municipal Court
City of Mesquite
PO Box 850137
Mesquite, TX  75185