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Defensive Driving
Request Form
Citation Number
___________________
| I wish to enter a plea of: _____ Guilty
_______ NO CONTEST and 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.
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Signature
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____________________________
Day Time Telephone Number
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| _________________________
Address
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____________________________
City, State, Zip Code
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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.
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_________________________
Defendant's Signature
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SWORN TO AND SUBSCRIBED before
me, the undersigned authorit, on this the ______ day of _________________, 19____.
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(Notary Seal)
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_________________________________
Notary Public
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Print and fill out this form
and return to:
Attn: Municipal Court
City of Mesquite
PO Box 850137
Mesquite, TX 75185
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