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Request for Deferred Disposition
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This form has been modified since it was saved. Please review all fields before submitting.
REQUEST FOR DEFERRED DISPOSITION
DATE:
*
DATE:
DATE:
NAME:
*
STREET ADDRESS:
*
CITY, STATE AND ZIP CODE
*
PHONE #:
*
EMAIL:
*
CITATION #:
*
OFFENSE:
*
I am entering a plea of:
*
Guilty
No Contest
I am requesting to be granted a deferred disposition and I meet ALL of the following requirements:
*
I am 17 years of age or older.
I have a valid, non-commercial driver's license.
I have not been granted a deferred disposition with Webster or any other court in the last 12 months.
You must click on one of the following statements:
*
I was over 25 years of age when I received my citation.
I was under 25 years old when I received my citation, but it was NOT for a moving violation.
I was under 25 years of age when I received my citation and it WAS for a moving violation. I understand that I will be required to take a driver's safety course as part of my probation.
I understand that this form is just a request to be granted a deferred disposition and that nothing has been granted by the judge at this time. I understand I must submit this request with a copy of my driver’s license before my court date.
MUST SUBMIT COPY OF DRIVER'S LICENSE:
*
MUST SUBMIT COPY OF CURRENT INSURANCE IF APPLYING FOR DEFERRED DISPOSITION FOR A NO INSURANCE VIOLATION
ELECTRONIC SIGNATURE:
*
Please type full name and date in lieu of signature
I WISH TO RECEIVE MY PAPERWORK IN THE FOLLOWING MANNER:
*
By mail to the home address provided above
By email to the email address provided above
Please contact the court office at 281-338-6702 if you have any questions.
Leave This Blank:
Receive an email copy of this form.
Email address
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