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2. First Name*
3. Last Name*
5. Street/PO Box*
7. City*
8. State*
9. ZIP*
11. Email Address *
12. Driver's License (ID Card, if applicable)*
14. Insurance
    (Required for Driving Safety Course Option and for Insurance Violations)
18. Juvenile Cases (Age 16 and Under)
    A parent/guardian must sign the plea offer form, present a driver's license/ID Card, and phone number along with the required documentation from the defendant.
20. Parent/Guardian Driver's License/ID Card
21. Parent Phone Number
25. Plea and Acceptance of Prosecutor's Offer Form*
    Form must be signed. JUVENILE CASES (AGE 16 AND UNDER) Form must also be signed by a parent/guardian.
27. If the Judge approves said plea offer, you will receive a copy of the Order by email. DO NOT take any classes or pay until you have been granted permission by the court.
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29. 1. Receive an email copy of this form.
30. Email address

    This field is not part of the form submission.

31. Submit Submit and Print

* indicates a required field