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2. Attorney First Name
3. Attorney Last Name
5. Law Firm Name/Address
7. Attorney Email Address *
8. Phone Number*
12. DEFENDANT INFORMATION
14. Defendant Driver's License (ID Card, if applicable)
15. Defendant Insurance
    (Required for Driving Safety Course Option and for Insurance Violations)
17. Other Document(s)
19. Plea and Acceptance of Prosecutor's Offer Form*
21. 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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23. 1. Receive an email copy of this form.
24. Email address

    This field is not part of the form submission.

25. Submit

* indicates a required field