Deferred Disposition Request

* indicates a required field

**REQUEST FOR DEFERRED DISPOSITION FOR NO PROOF OF FINANCIAL RESPONSIBILITY (INSURANCE) MUST BE DONE IN PERSON BEFORE THE JUDGE!!

First Name*

Last Name*

Citation / Ticket / Cause Number*

Violation/Offense*

Street / PO Box*

City*

State*

Zip Code*

Email Address*

Confirm

Phone Number*

I understand that I may have this citation dismissed by Deferred Disposition (Probation) in lieu of a conviction on my driving record. I understand that I can only make this request PRIOR to or on the court date indicated on my citation. I also understand that Deferred Disposition Probation is a privilege, not a right, offered solely by the discretion of the Court.

I waive my right to a jury trial and enter my plea of*

ELIGIBILITY

To be eligible for Deferred Disposition, Statements 1 - 5 must be acknowledged as true and correct.

(1) I am the individual who received the citation referenced above.*

True and Correct

(2) I was not charged with exceeding the posted speed limit in excess of thirty (30) miles per hour.*

True and Correct

(3) I do not possess a commercial driver’s license (CDL) in any State.*

True and Correct

(4) I have not had probation in the City of Ingleside for dismissal of a traffic citation within the one (1) year period prior to the issue date of my citation.*

True and Correct

(5) I am not currently on probation for any citation in any other Court.*

True and Correct

AFTER receiving approval from the Judge, I will receive a copy of my probation order in the manner in which it is received by the court. I understand I will be placed on Probation for a period of time not to exceed six (6) months and IF I VIOLATE any term of my probation, this citation will not be dismissed and a conviction may be reported to the Texas Department of Public Safety.

Payment Information*

Payment Instructions

DO NOT PAY BEFORE YOUR REQUEST HAS BEEN GRANTED. Once your request has been granted by the Court, you will receive a copy of the Order in the manner in which it is received; i.e., email or mail.

You are REQUIRED to submit Proof of Identification.

If you are unable to upload your identification with this form, email a copy to IMC@INGLESIDETX.GOV

THIS FORM WILL NOT BE ACCEPTED UNLESS REQUIRED IDENTIFICATION HAS BEEN RECEIVED!

Upload Driver's License/Identification*

Proof of Insurance, if applicable

By typing my name-I adopt this as my signature and have read, affirm and agree to the information herein-Defendant Signature*

Defendant Signature

Date*