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IN THE COUNTY COURT IN AND FOR MIAMI-DADE COUNTY, FLORIDA

Traffic Division - Request for Trial

THE STATE OF FLORIDA


VS.

Defendant

Driver's License #

Case Number(s)

State

I request that the citation listed above be set for trial. If it is determined
that I have committed an infraction, I understand that the Court may impose a
civil penalty not to exceed $500.00 (violations involving a death or speeding in
school/construction zones the fine shall not exceed $1,000.00) or require
attendance at traffic school, or both, pursuant to F.S. 318.14(5).

Driver's License Number

Date of Birth

ADDRESS

CITY

APT.

STATE

ZIP CODE

PHONE NUMBER

PLEASE CHECK IF ADDRESS IS DIFFERENT FROM THE ADDRESS ON YOUR CITATION.

I have read and understand the above, and I hereby acknowledge receipt of a copy of this form.

Defendant's Signature

Date

Mailing Instructions
Please printout, complete form, sign, date and mail to:
Clerk of Courts Traffic Division
P.O. BOX 19321
Miami, Fl. 33101-9321

CLK/CT 894 REV. 10/10

Clerk's web address: www.miami-dadeclerk.com

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