894 Web PDF
894 Web PDF
894 Web PDF
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).
Date of Birth
ADDRESS
CITY
APT.
STATE
ZIP CODE
PHONE NUMBER
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