2. The local rules of Jefferson County District Court allow you to submit a written statement instead of appearing at the hearing. The written statement must be received by the Clerk no later than 7 days prior to the hearing. You must also provide the Clerk with an email address so that the court can advise you about the result of the hearing. No appeal may be taken from the result. Once the court receives your email it will be given to the Judge for review. We will then mail the judge’s decision, (this will not come on email) it takes approximately two to four weeks for you to get your decision. You must have responded to the requirements on the back of the green copy of your ticket and you must have already received a court date from the Court before using this form.
3. Preferred Method of Communication*

   1. Regular Mail
   2. Email
5. Defendant's Information
7. First Name*
8. Last Name*
9. MI
11. Date of Birth*
    Date of Birth
13. Mailing Address
15. City
16. State
17. Zip Code
19. Email Address
21. Mitigation Information
23. Date of Hearing
    Date of Hearing
24. Ticket Number*
26. Statement
Leave This Blank:


28. 1. Receive an email copy of this form.
29. Email address

    This field is not part of the form submission.

30. Submit

* indicates a required field