IN THE COUNTY COURT IN AND FOR SANTA ROSA COUNTY, FLORIDA
________________________________
____________________________________
Plaintiff Citation #
Case #
VS
________________________________
____________________________________
Defendant
Driver’s License #
AFFIDAVIT OF DEFENSE OR ADDMISSION AND WAIVER OF APPEARANCE
Before me personally appeared ________________________________________________________
Defendant Name
who after first being placed under oath, swears or affirms as follows:
1. My name, address and telephone number are:
Name:
________________________________________________________________
Address:
________________________________________________________________
Telephone No: ________________________________________________________________
2. I am the defendant in the above-referenced case and I am charged with the following violation(s):
(List the charge(s) as you understand it (them) to be. NOTE: This is not an admission that you
violated any law.)
____________________________________________________________________________
3. Check only one of five (5) listed options as your plea:
☐ I hereby plead Not Guilty and request a hearing. I intend to attend the hearing and present a
defense. I understand that I will be sent notice of the time and place of the hearing by mail to the
address listed above.
☐ I hereby plead Not Guilty and file this affidavit of defense as my sworn statement herein. I
understand that when I plead not guilty, I do not have to supply any further statement. I
understand that by my plea of not guilty, a hearing will be scheduled and the Judge will make a
decision as to whether or not I am guilty of the infraction based upon the sworn testimony of the
witnesses, other evidence, and my sworn statement. I understand that I am waiving my personal
appearance at the final hearing of this matter.
☐ I hereby plead Guilty and file this affidavit as an explanation of what happened and as a
statement that the Judge can consider before pronouncing a sentence. I understand the Judge will
determine the appropriate civil penalty and decide whether to adjudicate me guilty.
☐ I hereby plead No Contest and file this affidavit as an explanation of what happened and as a
statement that the Judge can consider before pronouncing sentence. I understand that I am not
required to make a statement. I understand that by pleading no contest, I am neither admitting nor
denying that the infraction was committed, but I do not contest the charges. I understand that I
may be found guilty even though I entered a plea of no contest. I understand that the hearing
1