Application For Deferred Disposition/probation Application Form printable pdf download

DEFERRED DISPOSITION/PROBATION APPLICATION FORM (Art. 45.051 CCP)

NOTICE – READ CAREFULLY BEFORE COMPLETING: This form may not be used by juveniles to

apply for deferred disposition. All juveniles, 16 years or younger, must appear in open court for all

proceedings with a parent or legal guardian. If the offense is traffic related and you hold a commercial

driver’s license, you are not eligible to request this option. If the offense is traffic related, you must

submit a copy of your current drivers’ license and liability insurance with your application. This request

must be received by the Court or postmarked within 10 days of receiving your citation. Contact the court

for the correct bond and special expense fee amount to submit for this option. The amount will be equal

to the total “window fine” and court costs for the charge. If your request is approved, you will receive by

mail documentation setting forth the terms of your deferred disposition.

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CITATION (TICKET) NUMBER: ___________________________________________________________

FULL NAME: ___________________________________________________________________________

ADDRESS: ______________________________________________________________________________

(INCLUDE APT. #)

(CITY)

(STATE)

(ZIP CODE)

PHONE: _________________________________________________________________________________

(HOME)

(CELL)

I do hereby enter my plea of No Contest, waive my right to a jury trial and request Deferred Disposition

(Probation) for the Class C Misdemeanor offense of: ________________________. I understand that I must

make this request on or before my appearance date and I must meet all the eligibility requirements in order for

this request to be granted by the Court. I understand that Deferred Disposition is a privilege, not a right, offered

at the sole discretion of the Court.

I swear the following statements are true and correct:

1. I am the defendant in the above numbered citation.

2. I hereby enter a plea of “No Contest” and waive my right to a jury trial.

3. I was not charged with exceeding the posted speed limit in excess of 24 mph, operating a motor vehicle

without financial responsibility (if an accident was involved), subsequent violation of the financial

responsibility law, subsequent violation involving alcohol, and I do not hold a commercial driver license.

4. I have not been on Deferred Disposition for dismissal of an offense within one (1) year prior to the offense

date in this matter.

5. I am not currently on Deferred Disposition for another offense in any court.

Application For Deferred Disposition/probation Application Form