Order To Defer Traffic Infraction Form - Cheney Municipal Court printable pdf download

Name: ____________________________

Completion Date: _______________________

CHENEY MUNICIPAL COURT

611 SECOND STREET, CHENEY, WA 99004

509-498-9231

FAX 498-9332

ORDER TO DEFER TRAFFIC INFRACTION

Driver’s License Number

State

Citation Number

Charge

Moving______ Non Moving ________

Name, Last

First

Middle

Street Address

City

State

Zip Code

Traffic School

(Choose one of the following)

_____ Ordered

______Waived

Provide Certificate By:

□

Online at

1-888-329-7069 or

□

Reduce the Risk Traffic Safety Class, Cheney City Hall Council Chambers,

611 2

St, Cheney, WA 99004

I HEREBY certify and agree as follows:

I am the person named above.

I agree that I have committed the infraction(s) listed on Citation Number shown above.

I ask the Court to defer entry of a finding that I committed the infraction(s).

I have not had another _____moving, or _____ non moving traffic infraction deferred by any court within the

last seven (7) years.

I AGREE to the following conditions of my deferral:

1. I agree to pay the Court Administrative Fee of $________, by _____________________.

2. I will pay for and attend the Traffic Safety School, by the date above.

3. I will not commit any ___ moving, or ___ non moving infractions for 1 year.

4. I will appear in court on _____________at _______ to review my compliance with #1, #2, #3 above, unless

excused by the court at my request. No summons to appear will be sent to me.

5. I agree that if I fail to pay the fee, fail to attend traffic school (if required), fail to appear in court as required in

#4 above, or commit any _____ moving or ____ non moving infractions within 1 year, the Court will enter a

finding that I have committed the infraction(s) listed on the Citation shown above, will report the finding to the

Washington State Department of Licensing and I will pay the original amount due, (less admin. fee) on the

infraction(s) within 30 days of being notified.

6. I agree that if I fail to pay the fine due in #5, the Court may add a $52.00 fee, send the account to

Collection, Notify DOL, and my license will be suspended.

7. I agree to keep the court informed in writing of my mailing address for 1 year.

I UNDERSTAND that pursuant to RCW 46.63.070(5) the court will dismiss my infraction(s) one-year from the date

below if I comply with Conditions #1, #2, and #3 above.

I certify or declare under the penalty of perjury under the Laws of the State of Washington that my foregoing

statements are true and correct.

Signed on ____________ day of ______________, 20___.

________________________________________

Defendant’s Signature

___________________________________________

________________________________________

Prosecutor’s Signature

Defendant’s Attorney

IT IS HEREBY ordered that the finding on the above Citation be deferred for 1 year and a dismissal will be entered at

that time if all conditions are met as agreed to above.

___________________________________________

Judge

Order To Defer Traffic Infraction Form - Cheney Municipal Court

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