Form 40-127 - State Court Costs And Arrest Fees
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140-127
(Rev.5-98/8)
b.
38100
DO NOT WRITE IN SHADED AREAS
a. T Code
STATE COURT COSTS AND ARREST FEES
COUNTY QUARTERLY REPORT -
(This report must be filed by the due date even if no payment is due.)
c. County identification number
g.
e. Due date of report
f. Report for quarter ending
County name and mailing address
d.
If any information preprinted on this form
is incorrect, cross out the incorrect infor-
mation and write in the correct information.
i.
h.
Column 1
Column 2
Column 3
DESCRIPTION
TOTAL COLLECTED
SERVICE FEE
AMOUNT DUE STATE
SEE BACK FOR INSTRUCTIONS
(10% of Column 1)
(Col. 1 minus Col.2)
PART I - See instructions for Part I.
$
$
1. Arrest Fees
(See instructions for Item 1)
1.
2. Compensation to Victims of Crime (CVC)
2.
3. Judicial and Court Personnel Training (JCPT)
3.
4. Juror Donations - Compensation to Victims of Crime
4.
5. Juvenile Probation Diversion (JPD)
5.
6. TLFTA
(See instructions for Item 6)
6.
PART II - For offenses committed BEFORE September 1, 1997 ONLY.
7. Abused Children's Fund
7.
(See instructions for Item 8)
8. Breath Alcohol Testing (BAT)
8.
9. Comprehensive Rehabilitation (CR)
9.
10. Crime Stoppers Fund (CSA)
10.
11. Criminal Justice Planning (CJP)
11.
12. Law Enforcement Management Institute (LEMI) - $0.50
12.
13. Law Enforcement Officer Administrative (LEOA) - $1
13.
14. Law Enforcement Officers Continuing Education (LEOCE) - $2
14.
15. Misdemeanor Court Cost - General Revenue (GR)
15.
16. Operator's and Chauffeur's License (OCL)
16.
PART III - For offenses committed ON or AFTER September 1, 1997 ONLY.
(See instructions)
17. Consolidated Court Costs (CCC)
17.
18. Fugitive Apprehension (FA)
(See instructions)
18.
19. Juror Donations - Child Welfare Services
19.
20. Prevention of Juvenile Crime and Delinquency (JCD)
(See instructions)
20.
(Total of Items 1-20 in Column 3)
21. TOTAL DUE FOR THIS PERIOD
21.
* * * DO NOT DETACH * * *
(Same as Item 21)
22. TOTAL AMOUNT DUE AND PAYABLE
22.
j.
k.
County name
For assistance call 1-800-531-5441, Ext. 3-4276, toll free nationwide, or call 512/463-4276.
T Code
County identification no.
Period
(From a Telecommunications Device for the Deaf (TDD), call 1-800-248-4099
toll free, or call 512/463-4621.)
38020
(type or print name)
I
_________________________________________________________ certify
that the information above is true as shown in the records of the treasury of the county named.
Complete this report and make the amount in Item 22 payable to:
Authorized agent
STATE COMPTROLLER
Mail to: COMPTROLLER OF PUBLIC ACCOUNTS
Date
Title
111 E. 17th Street
Daytime phone
(Area code and number)
Austin, Texas 78774-0100
40-127 (Rev.5-98/8)
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