Statewide Traffic Tickets/infractions Amnesty Program Butte County - Participation Form Page 3
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Statewide Traffic Tickets/Infractions Amnesty Program
October 1, 2015 to March 31, 2017
Participation Form
PLEASE NOTE THE FOLLOWING:
Are you eligible for the 50% amnesty reduction?
If, after this form is submitted, the court/county/collecting entity discovers you are not eligible for amnesty because
you have 1 or more outstanding warrants or owe victim restitution in this county, you shall be notified within 10
business days that your form is being suspended. You will then have 20 business days to bring written proof to the
court/county/collecting entity that the outstanding warrant(s) and/or victim restitution issues have been addressed.
On the 21st business day, or earlier if the information you provide does not demonstrate you are eligible for amnesty,
the court/county/collecting entity will retroactively cancel the amnesty program, restore previously reduced court-
ordered amounts, and credit any paid amounts toward your revised outstanding debt. The court/county/collecting
entity will send you notice of this action to the address indicated on this document.
Are you eligible for the 80% amnesty reduction?
If, after this form is submitted, the court/county/collecting entity discovers you are not eligible for the 80 percent
reduction in bail/fines/fees because you are not receiving public assistance as listed or because your household
income is not at or below 125 percent of the federal poverty rate, you shall be notified within 10 business days that
your amnesty discount will be revised. You will then have 20 business days to bring written proof to the
court/county/collecting entity that you do receive the specified public assistance or that your income is not at or
below 125 percent of the federal poverty rate for your household. On the 21st business day, or earlier if the
information you provide does not demonstrate that you are eligible for the 80 percent discount, the
court/county/collecting entity will determine whether to revise the discount, if you are eligible, to 50 percent of the
amount owed for court-ordered debt or impose the full amount as discussed above and credit any paid amounts
toward your revised outstanding debt. The court/county/collecting entity will send you notice of this action to the
address indicated on this document.
FOR USE ONLY BY ENTITY ADMINISTERING THE AMNESTY PROGRAM
Citation due date:
Total outstanding balance:
Citation number:
Amnesty payment due:
The County of Butte AND/OR the Superior Court of Butte County has verbally verified case eligibility for the
amnesty program and has determined the following:
Eligible for:
50% reduction
Full Payment
80% reduction
Payment Plan
Driver’s License Reinstatement
Not eligible for (check all that apply):
50% reduction
80% reduction
Driver’s License Reinstatement
Certified by: _________
____________
Document specific arrangements here:
Rev. 9/24/2015
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