City Of Tucson Affidavit Of Civil Traffic Compromise printable pdf download

City Of Tucson Affidavit Of Civil Traffic Compromise

STATE VS.

__________________________________

COMPLAINT NO.

__________________________________ (citation number)

AFFIDAVIT OF CIVIL TRAFFIC COMPROMISE

STATE OF ARIZONA

)

) ss.

COUNTY OF PIMA

)

I, _______________________________________, being first duly sworn, on oath, say as follows:

(victim’s name) PLEASE PRINT

I, __________________________________________ am a person who sustained

(victim’s name) PLEASE PRINT

damages and/or injuries as a result of the accident which gave rise to the civil traffic charges of

____________________________________________________________________________

against _____________________________________________________________________

(defendant’s name) PLEASE PRINT

on _________________________________________.

(month/day/year)

I understand that I have a civil remedy for the injuries and/or damages sustained.

Check one of the following:

________ a. I have been fully compensated by the defendant for my losses.

________ b. I do not seek compensation.

I am aware that by signing this Affidavit I indicate my recommendation that the civil

traffic charges against him/her be dismissed.

________________________________________________

(victim’s signature)

Parent or legal guardian must sign for a minor child

SUBSCRIBED AND SWORN to before me this _______ day of ____________________, 20___.

My commission expires:

________________________________________________

Notary Public

City Of Tucson Affidavit Of Civil Traffic Compromise