Request To Address Civil Assessment For Failure To Appear Or Pay Page 2

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CIVIL ASSESSMENT FOR FAILURE TO APPEAR OR FAILURE TO PAY
Instruction and Information Sheet
Steps to Resolving Your Civil Assessment
Complete the form. “Request to Address Civil Assessment for Failure to Appear or Failure to Pay” (Form # ____)
1.
Insert your name, address, phone number and case number
2. Select and complete option 1, 2 or 3
3. Date and sign the Request
IMPORTANT: If you select option 2 or 3, you must attach the supporting documents and you must take care of the original
violations with which you were charged. Contact the clerk’s office at _______________________ if you need assistance.
Step 2:
Mail or submit your request, along with the supporting documents to the court location listed on your citation. The Court address is as
follows:
Barstow District; 235 East Mountain View, Barstow, CA 92311
Joshua Tree District; 6527 White Feather Road, Joshua Tree, CA 92252
Rancho Cucamonga District; 8303 N. Haven Ave., Rancho Cucamonga, CA 91730
San Bernardino District; 351 N. Arrowhead Ave., San Bernardino, CA 92415
Victorville District; 14455 Civic Drive, Suite 100, Victorville, CA 92392
Note: Only one request to address this civil assessment may be filed. The court will notify you of the outcome of your request by
mail.
FREQUENTLY ASKED QUESTIONS:
What is a Civil Assessment? A Civil Assessment of $300.00 is imposed on anyone charged with a traffic, misdemeanor or felony
offense that (after notice) fails to appear by the scheduled appearance/hearing date and/or fails to pay a court ordered fine by the due
date.
How is the Civil Assessment imposed? If you fail to appear on a date you are supposed to be in court, a warning notice will be
mailed to your last known address. If so mailed, there is a presumption that the notice has been received. There is no requirement
that the court prove that you actually received the notice, only that it was mailed.
Is there a grace period? If you appear within the 10-day time frame shown in the warning notice and show good cause for not
appearing on the date you were supposed to appear, the court may address the assessment.
What are the consequences of a civil assessment for a failure to appear or pay a fine? The court will notify the DMV and the
DMV may place a hold or suspend your driving privileges until the civil assessment is cleared with the court. Note: If your civil
assessment is for a failure to pay, you will be required to pay the fine in full, including the civil assessment amount, in order to get the
DMV hold lifted.
What if I moved? The Court is under no obligation to try to find your current address. You have an obligation to notify the court
while the case is still open of any change of address.
Can there be more than one civil assessment added to my case? Yes. It is possible to have a civil assessment added for each
missed court appearance. A separate warning notice is required to be sent for each assessment.
What is Good Cause? Good Cause is a sufficient reason that is beyond your control (e.g. medical emergency, military duty, etc.),
which prevented you from making an appearance or payment on or before the date listed on your citation (ticket) and a demonstration
that you attempted to resolve the matter as soon as possible after that date. Good Cause is determined on a case-by-case basis.
OTS-CRTIAE-RC-201300904
REQUEST TO ADDRESS CIVIL ASSESSMENT FOR
Page 2 of 2
FAILURE TO APPEAR/PAY PURSUANT TO PC1214.1(a)
Form #21288

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