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2. Before requesting a COURT DATE, click here for How to Handle Your Ticket.
   https://www.celina-tx.gov/577/How-to-Handle-Your-Ticket
4. First Name*
5. Last Name*
7. Ticket Number*
8. Violation/Offense*
10. Street/PO Box*
12. City*
13. State*
14. ZIP*
16. Email Address *
17. Phone Number / Text Number

    In providing your phone/text number, you are agreeing to receive notifications and/or scheduling information about the case.

19. Driver's License/Identification*
21. Acknowledgment & Waiver - Driving Safety Course

    NOTICE: (Re: Setting Moving Traffic Violations For Court) If you have a right to elect a driving safety course (DSC) or motorcycle operator training course (MOC) to dismiss your case, you waive that right by setting your case for an appearance in court. Except for juveniles** Article 45.0511 (b) (3), CCP requires that a request for DSC or MOC be made on or before the answer date on the notice to appear. The notice to appear is your citation or summons. If you are eligible and wish to take DSC or MOC to dismiss your citation, you must make that election now by requesting it from the court clerk. Do not set your case for court (motion/pre-trial/trial) if you want DSC or MOC. ACKNOWLEDGMENT & WAIVER: I hereby acknowledge that I have read and understand all of the above and that by setting my case for an appearance in court I am waiving any right I may have to have my case dismissed by the taking of a driving safety or motorcycle operator training course.

23. I hereby enter a plea of NOT GUILTY and request a trial by*
    -- Select One --Judge - I waive my right to a jury trial and request a trial before the Judge.Jury - I want a jury trial.
25. COURT DATE

    A court date may be mailed or emailed to the address indicated on this form.

27. Defendant Signature*
    By typing my name, I adopt this as my signature and have read, affirm and agree to the information herein.
28. Date*
    Date
Leave This Blank:


30. 1. Receive an email copy of this form.
31. Email address

    This field is not part of the form submission.

32. Submit

* indicates a required field