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2. First Name*
3. Last Name*
5. Ticket Number*
6. Violation/Offense*
8. Street/PO Box*
10. City*
11. State*
12. ZIP*
14. Email Address *
15. Phone Number / Text Number

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

17. Driver's License/Identification*
18. Proof of Incarceration
20. Acknowledgement of Rights
    I, the undersigned defendant, do hereby enter my appearance in the above-referenced cause(s), wherein I am charged with a misdemeanor(s) in the City of Celina Municipal Court. I understand that I have the right to plead not guilty and require the State to prove my guilt beyond a reasonable doubt before a Judge or jury, the right to hire an attorney, the right to subpoena witnesses.
22. I hereby knowingly and voluntarily waive my right to a jury trial and all other rights listed above and agree to pay the fine and costs the judge assesses. I understand that payment of the fine and costs constitutes satisfaction of the judgment and waiver of the right to appeal. I understand that my plea may result in a conviction appearing on either a criminal record or a driver’s license record.
24. Plea and Waiver*
    -- Select One --No ContestGuilty
26. FROM (Incarcerated date)*
    FROM (Incarcerated date)
27. TO (Incarcerated date)*
    TO (Incarcerated date)
29. Name of facility where incarcerated*
31. Facility Street *
33. Facility City*
34. Facility State*
35. Facility ZIP*
37. Defendant Signature*
    By typing my name, I adopt this as my signature and have read, affirm and agree to the information herein.
38. Date*
    Date
Leave This Blank:


40. 1. Receive an email copy of this form.
41. Email address

    This field is not part of the form submission.

42. Submit

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