CLERK OF THE CIRCUIT COURT
DUVAL COUNTY
501 WEST ADAMS STREET
JACKSONVILLE, FLORIDA 32202
Circuit Criminal Payment Plan Agreement
Name:
Case Number:
You have elected the option to enter into a Payment Plan Agreement with the Clerk’s Office. This will enable you to pay
citation(s), court costs and fees in monthly installments.
Terms and Conditions
1. This Payment Plan Agreement can only be established by the named person on this case.
2. Payment Plan Agreements sent by U.S. mail must be notarized and received in the Clerk’s Office on or before the payment
due date to avoid additional fees and possible suspension of your driver’s license. Postmarked date is NOT considered.
3. A one-time $25 processing fee is required at the time the Agreement is initiated and must be paid with your first monthly
installment of $ .
4. All late fees incurred prior to the Payment Plan Agreement must be included along with your first monthly installment.
5. After the first payment is made, your next due date will be approximately 30 calendar days later. Please see your payment
receipt for the exact due date.
6. Late fees incurred during the Payment Plan Agreement must be paid immediately in addition to the next monthly
installment.
7. Payments submitted by U.S. mail must be received by the Clerk’s Office on or before the due date to avoid additional fees
and possible suspension of your driver’s license. Postmarked date is NOT considered.
8. Payments may be made at one of the Clerk’s Office locations, or by mailing a cashier’s check or money order (made
payable to the Duval County Clerk of Courts) to Clerk of the Circuit Court, Duval County, Felony Department, 501 West
Adams Street, Room 2136, Jacksonville, FL 32202.
9. No personal checks accepted in office or by mail.
Late Payment Policy
1. Each missed payment will result in late fees being added to the total amount due and possible suspension of your driver’s
license. When making payment by mail or at one of the Clerk’s Office locations, late fees will be included in the next
monthly installment.
2. If you are late making payments a total of three (3) times during the duration of the Payment Plan Agreement, the balance
of your case will be referred to a collection agency. The collection agency will add a 40% collection fee to the balance
owed and the suspension of your driver’s license will not be cleared until payment has been made in full to the collection
agency. No Exceptions.
3. Unsuccessful completion of the K.E.Y.S. 2 Success program or a violation of your payment plan while in the program can
result in the suspension of your driver’s license and any remaining balance will be immediately referred to collections and
will no longer be eligible to be recalled.
I hereby state that I have read and agree to the Terms and Conditions and understand the Late Payment Policy listed above. I agree to pay
all installments on or before the established due date.
Print Name: ________________________ Driver’s License Number: _________________________
Home Address: _____________________________________________________________________
Home Phone Number: ________________ Cell Phone Number: ______________________________
__________________________________ _______________________________________________
Signature Date
Personally known by me or produced ______________as identification subscribed to before me, this ___day of ____________A.D._____.
JODY PHILLIPS
Clerk of the Court
_____________________________________
Deputy Clerk / Notary Public
