500-00421 – Notice of Violation (09/2019) Page 1 of 1
NOTICE OF VIOLATION
You are being charged with a violation of law as indicated below.
______Minors Misrepresenting Age, Procuring, Possessing or Consuming Alcoholic Beverages
(7 V.S.A. § 656)
Complaint #_______________________________
AND OR
______Marijuana Possession by a Person under 21 Years of Age, one ounce or less (18 V.S.A. § 4230b)
Complaint #_______________________________
AND OR
______Dispensing Marijuana to a Person who is 18, 19, or 20 years of age (18 V.S.A. § 4230(e)(2)
Complaint #_______________________________
1. As required by law, you must provide this officer with your correct name and mailing address.
Please also give the officer your telephone number.
2. Within 15 DAYS, you must contact the County Diversion’s Youth Substance Abuse Safety Program
(YSASP) at the address or phone number circled to your left.
3. Do not send any money to pay any legal penalty at this time. There is a program fee required by
the YSASP.
4. Until you have finished all conditions of the program, you must inform the YSASP office of any
changes in your name or address.
If you contact the Youth Substance Abuse Program within 15 days and complete all conditions of the
program, this violation will be voided, and no penalty will be imposed. There is a program fee. The
fee may be reduced based on your circumstances and paid in installments.
The Youth Substance Abuse Safety Program involves participating in a screening process about
your substance use and discussing your use with a YSASP case manager. You may need to
complete an assessment with a substance use clinician and follow their recommendations for
treatment. If you are under age 18, a legal guardian must give permission for you to participate in
the program.
If you fail to contact the Youth Substance Abuse Program within 15 days or fail to complete all
conditions of the program, the ticket for this violation will be issued. At that time, you may contest
the charge with the Judicial Bureau.
If the Judicial Bureau finds you in violation, you will have to pay a fine and your privilege to operate a
motor vehicle in Vermont will be suspended. The cost of your car insurance may increase
substantially. If you hold a license from another state, that state will revoke your privilege to operate
a vehicle also.
You may have other tickets or citations. For example, if you were driving, you may have been given a
ticket or criminal citation for operating a vehicle under the influence. Address your response to those
tickets or citations to the Judicial Bureau or State’s Attorney as explained on those documents.
_______________________________________________________________________________
Law Enforcement Officer Phone # Department Name
Date of Violation _____________________
Programs
ADDISON
282 Boardman Street
PO Box 881
Middlebury, VT 05753
802-388-3888
BENNINGTON
439 Main Street
Bennington, VT 05201
802-447-1595
CALEDONIA
24 Bagley Street
St. Johnsbury, VT 05819
802-748-8732
CHITTENDEN
200 Church Street
Burlington, VT 05401
802-865-7155
ESSEX
24 Bagley Street
St. Johnsbury, VT 05819
802-748-8732
FRANKLIN
120 N. Main St.
St. Albans, VT 05478
802-524-7006
GRAND ISLE
120 N. Main St.
St. Albans, VT 05478
802-524-7006
LAMOILLE
221 Main Street
PO Box 148
Hyde Park, VT 05655
802-888-5871
ORANGE
PO Box 58
Chelsea, VT 05038
802-685-3172
ORLEANS
71 Seymour Lane
Newport, VT 05855
802-334-8224
RUTLAND
50 Center Street
Rutland, VT 05701
802-786-3840
WASHINGTON
322 North Main Street,
Suite 5
Barre, Vermont 05641
Phone: 802 479-1900
WINDHAM
32 Walnut Street
Brattleboro, VT 05302
802-257-0361
WINDSOR
211 North Main Street
PO Box 474
White River Jct, VT 05001
802-295-5078
