DISTRICT COURT OF MARYLAND UNIFORM COMPLAINT AND CITATION OPTION FORM (TRAFFIC CITATION)
Return to:
Traffic Processing Center
P.O. Box 6676
Annapolis, MD 21401-0676
LOST OR MISSING TRAFFIC CITATION OPTION FORM
(FOR USE WITH DR-049 AND DR-049E MARYLAND UNIFORM COMPLAINT AND CITATION ONLY)
If you lost or misplaced your citation, you will need to complete this blank form, print and mail WITHIN 30 DAYS after receipt of the citation to:
District Court Traffic Processing Center
PO Box 6676
Annapolis, MD 21401
If you have more than one citation, you must send a separate form for each citation (the forms may be mailed in the same envelope). You will
need to access your citation information (citation number, fine amount, date of the violation, etc.) online using our public access site Case Search
at: http://casesearch.courts.state.md.us/casesearch/ to complete the necessary information on the form so your payment or request can be applied
correctly. An additional $10 service fee will be imposed for each dishonored check.
NAME
COUNTY IN WHICH
CITATION WAS WRITTEN:
ADDRESS
Check if address on
citation was different
CITY, STATE, ZIP
TELEPHONE NO.
WRITE IN YOUR CITATION NUMBER BELOW
CHECK THE APPROPRIATE BOX BELOW. IF MAILING IN FINE, FILL IN AMOUNT OF FINE.
PAY FINE AMOUNT $ OR
REQUEST TO ENTER INTO PAYMENT PLAN
REQUEST WAIVER HEARING
REQUEST TRIAL
If you pay the fine or enter into a payment plan, you agree to a guilty disposition for the charge(s).
Check the appropriate box and sign below to request a Payment Plan, Waiver Hearing, or Trial for any citations listed above.
Request to enter into a Payment Plan I admit that I committed the violation(s) charged in this citation. I have at least $150 in total outstanding fines. I am
requesting to enter into a payment plan to satisfy the violation(s) charged in this citation. If you are qualified, the court will mail the agreement to you or notify you otherwise. DO NOT
SEND PAYMENT with your request.
circumstances to a judge. I know this is not a trial, the officer and witnesses will not be present, and that my appearance in court is for sentencing only. DO NOT
SEND PAYMENT with your request.
DR-049O (Rev. 10/2020)
DEFENDANT’S SIGNATURE
DATE
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