1. This information is furnished to you as a courtesy by the Justices of the Peace of Travis County, Texas, to assist you in making a decision on
the charge(s) filed against you.
2. Submit all inquiries or responses to the court circuit above.
3. If you wish to enter a plea of Guilty or No Contest, please indicate this decision in the proper space below. Entering either plea below
indicates that you agree to waive appearance before the Court for trial and/or trial by jury and discovery. By entering this plea, you also agree to pay
the fine stated on the reverse side of this notice.
4. If any part of a fine, court costs, reimbursement fee or restitution is not paid within 30 days of conviction, a Time Payment Reimbursement
Fee of $15.00 shall be added to the total due per offense, as required by law.
5. Alternatives to payment of fines and court costs are available if you are unable to pay in whole or in part. See reverse side for more details.
6. If you wish to enter a plea of Not Guilty and desire a trial, please indicate this decision in the proper space below. The Court will send you
notice of the trial date by mail.
7. You must notify the Court of any changes in your address in writing.
8. Telephone calls DO NOT constitute an appearance before the court. Faxes and emails may constitute as an initial appearance.
9. You may be eligible to dismiss this charge by successfully completing a Driver Safety Course (DSC) or Motorcycle Operator Course
(MOTC). You will lose this right if you do not request DSC or MOTC on or before the appearance date on your citation. To determine
eligibility please read the reverse side of this form.
10. Certain charges are eligible for dismissal with proof of correction and a Dismissal Compliance Fine. Please see reverse side for eligible charges.
You have until the appearance date on your citation to show the court proof of the correction.
11. If you fail to respond to the charge(s) by the appearance date shown on the citation, an additional charge may be filed against you for either
Violation of Promise to Appear $236 or Failure to Appear $181 . Warrants may be issued for your arrest with a Warrant Reimbursement Fee of $50.00
added for each charge. Your driver's license renewal may be denied with an OMNI Reimbursement Fee of $10.00 for each charge and/or your case(s)
may be forwarded to a collection agency.
Date Citation No. Date of Birth:
(Include letters & numbers)
(check one)
1. I plead GUILTY/NO CONTEST (circle choice), and waive my right to a jury trial and discovery. Enclosed are my court costs and fines.
2. I plead NOT GUILTY, waive my right to a jury trial and request a trial before the court.
3. I plead NOT GUILTY and request a trial before a jury.
Printed Name (as shown on License) Signature
Current Mailing Address Contact No. Telephone Number ( home / cell ) -- circle one
City, State, Zip Code Place of Employment & Phone No.
E-Mail Address
*I hereby plead No Contest and waive my right to a trial by jury and discovery to the above violation and request that the court defer proceedings for
90 days from the date the affidavit is notarized so that I may complete a state approved DSC or MOTC course.
*I have not completed a DSC or MOTC course to dismiss another offense within 12 months of the offense.
*I am not taking nor am I enrolled in a DSC or MOTC, nor have I completed one that is not yet reflected on my driving record.
*I certify that I have read and meet all requirements for DSC or MOTC Eligibility. See Eligibility on Reverse Side.
*You must submit this form SIGNED and NOTARIZED, along with Court Costs (call the Court for this amount) + $10.00 non-refundable DSC Reimbursement Fee,
provide valid proof of insurance with your name on the policy, and proof of a valid Texas non-commercial driver's license/permit or be an active duty
member/dependent of the U.S. Military and present proof. All documentation is due to the Court on or before the appearance date on the citation.
*To satisfy the deferred proceedings at the conclusion of the 90 days, you must present a uniform certificate or verification of course completion and a Type 3A
driving record to the court.
SEE REVERSE SIDE FOR ADDITIONAL INFORMATION FOR DRIVING SAFETY COURSE (DSC).
Signature Address
Print Name as Shown on Driver's License City, State, Zip Telephone No.
Citation No. (Include letters & numbers)
Email Address
Sworn to and subscribed before me this day of
Notary Public of State of Texas or Court Clerk, J.P. No.
Travis County, Texas
Judge Yvonne Williams Judge Sylvia Holmes
J.P. Precinct One J.P. Precinct Three
4717 Heflin Lane, Suite 107 8656 B W. Hwy 71, Suite 100
Austin, TX 78721 Austin, TX 78735
(512) 854-7700 (512) 854-6763
JP1@traviscountytx.gov JP3@traviscountytx.gov
Judge Nicholas Chu Judge Raúl A. González
J.P. Precinct Two J.P. Precinct Five J.P. Precinct Four
Judge Randall Slagle
(512) 854-4545 (512) 854-9049 (512) 854-9479
WAIT AT LEAST 5-10 BUSINESS DAYS BEFORE CONTACTING THE COURT TO ALLOW THE FILING OF THE TICKET BY THE OFFICER
PLEASE SEE DISMISSAL INFORMATION ON REVERSE TO DETERMINE IF YOU ARE ELIGIBLE WITH TIMELY CORRECTION
JP2@traviscountytx.gov JP4court@traviscountytx.gov JP5Criminal@traviscountytx.gov
10409 Burnet Rd., Suite 180 1000 Guadalupe St., Room 112 4011 McKinney Falls Parkway
Austin, TX 78758-4427 Austin, TX 78701 Suite 1200, Austin, TX 78744
YOU MAY ALSO CHECK THE CASE STATUS ON THE JUSTICE OF THE PEACE WEBSITE AT: https://www.traviscountytx.gov/justices-of-peace
or State ID No
Driver's License No.
Please keep a copy of this request for your records
******************************************************************************************************************************************************************
PLEA
PLEA, REQUEST, AND AFFIDAVIT FOR DSC OR MOTC INFORMATION
(as of 01/01/2020)
Driver License Number
click to sign
signature
click to edit
![]()
click to sign
signature
click to edit
![]()
