Fillable Ri Tr018 Ri Tr018 (California)

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Ri Tr018 Ri Tr018 (California)

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PETITION FOR ABILITY-TO-PAY DETERMINATION
Instruction and Information Sheet
INSTRUCTIONS: Complete this form (RI-TR018) if you have a traffic or other infraction ticket and want to ask the
court to address your ability to pay the fine. You must attach supporting documentation to this form. You can ask the
court for monthly payments, more time to pay, a reduction in the amount owed, or to allow you to complete
community service instead of paying the fine. If you have more than one ticket, you must fill out one form for each. If
you want to fight the ticket do not use this form, visit our website at www.riverside.courts.ca.gov.
DO NOT use this form to address a civil assessment that has been added to your case. To address a civil
assessment, you must file the Request to Address Civil Assessment, which is available on our Local Forms page at
www.riverside.courts.ca.gov.
If the court has previously made an ability-to-pay determination on your case, you may only file a subsequent ability
to pay determination if there has been a change in your financial circumstances.
See Step 1 below for filing instructions.
Steps to processing your Petition for an Ability-to-Pay Determination
Step 1:
Complete the Petition for an Ability-to-Pay Determination (form RI-TR018) form, (pages 1 and 2).
Insert your name, address, phone number, and case number.
Complete the financial information.
Step 2: You may file this form YLDH6XEPLWDQH6XEPLWVXEPLVVLRQIHHRILVUHTXLUHG orPDLO\RXUUHTXHVW
along with the supporting documents to any one of the locations below.9LVLWRXUZHEVLWHDW
ZZZULYHUVLGHFRXUWVFDJRYIRUPRUHLQIRUPDWLRQThe court will notify you of the outcome of your petition
Step 3:
Submit the completed form and the required attachments to the clerk.
Banning 311 E. Ramsey, Banning, CA 92220
Blythe 265 N. Broadway, Blythe, CA 92225
Corona 505 S. Buena Vista Ave., Room 201, Corona, CA 92882
Hemet 880 N. State Street, Hemet, CA 92543
Indio 46-200 Oasis St., Indio, CA 92201
Murrieta 30755-D Auld Rd., Ste. 1226, Murrieta, CA 92563
Moreno Valley 13800 Heacock St., Bldg. D #201, Moreno Valley, CA 92553
Approved for Optional Use
Riverside Superior Court
Form RI-TR018 [Rev. 07/01/19]
Statutory Authority
riverside.courts.ca.gov/localfrms/localfrms.shtml
by mail.
SUPERIOR COURT OF CALIFORNIA, COUNTY OF RIVERSIDE
BANNING 311 E. Ramsey St., Banning, CA 92220
INDIO 46-200 Oasis St., Indio, CA 92201
BLYTHE 265 N. Broadway, Blythe, CA 92225
MORENO VALLEY 13800 Heacock St., Ste. D201, Moreno Valley, CA 92553
CORONA 505 S. Buena Vista Ave., Rm. 201, Corona, CA 92882
MURRIETA 30755-D Auld Rd., Suite 1226, Murrieta, CA 92563
HEMET 880 N. State St., Hemet, CA 92543
RI-TR018
YOUR INFORMATION:
CONFIDENTIAL
FOR COURT USE ONLY
Name:
Address:
City:
State:
Zip:
New Address
Telephone:
Date of Birth:
CITATION NUMBER:
CASE NUMBER:
PETITION FOR ABILITY-TO-PAY DETERMINATION
INSTRUCTIONS: Complete this form (RI-TR018) if you have a traffic or other infraction ticket and want to ask the
court to address your ability to pay the fine. You must attach supporting documentation to this form.
1.
I am asking the court to (Check all that apply):
Set me up on a payment plan
Reduce my monthly payments
Give me more time to pay
Let me do community service instead of paying my fine
Reduce the amount I owe
2.
I previously submitted a Petition For Ability-to-Pay Determination; however, there has been a change in my
financial circumstances. (Check all that apply)
I lost my job or my work hours were reduced
I am now receiving public benefits
I suffered from a serious injury or disability
Other:
3.
I am requesting the court consider my ability to pay based on the following. I receive (Check all that apply.
You must attach proof to this form that you are receiving these services):
a.
Medi-Cal
Food Stamps
SSP
County Relief/General Assistance
IHHS (In-Home Supportive Services
CalWORKS or Tribal TANF (Tribal Temporary Assistance
for Needy Families
CAPI (Cash Assistance Program for Aged, Blind, and Disabled).
b.
My gross monthly household income (before deductions for taxes) is less than the amount listed below:
Family Size
Family Income
Family Size
Family Income
Family Size
Family Income
If more than 6 people
at home, add $450.00
for each extra person.
1
$1,264.59
3
$2,164.59
5
$3064.59
2
$1,714.59
4
$2,614.59
6
$3,514.59
c.
I do not have enough income or available credit to pay for my household’s basic needs. (You may be
required to provide proof of income and expenses). (Explain):
Page 1 of 2
Approved for Optional Use
Riverside Superior Court
Form RI-TR018 [Rev. 07/01/19]
PETITION FOR ABILITY-TO-PAY DETERMINATION
CRC 4.335
riverside.courts.ca.gov/localfrms/localfrms.shtml
DEFENDANT:
CASE NUMBER:
FINANCIAL AFFIDAVIT
INSTRUCTIONS: Complete this information to assist the court in making a determination of your ability to pay. If you
need assistance with completing this information, please call 1-877-955-3463 for assistance over the telephone.
PERSONAL INFORMATION
Phone no:
Alternate phone no:
Date of birth:
Social Security no:
I.D. or driver’s license no:
Email address:
Name of Relative:
Relative’s phone no:
FAMILY
Spouse/Partner’s name:
Number of dependents living with you
EMPLOYMENT
Employer:
Address:
City:
State:
Zip:
Phone no:
Type of job:
INCOME AND EXPENSES
Net monthly income:
$
Other income source:
Other income amount:
$
Monthly basic expenses:
Rent/mortgage payment
$
Utilities (gas, electric, water, phone)
$
Food
$
Public Transportation
$
Car payment
$
Gas and car insurance
$
Child care/support
$
Court ordered program fees
$
Other necessary monthly expenses
$
Total Monthly Expenses
$
I certify under penalty of perjury under the laws of the State of California that the information given by me in the
affidavit is true and correct; it reflects my financial situation, and that I have no other income whatsoever. Further,
the court has my expressed permission, as needed, to: 1) verify the information furnished through credit bureaus and
other tools, including references, and 2) make automated phone calls to the telephone number(s) provided, even if
the telephone number is a cellular telephone.
Dated:
Printed Name:
Signature:
Page 2 of 2
Approved for Optional Use
Riverside Superior Court
Form RI-TR018 [Rev. 07/01/19]
PETITION FOR ABILITY-TO-PAY DETERMINATION
CRC 4.335
riverside.courts.ca.gov/localfrms/localfrms.shtml
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Completed 27 January 2022

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