State of Alabama
Unified Judicial System
FORM No. UTC-3 REV . 3/89
UTC TRANSMITTAL FORM
UTC Control
Page____of____Pages
TO: (Court Name & Address)
The District Court of The Municipal Court of
Court Name : ______________________________________
Court Address: _____________________________________
_
________________________________________________
FORM: (Law Enforcement Agency Name & Address)
Agency ORI :
Agency Name: ____________________________________
Agency Address: __________________________________
________________________________________________
COURT CASE NUMBER
SERIES
UTC
NUMBER
DATE
ISSUED
D.L.
ATTCH.
REMARKS
(DEFENDANT’S NAME AND/OR OFFENSE)
Year Number
TR
TR
TR
TR
TR
TR
TR
TR
TR
TR
TR
TR
TR
TR
TR
TR
TR
TR
TR
TR
TR
Officer’s Signature:
___________________________________________________
Officer’s Identification Number: ________________________________
The above listed traffic tickets are received for court action by:
Name: _________________________________________________
Title: _____________________________ Date: _______________
COURT ORL: AL J
Original – Court Copy – Police Agency