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vs. Defendant (Indiana Legal Help)

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Page 1 of 2 Approved by the Coalition for Court Access
CCA-IF-1219-6000
www.indianalegalhelp.org
STATE OF INDIANA IN THE ____________________________COURT
COUNTY OF ___________________ CAUSE NO. _______________________________
State of Indiana, Date of Birth ______________________________
vs.
________________________ Driver License # ____________________________
Defendant
APPEARANCE BY UNREPRESENTED PERSON IN TRAFFIC AMNESTY CASE
1. My name is _________________________________ and in this case I am not represented
by a lawyer.
2. My contact information for receiving legal service of documents and case information as
required by Court Rules is:
Address:
Email address:
☐ I will accept service at the above email address.
Phone:
Fax:
OR, if in a related case, you have used the Attorney General confidential address, you may
check the box below:
☐ Attorney General confidential address
3. This is a IF case type as defined in Administrative Rule 8(B)(3).
4. There are other cases related to this case: (If yes, please indicate
below)
☐ Yes
☐ No
Caption and case number of related cases:
Caption: Case No.:
Caption: Case No.:
____________
Page 2 of 2 Approved by the Coalition for Court Access
CCA-IF-1219-6000
www.indianalegalhelp.org
Caption: Case No.:
Additional information as required by local rule:
Signature
CERTIFICATE OF SERVICE
☐I hereby certify that I sent a copy of this document on ________________________ by
certified mail, postage prepaid to the ______________________ County Prosecutor at the following
address:
______________________________
______________________________
______________________________
☐I hereby certify that I sent a copy of this document on _______________________by E-
service using the Indiana E-filing system to the _________________________ County Prosecutor.
______________________________
Signature
Page 1 of 3 Approved by the Coalition for Court Access
CCA-.IF-1219-6001
www.indianalegalhelp.org
STATE OF INDIANA IN THE ________________ ________________COURT
COUNTY OF ___________________ CAUSE NO. _______________________________
State of Indiana, Date of Birth _______________________________
vs.
________________________ Driver License # ____________________________
Defendant
VERIFIED PETITION FOR REDUCTION OF JUDGMENT, FEES, AND/OR COSTS
PURSUANT TO IC 9-33-4
________________________________, Defendant, petitions the Court, pursuant to Indiana Code
Chapter § 9-33-4, for a reduction in “unpaid fees” (as that term is defined in IC § 9-33-4-3). The
following statements are made in support of Defendant’s Verified Petition for Traffic Amnesty.
1. Defendant is a “qualified person” (as that term is defined in IC § 9-33-4-3).
2. Defendant’s full name appears in the first sentence of Defendant’s Verified Petition for
Traffic Amnesty.
3. Defendant’s other legal names or aliases are ____________________________
_________________________________________________________________________________.
4. Defendant’s date of birth appears in the caption of Defendant’s Verified Petition for
Traffic Amnesty.
5. Defendant affirms:
Defendant does not owe a child support arrearage.
Defendant owes a child support arrearage but has been making the
required child support payments for at least the preceding six
months.
Defendant owes a child support arrearage and did not make the
required child support payments during the preceding six months.
6. Defendant affirms:
Defendant does not have an outstanding arrest warrant.
Defendant does have an outstanding arrest warrant.
7. Defendant affirms:
☐ Defendant was not sentenced to pay restitution to the victim of a crime.
Defendant was sentenced to pay restitution to the victim of a crime but
is current with the required payments.
Defendant was sentenced to pay restitution to the victim of a crime and
____________
Page 2 of 3 Approved by the Coalition for Court Access
CCA-.IF-1219-6001
www.indianalegalhelp.org
is not current with the required payments.
8. The last four digits of Defendant’s social security number are .
1
9. Defendant’s driver license number appears in the caption of Defendant’s Verified Petition
for Traffic Amnesty.
10. The case number or court cause number of the relevant violation appears in the caption of
Defendant’s Verified Petition for Traffic Amnesty.
11. Defendant believes the following information may assist the Court:
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
Wherefore, Defendant requests: (1) that the Court reduce Defendant’s unpaid fees in the above-
captioned cause by 50% (fifty percent) pursuant to Indiana Code Chapter 9-33-4; and (2) that the Court
issue an Order to the Indiana Bureau of Motor Vehicles reducing the reinstatement fees owed by 50%
(fifty percent).
I affirm under penalties for perjury that the foregoing representations and statements are
true.
Signature
Printed Name
1
Pursuant to Administrative Rule 9(G)(2)(f), complete social security numbers of living persons shall be excluded from public
access. If the Court needs Defendant’s complete social security number in order to proceed, then Defendant (a self-
represented litigant) respectfully requests the Court’s assistance.
Page 3 of 3 Approved by the Coalition for Court Access
CCA-.IF-1219-6001
www.indianalegalhelp.org
☐I hereby certify that I sent a copy of this document on ________________________ by
certified mail, postage prepaid to the ______________________ County Prosecutor at the following
address:
______________________________
______________________________
______________________________
☐I hereby certify that I sent a copy of this document on _______________________by E-
service using the Indiana E-filing system to the _________________________ County Prosecutor.
______________________________
Signature
CERTIFICATE OF SERVICE
Page 1 of 2 Approved by the Coalition for Court Access
CCA-IF-1219-6002
www.indianalegalhelp.org
STATE OF INDIANA IN THE ____________________________COURT
COUNTY OF ___________________ CAUSE NO. _______________________________
State of Indiana, Date of Birth ______________________________
vs.
________________________ Driver License # ____________________________
Defendant
ORDER FOR REDUCTION OF JUDGMENT, FEES, AND/OR COSTS PURSUANT TO
IC 9-33-4
This matter is before the Court on a Verified Petition for Traffic Amnesty filed in accordance
with IC 9-33-4-4.
The Petitioner was not required to pay a filing fee.
The Court finds that the Petition complies with the pleading requirements of IC 9-33-4-4(a) and
has been properly served on the Prosecuting Attorney.
☐The Prosecuting Attorney does not object to the granting of the Petition for Traffic Amnesty.
☐The Prosecuting Attorney has waived any objection to the Petition for Traffic Amnesty.
or
☐Hearing was held and evidence was presented on the Petition.
The Petitioner seeks a reduction of judgment, fees and/or costs associated with the following
violation(s):
CAUSE NO. OF RELEVANT VIOLATION DATE OF VIOLATION
____________________________________ _______________________________
Unpaid costs related to this violation include:
☐Unpaid Judgment, court costs, administrative fees, late fees or other fees;
and/or
☐Driving Privileges Reinstatement fee
☐The Court now DENIES the Petition for Traffic Amnesty.
☐The Court now finds that the Petitioner is a qualified person under IC 9-33-4, and the
violation(s) giving rise to the unpaid fees was/were committed before January 1, 2019.
Therefore, the Court now GRANTS the Petition for Traffic Amnesty as follows:
____________
Page 2 of 2 Approved by the Coalition for Court Access
CCA-IF-1219-6002
www.indianalegalhelp.org
This Court orders that the amount of above listed unpaid fees owed by petitioner be
reduced by 50%.
☐Some or all of the above unpaid fees consist of a driving privileges reinstatement fee.
Therefore, the petitioner is entitled to driving privileges reinstatement after:
(1) paying 50% of the otherwise required driving privileges reinstatement fee to
the Bureau of Motor Vehicles;
(2) providing proof of financial responsibility of the court (as set forth in IC 9-25-
2-3); and
(3) the person is determined not to be otherwise ineligible to have the person’s
driving privileges reinstated.
When payment of the reduced driving privileges reinstatement fee is complete, Petitioner shall
provide proof of financial responsibility to both the court and the Bureau of Motor Vehicles to
process the driver privilege reinstatement.
This order is being issued under IC 9-33-4 and is not a conviction, finding of guilt, or finding of
liability.
SO ORDERED ________________________________________________________________.
__________________________________________
Judicial Officer
Distribution:
RJO
______________________ Court Clerk
Prosecuting Attorney of ________________________ County
Petitioner
BMV
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vs. Defendant (Indiana Legal Help)

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Completed 31 December 2021

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