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Advanced Traffic Ticket Intake

About You

Name(Required)

First Last

Current Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone(Required)

Email(Required)

Your Ticket

(Please reference the corresponding sections of your traffic ticket.)

County

Court

Violation Sections(Required)

If you are unsure of your violations, simply type "Unsure".

Court Date

Has the date passed?

Yes

Your Driving Record

How is your driving record?

Perfect (No Priors)

Good (1-2 Priors)

Bad (Many Priors)

What state is your license in?

Was there an accident involved in the issuance of this ticket?

Yes

Were you insured at the time of the accident?

Yes

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Name*

First Last

Phone Number*

Email Address*

How can we help you?*

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