Monthly Remittance (Circuit Clerk Judicial Admin Fund)
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Monthly Remittance (Circuit Clerk Judicial Admin Fund) Form. This is a Alabama form and can be use in Municipal Statewide.
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Tags: Monthly Remittance (Circuit Clerk Judicial Admin Fund), MC-21, Alabama Statewide, Municipal
Form MC-21
Rev. 7/2/2012
Monthly Remittance Form for the
CIRCUIT CLERKS’ JUDICIAL ADMINISTRATION FUND
ACT 2012-535
Monthly report of court costs collected pursuant to ACT 2012-535, effective June 21, 2012, for the
month of:
,
Month
Year
, from the Municipal Court of
Number
Of
Cases
Disbursement
On
Each
Case
*Traffic Cases
Partial
Payments
Total
$2.33
Non-Traffic Misdemeanors/
Municipal Ordinance Violations
Sub-Total
$5.00
$
$
$
GRAND TOTAL
*Does not apply to “parking”, “seat belt” and “open container” violations.
Date
Signature of Remitter and Title
Court ORI No.
Print Name of Remitter
Check No.
Telephone Number
The costs SHALL BE REMITTED by the 10th of each month. Make check payable to the CIRCUIT
CLERKS’ JUDICIAL ADMINISTRATION FUND. Keep a copy of this form for your records and mail the
original form along with remittance check to:
, Circuit Clerk
County
, AL
Mailing Address
City
Zip code
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