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