Madera Superior Court Form Adopted for Optional Use MAD-TRC-0003 (Rev. 3/19/19) AGREEMENT TO PAY TRAFFIC VIOLATOR SCHOOL F EES IN INSTALLATIONS Page 1 of 2 SUPERIOR COURT OF CALIFORNIA, COUNTY OF MADERA STREET ADDRESS: 200 South G Street MAILING ADDRESS (Same) CITY AND ZIP CODE: Madera, California 93637 BRANCH NAME: Madera FOR COURT USE ONLY PEOPLE OF THE STATE OF CALIFORNIA vs. DEFENDANT: AGREEMENT TO PAY TRAFFIC VIOLATOR SCHOOL FEES IN INSTALLMENTS (Vehicle Code, 247 42007) TO BE COMPLETED BY COURT Read carefully and, if you agree, sign and return the form to the clerk. CITATION NUMBER: CASE NUMBER: 1. I am the defendant in this case. I have been charged with the following infraction violation(s) that do not require me to go into court and that are eligible for confidential conviction(s) for completion of traffic violator school: a. 247 b. 247 c. 247 d. 247 e. 247 2. My court appearance date or extension date has not passed, and I am providing proof of correction for any correctable violations. 3. I want to pay the traffic violator school fees for the violation(s) listed above. I understand that the court does not have to allow me to make installment payments. 4. TERMS OF THE AGREEMENT: The total fee (including an administrative fee of $35.00) is $ Initial Payment (10% minimum): $ Remaining balance after first payment: $ ( ) I agree to pay the remaining balance within 90 days. I will pay in monthly installments of at least $ due on the day of each month, starting on and until paid in full on or before . ( ) Other (explain): I agree that: All payments must be made by the due date and there is no grace period. If I do not make any payment on time, I may have to pay the rest of my unpaid fees immediately. I understand that if I do not complete my payment plan the court may: Charge me with a failure to pay under Vehicle Code section 40508. Charge a civil assessment of up to $300 (Pen. Code, 247 1214.1) or have a warrant issued for my arrest. Report convictions and the failure to pay to the Department of Motor Vehicles, which may suspend or place a hold on my driver222s license. Assign the case to a collection agency or the State Franchise Tax Board for collection. I understand that my case will continue to be open until the date that my last installment is paid. If I pay as agreed and if my proof of completion of traffic school is reported, a confidential conviction will be reported to the DMV and no further proceedings will be held. By signing below, I affirm that I have read, understood, and accepted the above terms and conditions. I also affirm that I have read and understood my right printed on the reverse side and that I choose to give them up. (SIGNATURE OF DEFENDANT) (DATE) (TYPE OR PRINT NAME) (DRIVER222S LICENSE/ID NUMBER) (ADDRESS) (CITY, STATE AND ZIP CODE) (TELEPHONE NUMER) CLERK OF THE SUPERIOR COURT ACCEPTED (date): BY: (DEPUTY CLERK) American LegalNet, Inc. www.FormsWorkFlow.com MAD-TRC-0003 [Rev. 3/12/2019] AGREEMENT TO PAY TRAFFIC VIOLATOR SCHOOL FEES IN INSTALLMENTS Page 2 OF 2 (Traffic Infractions) ADVISEMENT OF RIGHTS By choosing to pay traffic violator school fees in installments and not go into court, you will be giving up these rights: To appear in court without deposit of bail for formal arraignment, plea, and sentencing; To ask for community service (if available) instead of paying the total amount due; To request and have a court trial, to challenge the charges without deposit of bail, unless the court orders bail; To have a speedy court trial and have the charges dismissed if a speedy trial is requested but not provided; To be represented by an attorney at your expense; To subpoena or present witnesses and physical evidence using the power of the court at no cost to you and to testify on your own behalf; To confront and cross-examine all witnesses testifying under oath against you; and To remain silent and not testify. At any time before your final payment, if you have experienced a change in financial circumstances, you may ask that the court consider your ability to pay. If the court considers your ability to pay, the court may modify your installment plan, allow you to complete community service (if available) instead of paying the total amount due, or suspend all or part of the fine. The court is not required to offer you any or the above options, and the court may deny your request. If the court grants your request, you may no longer be eligible for traffic school. American LegalNet, Inc. www.FormsWorkFlow.com