Corona Payment Processing Center, 505 S. Buena Vista, Corona, CA 92882 Indio Superior Court, 46-200 Oasis Street, Indio, CA 92201 For Court Use Only SUPERIOR COURT OF CALIFORNIA, COUNTY OF RIVERSIDE PEOPLE OF THE STATE OF CALIFORNIA vs. DEFENDANT: AGREEMENT TO PAY TRAFFIC SCHOOL FEES IN INSTALLMENTS (Vehicle Code § 42007) Citation Number: Instructions: Complete your name in the caption above, your citation number to the right, and complete #1 below. Read all pages of this form carefully and, if you agree, sign, fill out the information at the bottom of the form and return the form to the Court Clerk. The Court Clerk will complete #4 and provide you a copy of the form. 1. 2. Case Number: I am the defendant in this case and I have been charged with the following infraction violation(s) that does not require a mandatory appearance and is eligible for dismissal upon completion of traffic violator school: a. § b. § c. § d. § e. § My court appearance date has not expired and I am providing proof of correction for any correctable violations. 3. I want to pay the traffic violator school fee for the violation(s) listed above, but I am not able to and I ask the court to allow me to pay in installments. I understand that the court has costs and expenses from accepting a request to pay these fees in installments and the court does not have to allow me to make installment payments. 4. TERMS OF AGREEMENT: The total fee, including an administrative fee of $35.00 to pay in installments, is $ I agree to pay the total amount within 90 days as follows: $ each month starting (date): Other (explain): I agree that: and by the . day of the month until paid in full. All payments must be made by the due date and there is no grace period. If I do not make a payment on time, I may have to pay the rest of my unpaid fees immediately. If I do not make my payments by each due date, I will see the clerk on the next court day after the due date of the missed payment. I understand that proof of my completing traffic school is due on on the traffic school completion date. and that no extensions will be granted I understand that if I do not make a payment each due date, I may be charged with a misdemeanor under Vehicle Code section 40508, be charge up to $300 under Penal Code section 1214.1 or have a warrant issue for my arrest, and the court may impound my driver’s license and report convictions to the Department of Motor Vehicles. The court also may assign my case to a collection agency to 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. On , if I pay as agreed and if my original certificate of traffic school completion is filed with the clerk, my eligible violations will be dismissed and no further proceedings will be held. By signing below I declare that I have read and understand my rights printed on the second page, which I now choose to give up, and that I have read, understand, and accept the terms and consequences stated above. (SIGNATURE OF DEFENDANT) (DATE) (ADDRESS) (EMAIL ADDRESS) (DRIVER’S LICENSE/ID NUMBER) ACCEPTED (date): RI-TR04 Rev. 07/06/10 (TYPE OR PRINTED NAME) (PHONE NUMBER) BY: (CITY, STATE, AND ZIP CODE) CLERK OF THE SUPERIOR COURT/DEPUTY CLERK AGREEMENT TO PAY TRAFFIC SCHOOL FEES IN INSTALLMENTS Page 1 RI-TR04 American LegalNet, Inc. www.FormsWorkFlow.com 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 for formal arraignment, plea and sentencing; To have a court trial and challenge the charges; 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. Approved Traffic Schools To obtain a list of approved traffic schools, visit the Court’s website at www.riverside.courts.ca.gov From the home page click on the ‘Traffic’ button, and then click on the ‘Traffic School’ link. There you will find a listing of approved traffic schools recognized by the DMV and a listing of additional traffic schools and home study courses approved by Riverside County. How to Pay Your Monthly Payments After the submission of your completed form, payments may be submitted by mail to the Payment Processing Centers, On-line through the Court’s website (www.riverside.courts.ca.gov) using your Visa, MasterCard, Discover, American Express card, Checking or Savings Account, or in person. RI-TR04 Rev. 07/06/10 AGREEMENT TO PAY TRAFFIC SCHOOL FEES IN INSTALLMENTS Page 2 American LegalNet, Inc. www.FormsWorkFlow.com INSTRUCTION SHEET FOR COMPLETING THE AGREEMENT TO PAY TRAFFIC SCHOOL FEES INSTALLMENT PAYMENTS FORM An Agreement To Pay Traffic School Fees In Installment form is required if you elect to make payments on violation(s) which are eligible for traffic school dismissal and that do not require a mandatory appearance. Instructions for Completing the Form: NOTE: If the court mailed you this form, some of the information may already be pre-printed for you. 1. Read pages 1 and 2 of the Agreement To Pay Traffic School Fees In Installments form. IMPORTANT: Page 2 is the advisement of your rights. 2. Fill-in your name next to ‘DEFENDANT’ in the heading. 3. Fill-in your Citation Number. This is the pre-printed number on the upper right-hand corner and/or the lower right-hand corner of your citation. Please include all number and letters that appear. 4. In #1, list the infraction violation(s) that you want to attend traffic school on. For example, you were cited for Exceeding the Maximum Speed (VC 22349B) and No Evidence of Current Registration (VC 4000(a)(1)). You would list the violation on the form as follows: a. § VC 22349B You will only list the violation(s) that are eligible for dismissal based on completing traffic school. 5. Sign, date and print your name, address, Driver’s License number and phone number at the bottom of the form. 6. You may return the completed form to the court location listed at the bottom of your citation. If you chose to mail, the form can be mailed to one of the following addresses: Banning, Corona, Hemet, Moreno Valley, Murrieta, Riverside, Temecula Payment Processing Center 505 S. Buena Vista Corona, CA 92882 Indio, Palm Springs, Blythe Indio Superior Court 46-200 Oasis Street Indio, CA 92201 7. Failure to deliver the completed form, make an appearance, or pay in full on or before your appearance date may result in a civil assessment of $300.00 being imposed under Penal Code section 1214.1, a vehicle license hold, or wage garnishment. How to Pay Your Monthly Payments After the submission of your completed form, payments may be submitted by mail to the Payment Processing Centers, or On-line through the Court’s website (www.riverside.courts.ca.gov) using your Visa, MasterCard, Discover, American Express card, Checking or Savings Account. RI-TR04 Rev. 07/06/10 AGREEMENT TO PAY TRAFFIC SCHOOL FEES IN INSTALLMENTS Page 3 American LegalNet, Inc. www.FormsWorkFlow.com