Event Code: 6724 Party Type: D1 Map Attached IN THE CIRCUIT COURT, EIGHTEENTH JUDICIAL CIRCUIT, BREVARD COUNTY, FLORIDA IN THE COUNTY COURT, BREVARD COUNTY, FLORIDA CASE NUMBER 05 DIVISION AXXX-XX CITATION NUMBER BAR CODE LABEL ANIMAL CONTROL PARKING TRAFFIC NOTICE OF HEARING PLAINTIFF CLOCK IN STATE OF FLORIDA vs DEFENDANT First Middle Last Suffix Participant ID You are hereby advised that: Pursuant to Florida Statute, any person electing to appear before the designated official shall be deemed to have w aived his right to: 1. Pay the civil penalty. 2. Attend driver improvement school. Upon a finding of guilt, the official may: 1. Impose a civil penalty not to exceed $500.00 and points may be assessed. 2. Require attendance at a driver improvement school. 3. Impose a penalty and attendance at a driver improvement school. In order to cancel your requested hearing, you must: 1. Have your request in the Clerk' s Office at least 7 business days prior to your scheduled hearing. 2. Pay the original civil penalty plus an additional 20% at the time of the requested cancellation. In order to change the date of your requested hearing, you must: 1. Have your request in the Clerk' s Office at least 7 business days prior to your scheduled hearing. Please note: The Clerk' s Office has the authorization to grant one (1) continuance. If your hearing is scheduled before a Traffic Hearing Officer, video equipment is not available. Pursuant to Florida Rules of Court 6.460(b), if you w ant to have your hearing recorded, you must provide the equipment and the tape. After court, you must give the tape to the Court Clerk. The tape w ill be kept no less than 3 years and then destroyed. Citation No. Offense Citation No. Citation No. Offense Offense Date Hearing Date Time Offense Division Location I understand that by signing below , I am required to be present as indicated above. If I fail to appear, my driver' s license may be suspended and additional penalties may be assessed. I hereby certify that my address show n below is correct and that I w ill advise the Clerk' s Office, in w riting, of any change of address or telephone number w ithin 24 hours of such change. I acknow ledge that the Clerk has advised me of all my options pursuant to Chapter 318.14, F.S. If this case involved an accident and you or anyone else w as injured, please initial. ______________ I have read and understand all information contained on this form. Signature Address City, State, Zip Daytime Phone Home Phone DATE CLERK OF THE COURT BY Law 542 Rev. 01/2006 DC If you are a person w ith a disability w ho needs any accommodation in order to participate in this proceeding, you are entitled, at no cost to you, to the provision of certain assistance. Please contact Court Administration at 2825 Judge Fran Jamieson Way, 3rd Floor, Melbourne, FL 32940, 321-633-2171, w ithin 2 w orking days of your receipt of this notice. If you are hearing or voice impaired, call 1-800-955-8771. For other information, please call 321-637-5413. American LegalNet, Inc. www.FormsWorkflow.com