In The State Court of Chatham County, Georgia www.statecourt.org · Phone (912) 652-7228 · FAX (912) 652-7241 · criminal@statecourt.org Petition to Plead Guilty in a Traffic Case Now comes who was operating pursuant to State Driver’s License # ____________ who was cited _______________on Georgia UNIFORM TRAFFIC CITATION, SUMMONS ACCUSATION /WARNING numbered (s) ____________, __________ and _________. All charges cited are NOT among those charges which may be disposed of administratively by the Traffic violations Bureau. Those charges may, however be disposed of by Clerk. . For identification purposes, petitioner states his/her date of birth as , and the last four digits of his/her Social Security Account Number are . Further, petitioner claims that there was no accident involved in the incident resulting in the above citation(s) and that the charges cited therein include each of the following, AND NO OTHERS. Fines, Fees and Costs: $ I: II: $ $ III: I hereby certify that I am the individual charged on the Georgia Uniform Traffic Citation, Summons, Accusation / Warning cited above and hereby petition the State Court of Chatham County to accept my plea of GUILTY in the above matter. I understand that each charge(s) cited above is/are misdemeanor(s) and that by pleading guilty to the charge(s), I am voluntarily giving up any Constitutional rights I have in the matter, which include the right to remain silent and the right to a trial by a judge alone or jury . Code Section Charge(s) I acknowledge having been cited on UNIFORM TRAFFIC CITATION/ACCUSATION, as noted above, for violating the traffic law(s) of this State. I PLEAD GUILTY to the charge(s) and ask that the Court allow me to enter such plea and pay all fines and fees according to the Standing Order of the Court for such offense. I also agree to pay a service fee if, handled over the Internet, or EXACTLY the sum of the fines, fees and costs shown above, per the Courts Standing Order dated March 31, 2000. I understand that the Court may accept my plea offer only if the charges shown above constitute each and every charge indicated in the citation and that there was no other incident or accident involved in the matter addressed herein. If accepted I agree to pay all associated fines, fees and costs, in full, by cash or credit card and that the Court will record the disposition of each charge shown, as required by law. I understand that once all of the above is accomplished I will be excused from the State Court and no longer required to appear on this matter. Accordingly, I hereby present my answers to the Court for the following questions, as a matter of record: 1. Does the petitioner freely and voluntarily admit to each of the offense(s) shown above and acknowledge guilt as to each ? Petitioner’s Response: (Write YES or NO) 2. Does the petitioner waive any rights, pertaining to these charges, including the right to a trial, either before a judge alone or before a jury, and all rights to any appellate review as may be provided by law? (Write YES or NO) Petitioner’s Response: 3. Does the petitioner certify that these statements are true to the best of his/her knowledge and belief? And does the petitioner claim to be the person charged on the citation indicated above? And does the petitioner hereby certify validation of this filing with the Clerk of State Court, IF FILED ELECTRONICALLY, just as if the petitioner’s signature were on the face of this document? Petitioner’s Response: (Writes YES or NO) This petition is hereby filed with the Clerk of State Court along with funds in the amont of ____________. Such funds comprise the SUM of all fines, fees and surcharges associated with ALL charges cited in this case. I further understand that once approved by the Court, as indicated by the Court’s official stamp, hereon, that the disposition of this matter will be entered into all appropriate records and I will no longer be required to attend court on this matter. Signature __________________________________________________ , Petitioner Date American LegalNet, Inc. www.FormsWorkFlow.com g-PetitiontoPleadGuiltyinaTrafficCase 09-05