Diversion Management Registration Form

By completing this form, you will help us to establish a Diversion Management website for your jurisdiction. Please answer each question thoroughly.

You will also be asked to download an Excel spreadsheet specifically for your state. The spreadsheet includes ...

A list of violations and their corresponding violation codes.
A place to list those from your office that will be responsible for approving/rejecting applications and certificates of completion.
A place to list all jurisdictions and the court clerks that will receive automated notifications.

You can use this spreadsheet to indicate whether or not a specific violation is eligible for diversion, the fine associated with each violation, and how many days the violator has to complete your diversion program. The spreadsheet can then be emailed back to the Diversion Management Helpdesk for processing.

If you have any questions or concerns, please feel free to contact us at 585-250-6050 or email us at info@DiversionManagement.com.

Name of Jurisdiction: *

Name of District Attorney or Other Prosecutor: *

First Name Last Name

Title of Above: *

Email of Above: *

example@example.com

Office Phone Number: *

Area Code Phone Number

Physical Address of Office: *

Street Address

Street Address Line 2

City State

ZIP Code

Please provide information for the Operational Contact in case we need to address questions raised from callers to our Help Desk.

Name of Operational Contact: *

First Name Last Name

Title of Operational Contact:

Phone Number of Operational Contact: *

Area Code Phone Number

Email of Operational Contact: *

example@example.com

Please note that the cost for our service is the greater of $20 or 10% of the total, no matter how many violations are listed on a citation/ticket, assuming all can be processed through diversion.

Please click on the link below and download the spreadsheet. You will need to complete the entire form, save it, and email it to the Diversion Management Helpdesk -- info@DiversionManagement.com.

Download the spreadsheet

Violators that register will receive an email upon submission of the application once they are accepted or denied in the program and again once their completion certificate is accepted or denied. Please provide information on whoever else will require copies of these emails, other than your office. If no other copies are required, write N/A:

Do you want the participant to provide their auto insurance information (company, policy #, and expiration date) on the application?

Please provide contacts of the individual(s) and/or company involved with your jurisdiction's website so that we can properly link to it in supporting your efforts. We will provide a detailed mock-up for your approval prior to launch.

We normally (without charge) handle all banking and reporting with an Escrow Account under your control at Bank of America. If you prefer to use a different financial institution, we will need its name, address, and contact person.

How do you want your jurisdiction to appear on the DiversionConnect.com website? (e.g., “County of Erie" or "Erie County")?

Please upload a high-resolution image of the logo or seal that you want included on your website. The larger the file, the better it will appear on your website.

Browse Files

Please indicate the full name and official title of the District Attorney or other prosecutor overseeing this program and the manner it should be displayed on the website.

Are there other restrictions from entering the program? For example, if the violator has had multiple traffic stops within a certain period, they are not eligible. These can be changed in the future if necessary.

If there are multiple violations on the same citation/ticket and one or more is not eligible for diversion, will all violations be handled in court?

To complete your registration, please agree to the following by signing and clicking on submit:

I confirm my authority to contract regarding files approved by me for processing by Diversion Management, LLC. I agree to the terms and conditions herein. I acknowledge that if payment has not already been collected, it will be authorized by me to Diversion Management, LLC. for those files sent by my office for processing, by the 15th day of each month or next business day, provided I am given all necessary records and a correct invoice.

Signature *

Name: *

First Name Last Name

Title: *

Email: *

example@example.com

Date: *

Date

Program Registration