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Legal Name
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First Name
Last Name
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Email
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Phone Number
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Date of Birth
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Date
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5
Was your ticket related to one of the following?
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School Zone
Construction Zone
Car Accident
None of the Below
School Zone
Construction Zone
Car Accident
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Do you have a Commercial Drivers License (CDL)?
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Have you had any tickets in the past 12 months?
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Have you ever had any prior driving offense other than a speeding ticket?
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9
Do you have any other pending criminal matters?
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10
City, county or other Jurisdiction that gave you the ticket.
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11
Picture of Ticket
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12
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