Driver Intake Form

1
My NAME is
First Name
Middle Name
Last Name
2
My best EMAIL ADDRESS is(This is used for us to communicate with you as well as send any updates or documents)
example@example.com
3
My best PHONE NUMBER is
Area Code
Phone Number
4
My Date of Birth is
Date
Month
Day
Year
5
My DRIVER'S LICENSE NUMBER IS *
6
The next few questions will deal with the information LISTED ON YOUR TICKET.

To ensure accurate and speedy help from us, please have your ticket information ready so you can fill out the info requested.
7
What Is Your Ticket/Citation Number
8
The name of the COURT listed on my ticket isPlease search for the court in which your ticket says you must report to
9
What Is Your "APPEAR ON OR BEFORE DATE"This should also be listed ON YOUR TICKET
Date
Month
Day
Year
10
My ProductsOur services are based on a 3-tier approach and are described below. If at any point something comes up that was not anticipated, this will be discussed with you at the time and can be added as an a-la-carte option.
prevnext( X )
My Bag
1
My Bag
Great Product Name
$20
Quantity:1
Size:Small
RemoveEdit
Great Product Name
$20
Quantity:1
Size:Small
RemoveEdit
Great Product Name
$20
Quantity:1
Size:Small
RemoveEdit
Great Product Name
$20
Quantity:1
Size:Small
RemoveEdit
ORDER SUMMARY
Total costUSD
BESTAll services included in "Good" and "Better" PLUS we will request evidence and set the case for jury trial, forcing lowest offer from court. * You Must be willing to go to jury trial if necessary*
$450.00Edit
Back
BETTERIncludes the services listed on the "GOOD" option as well as: Request and review evidence from court. We can also propose that you be given the option of a Driver Safety Course or Deferral, but negotiate for lower price and shorter term of probation. We will also negotiate for lengthier payment plan timing. A longer settlement time occurs due to negotiation, but this also allows for longer payment time.
$400.00Edit
Back
GOODThis covers: Request an offer from the court listed on your ticket- we will not attempt negotiation. This usually comes with an offer that will keep the ticket off your record. Typical offers from court include a 6 hour Driver Safety Course (DSC) (cost about $25) plus a fee issued by the court and/or a deferral of your case. A deferral is basically probation- from anywhere from 1-180 days, plus a fee issued by the court- but means dismissal upon successful completion! Quickest settlement.
$325.00Edit
Back
Total cost $0.00
Payment Methods
Credit Card
First Name
Last Name
Google Pay
After submitting the form, you will be redirected to the Google Pay to complete the payment process.
Apple Pay
After submitting the form, you will be redirected to the Apple Pay to complete the payment.
11
Invoice ID
12
Please UploadAdd a photo of your license and your ticket(s), as well as anything else you want us to have.
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
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