Date: ____________________



Superior Court of California

County of ______________


Court Address: _________________






Please accept this correspondence as my formal plea of NOT GUILTY and request for a Trial by Written Declaration for the traffic infraction citation referenced below with all relevant information:


My Name:_____________________________

Citation Number:________________________

Citation Date:___________________________

Driver License #:________________________

Telephone #:____________________________

Mailing address:_________________________




Attached please find a check in the amount of __________ for the bail amount due in full. Please forward all necessary forms for Trial by Written Declaration to the above address.