$

 

 

 

 

 

  $

 

 

  $

Sub-Total 

Total 

 
Partial 
Payments 

   

Disbursement 
Amount 
 

Per Month 
for the entire 
suspension 
or revocation 
period 

     

$75.00 

JS Form ALEA-AIDPEF  
 

Rev Jun 26 2018 

 

     
Monthly Remittance Form for the 
ALABAMA IMPAIRED DRIVING PREVENTION AND ENFORCEMENT FUND   
ACT 2014-222 and Act 2018-517 
 
For questions concerning the form contact Sherita Pace at (334) 517-2944 
OR 
via email to sherita.pace@alea.gov  

onthly report of court costs collected pursuant to ACT 2014-222, effective July 1, 2014, and Act 2018-
517, effective July 1, 2018 (note that the distribution remains the same under both Acts) for the month 
of:  

 

 

, from the Municipal Court of  

 

 

 

 

 

Month                 

, 
  Year 

 

 
Signature of Remitter and Title 

 

 

 

 

 
Print Name of Remitter 

 

 

 

 
Telephone Number 

 

 

 

 

Alabama Law Enforcement Agency (ALEA) 
Attn: Sherita Pace 
PO Box 304115 
Montgomery, AL 36130-4115 

 

   

he costs SHALL BE REMITTED by the 10th of each month.   

ake check payable to the ALABAMA IMPAIRED DRIVING PREVENTION AND ENFORCEMENT 

FUND.   

ail the original form along with remittance check to: 

   

 
 

 
 

 
 

 
 

 
 

 
 

 
 

 
 

 
 

 
 

 
 

 
 

   

 

DUI/Interlock (for defendants 
who DO NOT OWN A 
VEHICLE or DO NOT HAVE 
AN INTERLOCK DEVICE 
INSTALLED) 

RAND TOTAL 

ate    
 

ourt ORI No.  
 
 

heck No.  

 

 
 

 
 

 
 

 
 

 
 

 
 

 
 

 
 

      U

    M

   

     

    G

          D

 

  C

 

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